Over the last decades, the rising rate of persons exposed to antipsychotics in the general population of developed countries became a growing public health concern. The prescription of first-generation antipsychotics was initially restricted to the more severe psychiatric diseases as a consequence of the neurologic side effects of these molecules. The introduction of second-generation antipsychotics, with comparable effectiveness to that of first-generation antipsychotics, but with better neurological tolerance, contributed to the extension of licensed indications and to the rise in antipsychotic prescriptions. Such a rise is especially dramatic among youths, and even more so because of the increasing proportion of off-label prescriptions. The feeling of innocuousness leading to rising prescription rates of second-generation antipsychotics is misleading considering the metabolic and vascular adverse effects of these drugs. This issue is especially worrying in children and adolescents as the impact of antipsychotics on a developing brain is unknown. – Pharmacoepidemiological studies are required to better assess the benefit/risk ratio of these molecules in naturalistic conditions.
Bull. Acad. Natle Méd., 2016, 200, no 6, 1155-1166, séance du 21 juin 2016