Risperidone [Risperdal-(TM)] is a relatively new medication for the treatment of autism. Risperidone affects the 5-HT and DA neuronal systems, both of which have been found to be abnormal in many persons with autism. The abstracts seem to indicate that Risperidone is especially effective in persons with autism who also display aggressive or explosive behaviors. Consult your physician for the best treatment for your child or adult with autism.
Medline Articles on Risperidone and Autism - All articles from all years.
Selected Journal Article Abstracts:
Title
Risperidone in the treatment of autism.
Author
Gabriele Masi and others.
Source
J Child Neurol 2001;16:395-400
Summary
The atypical antipsychotic risperidone appears to alleviate some of the symptoms of autism in preschool children who show severe behavioural problems such as tantrums or aggression, report investigators in Italy.
In a small preliminary study, Dr. Gabriele Masi and associates of the University of Pisa initiated treatment with risperidone 0.25 mg in 10 children, ages 3.75 to 6.5 years. Seven were diagnosed with an autistic disorder and three with pervasive developmental disorder not otherwise specified. Dosage was increased to 0.5 mg/day in five children.
As reported in the June issue of the Journal of Child Neurology, modest but significant improvements in the Childhood Autism Rating Scale, Children's Psychiatric Rating Scale, and Children's Global Assessment of Functioning were documented among the eight children who completed the 16-week trial.
According to the Clinical Global Impression score, four children were improved or very much improved; target symptoms in the children who completed the study were also improved.
Parents withdrew two children from the study, one because of tachycardia and flushes, the other because of fever and hyporexia. Two children had a slight increase in motor hyperactivity. However, vital signs, electrocardiograms, and liver enzymes were unaffected, no behavioural deterioration was observed, and none of the children were troubled by drowsiness.
Dr. Masi and colleagues note that children are more sensitive than adults to extrapyramidal symptoms and tardive dyskinesia caused by typical. They suggest that "risperidone may be useful in reducing the global severity of autistic symptoms, even if the observed behavior change is modest."
Title
Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. Background and rationale for an initial controlled study of risperidone.
Author
McDougle CJ; Scahill L; McCracken JT; Aman MG; Tierney E; Arnold LE; Freeman BJ; Martin A; McGough JJ; Cronin P; Posey DJ; Riddle MA; Ritz L; Swiezy NB; Vitiello B; Volkmar FR; Votolato NA; Walson P
Address
University School of Medicine, Indianapolis, Indiana, USA. cmcdougl@iupui.edu
Source
Child Adolesc Psychiatr Clin N Am, 2000 Jan, 9:1, 201-24
Abstract
This article has reviewed the background and rationale for the choice of risperidone as the first drug to be studied by the RUPP Autism Network. Risperidone has potent effects on 5-HT and DA neuronal systems, both of which have been implicated in the pathophysiology of autism. Unlike the typical antipsychotics, haloperidol and pimozide, which have been shown to be effective for reducing many of the maladaptive behaviors associated with autism, risperidone's 5-HT2A/DA D2 ratio of receptor blockade appears to produce a lower risk of acute and chronic extrapyramidal side effects, as well as enhanced efficacy for the "negative" symptoms of autism. Indirect clinical and preclinical evidence supports the use of risperidone to treat impaired social behavior, interfering repetitive phenomena, and aggression, targets of pharmacotherapy for many patients with autism. Numerous published open-label trials in children and adolescents with autism and related PDDs and one double-blind, placebo-controlled study in adults suggest that risperidone has promise for the treatment of children and adolescents with autism. Because most of these studies have been short-term, open-label trials in small samples, however, a large-scale controlled study of risperidone in children and adolescents with autism is needed to confirm these results. Finally, because it is likely that children who demonstrate short-term benefit from risperidone will remain on the medication indefinitely, the longer-term effectiveness and safety of risperidone in this population also needs to be determined. The design of this study and the assessments used are described separately.
