Beta-carotene and Oxidative Stress in Pediatric Second Generation Antipsychotic Use
Beta-carotene and Oxidative Stress in Pediatric Second Generation Antipsychotic Use
Weight gain, hypertension, high cholesterol and sugar abnormalities in childhood are strongly
 linked and predict the risk of further complications and early death in adulthood. The newer
 antipsychotics, called the second generation antipsychotics are commonly used to treat mood
 disorders in adult and pediatric populations. Their use has substantially increased (up to
 5-fold) in the past 15 years in children due to their approved use by the Food and Drug
 Administration and higher acceptance in the general medical community. However, second
 generation antipsychotics are known to have very damaging side effects that cause children to
 gain substantial amounts of weight, have high cholesterol, high blood pressure and high sugar
 levels. Despite the known risks their use is still needed and may be contributing to the high
 rates of obesity-related diseases in childhood and ultimately shorter life-spans in
 adulthood. How second generation antipsychotics cause these side effects is still not well
 known. Preliminary evidence has identified a novel pathway that may be associated with second
 generation antipsychotic side effects. This pathway has not been studied, is involved in
 vitamin A metabolism and is called the beta-carotene pathway. Beta-carotene is an important
 part of our diet because it acts as an anti-oxidant (fights harmful oxidative stress in the
 body) and it produces the active form of vitamin A which is essential for several processes
 in our body. The investigator's work has identified a backup in this pathway which the
 investigators hypothesize is due to genetic variation of the enzymes found within this
 pathway.

 The investigators hypothesize that genetic variation in the beta-carotene pathway is
 responsible for the side effects associated with second generation antipsychotics. The
 investigators want to complete a cross-sectional, pilot study in the pediatric population
 that will be used for future prospective, extramural applications.

 The investigators propose two aims for this study:

 Aim 1: Determine how second generation antipsychotics change beta-carotene metabolism. For
 this aim, the investigators hypothesize that high beta-carotene:retinoic acid ratios will be
 due to genetic varition in the beta-carotene pathway.

 Aim 2: Define the relationship between beta-carotene metabolism, oxidative stress and second
 generation antipsychotic induced insulin resistance. For this aim the investigators
 hypothesize that low beta-carotene levels will be associated with high oxidative stress
 levels and insulin resistance.
Inclusion Criteria:

 1. Children aged 10 to 17 years currently treated with one or more antipsychotics as
 determined by a physician

 2. No changes in antipsychotic dosage for the past 6 weeks.

 Exclusion Criteria:

 1. Guardian or child unwilling or unable to participate.

 2. A diagnosis of diabetes or dyslipidemia prior to starting an antipsychotic.

 3. Abuse or dependence diagnoses