Risperidone retardation

Findling, R., Aman, M., and Derivan, A. (2000). Long-term safety and efficacy of risperidone in children with significant conduct problems and borderline IQ or mental retardation. Presented at the 39th Annual American College of Neuropsychopharmacology, San Juan, Puerto Rico, December 2000. 

Aman, M.G., Findling, R.L., Derivan, A., and Merriman, U. (2000) Risperidone versus placebo for severe conduct disorder in children with mental retardation [NCDEU abstract]. / Child Adolesc Psychopharmacol 10 253. 

Cohen S, Glazewski R, Khan S, Khan A. Weight gain with risperidone among patients with mental retardation effect of calorie restriction. J Clin Psychiatry 2001 62(2) 114-6. 

Chapter 1 examined three risperidone studies that confirm the braindisabling principles of psychiatric treatment by demonstrating that the drug causes a metabolic suppression in the frontal and temporal lobes (deactivation) that occurs in both normal persons and patients diagnosed with schizophrenia, and that this disabling effect correlates with a reduction in the expression of symptoms, such as hallucinations and delusions, that require a fully functioning brain. As previously noted, if measured, the effect would also correlate with an overall reduction in spontaneous mental activity and verbal expressions, which are common clinical phenomena in patients who experience psychomotor retardation in response to neuroleptics. 

The efficacy and safety of risperidone have been examined in special groups of patients, such as those with psychotic depression (4), autistic disorders (41), bipolar disorder (5), mental retardation (6), and children and adolescents (7). 

Patients with bipolar disorders may benefit from risperidone. This has been observed in an open trial of ten patients with rapid cycling bipolar disorder who were refractory to lithium carbonate, carbamazepine, and valproate eight improved after 6 months of treatment. One patient dropped out through non-adherence to therapy and one because of adverse effects (agitation, anxiety, insomnia, and headache) (5). There was a similar beneficial effect in eight adults with moderate to profound mental retardation (6). Risperidone was associated with a significant reduction in aggression and self-injurious behavior, whereas adverse effects were primarily those of sedation and restlessness. 

A 24-year-old woman with mental retardation and an unspecified psychosis took risperidone 2 mg/day and trihexyphenidyl 2 mg/day and after 2 weeks developed symptoms that included tilting of her body backwards and to the left and tremors and cogwheel rigidity of the limbs (101). Risperidone was withdrawn and olanzapine 5 mg/day started after 4 weeks there was no improvement and she was then lost to follow-up. 

Cohen SA, Ihrig K, Lott RS, Kerrick JM. Risperidone for aggression and self-injurious behavior in adults with mental retardation. J Autism Dev Disord 1998 28(3) 229-33. 

The results of a similar study of ours, in which the study drugs were three atypical neuroleptics or antipsychotics, are given in Table 5-4. During the time of this study, clozapine, olanzapine, and risperidone were the only atypical neuroleptic or antipsychotic agents in general use at HCPC these three drugs were selectively used in accordance with the clinical criteria set by the Harris County Mental Health and Mental Retardation Authority. These criteria included documentation of at least two failures to respond clinically to treatment with different typical neuroleptic agents. 

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