Risperidone developmental disorders

McDougle, C.J., Holmes, J.P., Bronson, M.R., Anderson, G.M., Volkmar, F.R., Price, L.H., and Cohen, D.J. (1997) Risperidone treatment of children and adolescents with pervasive developmental disorders a prospective, open-label study. / Am Acad Child Adolesc Psychiatry 36 685-693. 

The main indications for atypical antipsychotics are the acute and maintenance treatment of schizophrenic disorders, with an emphasis on the treatment of refractory and chronic disorders. However, because of the lower risk of EPS and in particular of tardive dyskinesia, there is a tendency toward a wider range of indications for some of the atypical neuroleptics. Favorable effects in drug-induced psychoses have been demonstrated for olanzapine. Clozapine seems effective in the treatment and relapse prevention of manic episodes and bipolar disorders, and risperidone has been shown to have good efficacy in conduct disorders and in the pervasive developmental disorders. 

There have been numerous trials of use of the atypical antipsychotics in patients with developmental disabilities, but most of these trials were uncontrolled open-labeled studies or case reports (Aman and Madrid, 1999). Findings were reported for 86 adults and 1 child with prominent self-injury. The reports of adults assessed clozapine (1 report) and risperidone (4 reports). Improvement was observed for a majority of participants in all of these trials. The patients presented with a multitude of conditions, ranging from nonspecific MR and associated behavior problems, to pervasive developmental disorders (including autism), to various psychiatric disorders, including schizophrenia and manic disorder. Self-injury appeared to respond to treatment regardless of concomitant condition. In the only clozapine report with a child (who had autistic disorder), a mean dose of 283 mg/day caused a transient reduction in self-injury. 

McDougle CJ, Holmes JP, Carlson DC, et al. A double-blind, placebo-controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders. Arch Gen Psychiatry 1998 55 633-641. 

Adults with autistic disorder (n = 17) or pervasive developmental disorder not otherwise specified (n = 14) participated in a randomized, 12-week, double-blind, placebo-controlled trial of risperidone (41). Among those who completed the study, risperidone (n = 14) was superior to placebo (n = 16) in reducing the symptoms of autism, and the most prominent adverse effect was mild transient sedation during the initial phase of drug administration. Abnormal gait was reported in one patient taking risperidone. 

Zuddas A, Di Martino A, Muglia P, Cianchetti C. Longterm risperidone for pervasive developmental disorder efficacy, tolerability, and discontinuation. J Child Adolesc Psychopharmacol 2000 10(2) 79-90. 

Shea S, Turgay A, CarroU A, Schulz M, Orhk H, Smith 1, Dunbar F (2004) Risperidone in the treatment of disruptive behavioral symptoms in children with autistic and other pervasive developmental disorders. Pediatrics 114 e634—e641. 

Risperidone has been assessed in children with autistic disorder and disruptive behavior in a multicenter, two-part, open study (221). Part one consisted of a 4-month open phase in 63 children (aged 5-17 years 49 boys) taking risperidone 2.0 mg/day of the 12 dropouts, five were due to loss of efficacy and one to an adverse event (constipation) there was a mean weight gain of 5.1 kg, which was significantly greater than expected from developmental norms. Part two was a randomized, doubleblind study in which risperidone was either substituted by placebo (n = 16) or continued (n = 16) there were more relapses in those who took placebo (n = 10) than in... 

Demb HB, Nguyen KT. Movement disorders in children with developmental disabilities taking risperidone. J Am Acad Child Adolesc Psychiatry 1999 38(l) 5-6. 

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