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B.C. researchers find genetic variation that increases risk for kids on certain drugs

Posted on 01/02/2012 9:30am

B.C. researchers have found a genetic variation in children that puts them at six times greater risk of developing metabolic syndrome when they take certain drugs for mental health problems.

Metabolic syndrome is a bundle of conditions — like high blood pressure, obesity and diabetes — that can contribute to cardiovascular disease.

In other newly published B.C. research, it is shown that a simple waist-circumference test is a good indicator of metabolic syndrome in kids on the drugs, commonly known as second-generation antipsychotics. In that study, published in the Canadian Journal of Psychiatry, 19 per cent of kids on such drugs at BC Children’s Hospital had metabolic syndrome.

“Patients and their parents are pretty distressed about the weight gain and other side-effects of second-generation antipsychotic drugs,” said Dr. Dina Panagiotopoulos, an endocrinologist who sees kids referred to her for side-effect management.

“They often say they wished they knew about the side-effects before so they could do more about curbing carbohydrate cravings, about not drinking sugary drinks, and limiting time in front of [computer and television] screens,” said Panagiotopoulos, a co-author on both studies.

Both showed the link between risk factors for cardiovascular disease and the medications, proving the importance of parents and children being warned about diet and exercise when doctors prescribe the drugs.

Prescriptions of such medications have increased by up to 10 times in the last decade because of a perception that they are safer than older drugs.

“You can be a lot more successful in avoiding these problems if you tackle it pre-emptively ... and not after you’ve already gained 50 pounds,” said Panagiotopoulos, who conducted the research through the Child and Family Research Institute.

Second-generation antipsychotics like Seroquel and Risperdal are being used by about 5,500 children in B.C. for such problems as aggression, psychosis, mood and anxiety disorders, bipolar disease, autism spectrum disorders, substance abuse, schizophrenia and attention deficit hyperactivity disorder.

Panagiotopoulos said she has some five- and six-year-old patients who were prescribed such drugs by psychiatrists when they were aged two or three.

The drugs may be good at controlling mental illness symptoms but since they raise the risk for developing heart disease, doctors must be warned to monitor patients closely.

The study on the genetic variation was published in a medical journal called Translational Psychiatry. It included 117 kids on the drugs and 217 who were not between 2008 and 2010. While 19 per cent of drug-treated kids had metabolic syndrome, only 0.8 per cent of kids not taking such medications had it.

According to the genetic study, DNA analysis showed that eight per cent of kids had the variation on the MTHFR gene, whether they were on the drugs or not. But those who used the medications were six times more likely to have metabolic syndrome, especially high blood pressure and elevated blood sugar levels, which can lead to diabetes.

The data highlight the dangers of second-generation antipsychotic medications, Panagiotopoulos said, adding measurement of waistline circumference is better than body mass index for determining the risk of metabolic syndrome.

The waistline circumference should be measured when kids start the medication and repeated at every followup visit. Research has shown that stomach fat poses a greater risk for diabetes than fat in other parts of the body.

Sun Health Issues Reporter

pfayerman@vancouversun.com

Follow Pamela Fayerman on Twitter: twitter.com/MedicineMatters

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