Objectives: 
To evaluate the efficacy in terms of functional improvements, and tolerability of antipsychotic medication in children and adolescents with mental health or neurodevelopmental conditions.

Background:
There is limited data on long-term use of antipsychotic medication in children and adolescents. This is the first systematic review of double-blind randomized placebo control trials (RCTs) on the safety and efficacy of long-term antipsychotics across mental health /neurodevelopmental conditions in paediatric populations.

Materials and Methods: 
Search: In June 2018, nine electronic databases/trials registers were searched. Cochrane Highly Sensitive Search Strategy was used in MEDLINE, and this strategy was modified for other eight databases.

Inclusion/Exclusion: RCTs on antipsychotics used for more than 12 weeks; children and young people under 18 years, with any mental health/neurodevelopmental conditions.

Analysis: PS (first author) collected the data and two authors (PS and MK) independently evaluated the data. Improvement in daily functioning was the primary outcome. Side effects were systematically recorded. 

Results and Conclusions:
Six trials (from 2006 to 2017) were identified, involving a total of 939 children and adolescents aged 5 to 17 years with diagnoses of Autism, Conduct Disorders, Disruptive Behaviour, Bipolar Disorders, ADHD, and Schizophrenia. Four trials assessed aripiprazole and two assessed risperidone. Use of antipsychotic medication beyond 12 weeks was associated with significant functional improvements with an acceptable safety and tolerability profile. This conclusion is based on a small number of moderate-quality trials, and the findings needs to be interpreted cautiously. The choice of long term use of risperidone or aripiprazole in children or adolescents for 12 weeks or beyond needs careful consideration of the benefits and potential risks of these medication for each individual. Further research on long-term effects of antipsychotic medication in children and young people is needed.

13 - ANTIPSYCHOTIC MAINTENANCE TREATMENT IN PAEDIATRIC PATIENTS: A SYSTEMATIC REVIEW OF FUNCTIONAL IMPROVEMENTS AND TOLERABILITY ACROSS MENTAL HEALTH AND NEURODEVELOPMENTAL CONDITIONS