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Risk of seizures associated with antipsychotic treatment in pediatrics with psychiatric disorders: a nested case–control study in Korea

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Abstract

Antipsychotic drugs raise seizure risk in adults, and antipsychotic drug use is increasing among pediatric psychiatric disorder patients. However, few studies have examined seizure risk in this younger patient population. To evaluate seizure risk in pediatric patients on antipsychotics, we conducted a nested case–control study using a nationwide database. Patient information was retrieved from the Korean Health Insurance Review and Assessment (HIRA) database from 2008–2018. Antipsychotic use among newly diagnosed psychiatric patients was gathered starting 1 year before the index date and categorized as recent, past, consistent, or none. Seizure cases among these patients were defined based on (1) prescription of antiepileptic drugs or (2) an electroencephalography (EEG) examination among patients with seizure diagnostic code. A conditional logistic regression model was constructed to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for seizure risk due to antipsychotic use. In total, 1523 seizure cases and 6092 seizure-free controls aged 8–19 years with newly diagnosed psychiatric disorders were included for analysis. Logistic regression revealed a significant association between antipsychotic use and seizure development (recent users OR = 4.03, 95% CI 3.4–4.79; consistent users: OR = 2.84, 95% CI 2.44–3.3). Seizure risk enhanced further with an increase in the number of antipsychotic drugs used. Risperidone, aripiprazole, quetiapine, olanzapine, paliperidone, and blonanserin were independently associated with greater seizure risk. Pediatric patients receiving antipsychotics, especially new or multiple antipsychotic users, should be carefully monitored for seizure development.

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Acknowledgements

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2018R1D1A1B07043416).

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  1. Soo Min Jeon, Susan Park contributed equally as co-first authors.

Authors and Affiliations

  1. College of Pharmacy and Research Institute of Pharmaceutical Sciences, Kyungpook National University, 80 Daehak-ro, Daegu, 41566, Republic of Korea

    Soo Min Jeon, Susan Park & Jin-Won Kwon

  2. Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea

    Dohoon Kim

Authors
  1. Soo Min Jeon
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  2. Susan Park
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  3. Dohoon Kim
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  4. Jin-Won Kwon
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Contributions

Soo Min Jeon, Susan Park, and Jin-Won Kwon conceived the study, and Soo Min Jeon, Susan Park, Dohoon Kim, and Jin-Won Kwon executed the analysis and reviewed the results. Soo Min Jeon and Susan Park wrote the first draft of the manuscript. Jin-Won Kwon coordinated the study, and all authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Jin-Won Kwon.

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The authors declare that they have no conflicts of interest.

Ethical approval

Ethical approval for the study was obtained from the Institutional Review Board of Kyungpook National University (IRB number: KNU 2018–0141). The requirement for informed consent from the study population was waived by the board because the data was anonymous.

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Jeon, S.M., Park, S., Kim, D. et al. Risk of seizures associated with antipsychotic treatment in pediatrics with psychiatric disorders: a nested case–control study in Korea. Eur Child Adolesc Psychiatry 30, 391–399 (2021). https://doi.org/10.1007/s00787-020-01525-4

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  • DOI: https://doi.org/10.1007/s00787-020-01525-4

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