PURPOSE OF REVIEW: Treatment of children who develop schizophrenia in childhood 
and early adolescence presents unique considerations. There has been increasing 
attention to the importance of early intervention and whether treatment effects 
may be affected by brain development.
RECENT FINDINGS: Several recent trials support the use of antipsychotics for 
treatment of schizophrenia in children and adolescents. Clozapine shows greater 
efficacy in children and adolescents than it has in adults. A large-scale trial 
comparing a first-generation antipsychotic (molindone) with newer agents did not 
find significant differences in treatment response, although the newer 
antipsychotics were associated with more severe weight gain. Data regarding 
effects of antipsychotics on brain development in children and young adolescents 
with schizophrenia are sparse, although one report found no difference between 
effects of clozapine and olanzapine on cortical thickness.
SUMMARY: Although psychosocial interventions are an important adjunctive 
treatment, antipsychotic medications continue to be the mainstay of treatment. 
Careful monitoring of metabolic side effects and age-appropriate intervention is 
particularly important, as children and adolescents appear to be more likely to 
develop metabolic abnormalities such as pronounced weight gain, which may 
significantly impact adherence as well as lead to other health issues.