Can young people reliably rate side effects of low-dose antipsychotic medication using a self-report survey?

Many neuropsychiatric illnesses commence in adolescence, or sooner, and psychotropic medication plays a key role in the overall treatment. The monitoring and management of side effects from these medications is an important component of psychiatric care in the child and adolescent population. To best achieve this, clinicians are dependent upon reliable self-report of side effects from their young patients. There has been a noticeable increase in the use of antipsychotic medications to treat psychiatric disorders in young people over the past 10 years. Low doses of newer and purportedly safer ââ"šÂ¬Ã‹Å“atypical antipsychoticsââ"šÂ¬Ã¢"žÂ¢ have been used to treat symptoms of a diverse range of child and adolescent psychiatric disorders, including psychoses, bipolar disorder, autism and behavioural problems. Risperidone is the most commonly prescribed atypical antipsychotic for young people in North America, the United Kingdom and Australia. Low doses of risperidone have generally been shown to be safe and well tolerated in this population. Despite being generally well tolerated, many young people experience adverse effects associated with antipsychotics such as risperidone. Correll argued that young people may be more vulnerable to some adverse effects associated with antipsychotic medication, such as weight gain, sedation and extrapyramidal symptoms. Side effects from antipsychotic medication may cause discomfort and lead to non-compliance. Furthermore, concern has been expressed that these medications have potential to cause serious longer term consequences for children and adolescentsââ"šÂ¬Ã¢"žÂ¢ developing minds and bodies. The greater sensitivity and potential risk associated with antipsychotic usage in young people highlight the importance of effective side effect monitoring and management in this population. Side effect monitoring is contingent upon a young personââ"šÂ¬Ã¢"žÂ¢s ability to credibly self-report. An important question for clinicians is whether young people can reliably self-report antipsychotic side effects. Similarly, researchers need to establish the credibility of young peopleââ"šÂ¬Ã¢"žÂ¢s self report when investigating the safety and tolerability of these medications in this population.