Language of Publication
English
Title
A double-blind, placebo-controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders [see comments]
Author
McDougle CJ; Holmes JP; Carlson DC; Pelton GH; Cohen DJ; Price LH
Address
Department of Psychiatry, Indiana University School of Medicine, Indianapolis 46202-5200, USA. cmcdougl@iumc.iupui.edu
Source
Arch Gen Psychiatry, 1998 Jul, 55:7, 633-41
Abstract
BACKGROUND: Neurobiological research has implicated the dopamine and serotonin systems in the pathogenesis of autism. Open-label reports suggest that the serotonin2A-dopamine D2 antagonist risperidone may be safe and effective in reducing the interfering symptoms of patients with autism. METHODS: Thirty-one adults (age [mean+/-SD], 28.1+/-7.3 years) with autistic disorder (n=17) or pervasive developmental disorder not otherwise specified (n=14) participated in a 12-week double-blind, placebo-controlled trial of risperidone. Patients treated with placebo subsequently received a 12-week open-label trial of risperidone. RESULTS: For persons completing the study, 8 (57%) of 14 patients treated with risperidone were categorized as responders (daily dose [mean+/-SD], 2.9+/-1.4 mg) compared with none of 16 in the placebo group (P<.002). Risperidone was superior to placebo in reducing repetitive behavior (P<.001), aggression (P<.001), anxiety or nervousness (P<.02), depression (P<.03), irritability (P<.01), and the overall behavioral symptoms of autism (P<.02). Objective, measurable change in social behavior and language did not occur. Nine (60%) of 15 patients who received treatment with open-label risperidone following the double-blind placebo phase responded. Other than mild, transient sedation, risperidone was well tolerated, with no evidence of extrapyramidal effects, cardiac events, or seizures. CONCLUSION: Risperidone is more effective than placebo in the short-term treatment of symptoms of autism in adults.
Language of Publication
English
Title
Risperidone and explosive aggressive autism.
Author
Horrigan JP; Barnhill LJ
Address
Department of Psychiatry, University of North Carolina, Chapel Hill 27599-7160, USA.
Source
J Autism Dev Disord, 1997 Jun, 27:3, 313-23
Abstract
Many autistic patients with mental retardation have difficulties with explosivity and aggression. They often prove resistant to various pharmacotherapeutic interventions. In this study, 11 male outpatients (mean 18.3 years) were administered risperidone in an open-label fashion. The risperidone was started at 0.5 mg daily, and titrated upwards until maximum clinical benefit occurred. Serial clinical interviews were conducted, and Conners Parent-Teacher Questionnaires (short form) were completed by the caretakers. Substantial clinical improvement was noted almost immediately in each patient, with aggression, self-injury, explosivity, and poor sleep hygiene most improved. The modal dose for optimal response was 0.5 mg bid. Weight gain was a significant side effect (average velocity of 0.47 kg per week), while none of the patients experienced extrapyramidal side effects.
Language of Publication
English
Title
Risperidone in the treatment of two very young children with autism.
Author
Posey DJ; Walsh KH; Wilson GA; McDougle CJ
Address
Department of Psychiatry, Indiana University School of Medicine, Indianapolis, USA.
Source
J Child Adolesc Psychopharmacol, 1999, 9:4, 273-6
Abstract
This report describes the use of risperidone in the treatment of two very young children with autistic disorder, a 29-month-old boy and a 23-month-old boy, respectively. These children presented with severe and persistent symptoms of aggression and irritability that had not responded to previous treatment. In both cases, risperidone significantly reduced aggression and improved social relatedness. One patient's treatment with risperidone was complicated by persistent tachycardia and QTc interval prolongation that was dose-related. Consideration should be given to the appropriate use of medication in the treatment of very young children with autism when other interventions do not prove helpful.
Language of Publication
English
Title
An open trial of risperidone in young autistic children [see comments]
Author
Nicolson R; Awad G; Sloman L
Address
Department of Psychiatry, University of Toronto.
Source
J Am Acad Child Adolesc Psychiatry, 1998 Apr, 37:4, 372-6
Abstract
OBJECTIVE: To assess the benefits and side effects of risperidone in young autistic children. METHOD: In this open, prospective trial, subjects were treated with risperidone for 12 weeks. All subjects were started at 0.5 mg daily with individual titration to a maximum of 6 mg or 0.1 mg/kg daily. Behavioral ratings, completed by the investigators and the children's parents, included the Clinical Global Impressions (CGI), Children's Psychiatric Rating Scale, Conners Parent-Teacher Questionnaire, Childhood Autism Rating Scale, and Abnormal Involuntary Movement Scale. RESULTS: Ten boys, aged 4.5 to 10.8 years, were enrolled in the study and all completed the 12-week protocol. The mean final dose was 1.3 mg/day (range = 1 to 2.5 mg/day). On the basis of CGI-rated improvement, 8 of the 10 children were considered to be responders. Improvement was also demonstrated on the other scales. Transient sedation was common, and the children gained an average of 3.5 kg over the 12 weeks of the study. There was no evidence of either extrapyramidal symptoms or tardive dyskinesia. CONCLUSIONS: These results suggest that risperidone may be safe and leads to improvements in several behavioral symptoms in young children with autism. Controlled studies of risperidone in young autistic children are warranted.
Language of Publication
English
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