We appreciate the comments from Drs Kruszewski and Paczynski. We share their general concern regarding the cardiometabolic hazards posed by the use of SGAs in young populations. This concern provided the impetus for us to conduct the analysis and present our findings. During the past decade, several SGAs have been introduced, widely disseminated, and highly promoted (perhaps through “aggressive off-label marketing”) as treatment options for disparate emotional, cognitive, and behavioral therapeutic targets. It is our view that SGAs provide unequivocal efficacy and, as a class of drugs, are an important adjunct to the armamentarium of treatment options available to practitioners. However, results from pragmatic trials in adult and pediatric populations along with clinical experience have underscored the finding that many, but not all, SGAs are associated with significant metabolic risks. This observation has reduced the early therapeutic euphoria that accompanied the initial use of these drugs.
McIntyre RS, Jerrell JM. Antipsychotic Agents and Cardiometabolic Morbidity in Youth—Reply. Arch Pediatr Adolesc Med. 2009;163(4):394-395. doi:10.1001/archpediatrics.2009.29