Bibliographic information

GuidelineMental Health Gap Action Programme (‎mhGAP)‎ guideline for mental, neurological and substance use disorders, [‎3rd ed.]‎.
Year of Publication2023
Issuing InstitutionWorld Health Organization

Recommendation

Updated

Oral antipsychotic medicines – namely aripiprazole, olanzapine, paliperidone, quetiapine, risperidone – should be considered under specialist supervision for adolescents with psychotic disorders (including schizophrenia), carefully balancing effectiveness, side-effects and individual preference.

Recommended in favor

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Notes and Remarks

Remarks y The medicines included in the recommendation correspond to the WHO EML (13) and are listed in alphabetical order. y Clozapine should only be offered where lab tests are available to monitor white blood cell count, and under a mental health specialist’s supervision.

Implementation considerations y Only a few antipsychotics are officially licensed for children and adolescents which should be considered in medicine choice, taking into account the country and context. y Antipsychotic medicine should be considered for adolescents with psychotic disorders only under supervision of a mental health specialist. y Adolescents are more susceptible to side-effects from antipsychotic medicines than adults. In turn, during the clinical decision-making process, adolescents living with psychosis should be made aware of benefits and side-effects so that they are able to make informed choices regarding the treatment plan. Additionally, carer preference should be taken into consideration. y Furthermore, given the higher susceptibility of adolescents to side-effects, the medicines approved in a given country should be carefully considered before formulating a treatment plan.