25 to 0.5 mg/day and stabilize patients on dosages of 1 .5 to 3 mg/day. Risperidone

is known to cause EPS in adults as dosing increases above 6 mg/day.36 Because young patients arc more susceptible to these effects and optimal efficacy is known to occur at lower doses,37 the dosage of risperidone for the treatment of schizophrenia in children and adolescents should be in the range of 0.5 to 4 mg/day. Children and adolescents more often report tiredness and sedation with risperidone treatment than adults.32 Also unlike the adult population, there have been a few reports Inhibitors,research,lifescience,medical of stereotypies and elevations in liver enzymes occurring.24,38 Other side effects, apart from weight gain, are usually mild and similar Inhibitors,research,lifescience,medical to the adult population. Weight gain has been fairly well documented in the adolescent population and appears more check details pronounced than in adults. Kelly et ai39 reported mean gains of 8.7 kg over 6 months of treatment with risperidone – significantly more than that of traditional antipsychotics (3.0 kg) or no antipsychotic (-1.0 kg) during the same period. Martin and colleagues40 reported clinically significant

weight gains in 78% of children and adolescents treated with risperidone compared with 24% in Inhibitors,research,lifescience,medical a comparison group; the average weight gain was 1.2 kg/month. Risperidone is known to cause the greatest prolactin elevations of the SGAs dependent Inhibitors,research,lifescience,medical on both dose and dopamine D2 receptor occupancy.41 At higher doses, there have been reports of menstrual irregularities occurring in young patients42 and galactorrhea has occurred in both

sexes during clinical treatment. When side effects occur, lowering the dose of risperidone has often been found to be effective. Olanzapine, like risperidone, has been widely studied in adult populations,43 but data for adolescents with schizophrenia are scarce. The only study in the adolescent schizophrenic population44 reported an open trial of olanzapine in patients aged 10 to 17 years. The mean dosage Inhibitors,research,lifescience,medical was 17.5 mg/day and the side effects reported included weight gain, increased appetite, anticholinergic side effects, and sedation. Difficulty concentrating, sustained tachycardia, headache, nausea and vomiting, and transient liver elevations were also reported Terminal deoxynucleotidyl transferase in this study. Although not comparatively studied, olanzapine treatment in young populations appears to cause greater weight gains than risperidone: Potenza45 reported over 8 kg in only 12 weeks of treatment. Unlike the transient rise and fall in the adult population, a recent report found sustained prolactin elevation in 70% of children and adolescents treated with olanzapine, but little has been published regarding clinical side effects of this phenomenon.46 The mean dosages being used in the adolescent population are between 5 and 20 mg/day. It is not yet clear what is the ideal dose range for olanzapine in this group.