Risperidone for autism spectrum disorder

School for Policy Studies, University of Bristol, No 8 Priory Road, Bristol, UK, BS8 1TZ.
Cochrane database of systematic reviews (Online) (Impact Factor: 5.94). 02/2007; DOI: 10.1002/14651858.CD005040.pub2
Source: PubMed

ABSTRACT Autistic spectrum disorder encompasses a wide variety of behavioural and communicative problems. Both the core features and non-core features of autism have been targeted in a variety of therapies. Atypical antipsychotic medications, including risperidone, have been used for symptom and behaviour improvement and have shown beneficial outcomes, particularly in certain aspects of the disorder. However, given the nature of the condition presenting in young patients, the risks of these potentially long term therapies must be weighed against the benefits.
To determine the efficacy and safety of risperidone for people with autism spectrum disorder.
Electronic databases: CENTRAL (Cochrane Central Register of Controlled Trials) 2006 (Issue 3); MEDLINE (1966 to April 2006); EMBASE (1980 to April 2006);PsycINFO (1887 to April 2006); CINAHL (1982 to April 2006); LILACS (1982 to April 2006 ); (USA) (accessed April 2006); ZETOC (1993 to April 2006); National Research Register (NRR) (UK) 2006 (Issue 1) were searched. In addition further data were retrieved through contact with pharmaceutical companies and authors of published trials.
All randomised controlled trials of risperidone versus placebo for patients with a diagnosis of autism spectrum disorder. All trials had to have at least one standardised outcome measure used for both intervention and control group.
Data were independently evaluated and analysed by the reviewers. Data were evaluated at the end of each randomised controlled trial. Unpublished data were also considered and analysed.
Only three randomised controlled trials were identified. Meta-analysis was possible for three outcomes. Some evidence of the benefits of risperidone in irritability, repetition and social withdrawal were apparent. These must however be considered against the adverse effects, the most prominent being weight gain.
Risperidone can be beneficial in some features of autism. However there are limited data available from studies with small sample sizes. In addition, there lacks a single standardised outcome measure allowing adequate comparison of studies, and long-term followup is also lacking. Further research is necessary to determine the efficacy pf risperidone in clinical practice.

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    Acta Psychiatrica Scandinavica 05/2014; 130(2). DOI:10.1111/acps.12282 · 5.55 Impact Factor
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    ABSTRACT: Family courts are seeing an increasing number of separating or divorced families who have a special needs child. These cases present complex challenges for family law professionals charged with crafting parenting plans based on best interests standards. For many of these children, the typical developmentally based custodial arrangements may not be suitable, given the child's specific symptoms and treatment needs. We present a model for understanding how the general and specific needs of these children, as well as the demands on parents, can be assessed and understood in the context of divorce. This includes an analysis of risk and protective factors that inform timeshare and custodial recommendations and determinations. The risk assessment model is then applied to three of the most commonly occurring childhood neurodevelopmental and psychiatric disorders likely to be encountered in family court, namely, attention deficit/hyperactivity disorder, depressive disorders, and autistic spectrum disorders.Key Points for the Family Court CommunityThere has been a dramatic rise in the population of children with neurodevelopmental, psychiatric, and medical syndromes whose parents are disputing custody in the family courts.Family law professionals of all disciplines should develop a fundamental knowledge base about the most commonly seen special needs children in family court, such as those with neurodevelopmental conditions like autistic spectrum disorder, attention deficit/hyperactivity disorder, and severe depressive disorders (especially with teenagers), which may involve suicidal or self-harming behaviors.Commonly recommended parenting plans may be inappropriate for many special needs children, as some function significantly below their chronological age and pose extreme behavioral challenges.A systematic analysis of risk and protective factors should inform timeshare arrangements and determinations with this varied population, including the safety of the child and severity of the disorder, parental commitment and availability to pursue medical, educational, and therapeutic services, the parental attunement and insightful about the problem, and the differential parenting skills of each parent.
    Family Court Review 01/2015; 53(1). DOI:10.1111/fcre.12134

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