Risperidone and cognitive function in children with disruptive behavior disorders

Duke University, Durham, North Carolina, United States
Biological Psychiatry (Impact Factor: 10.25). 09/2007; 62(3):226-34. DOI: 10.1016/j.biopsych.2006.09.036
Source: PubMed

ABSTRACT Effects of risperidone on cognitive function in children with disruptive behavior disorders (DBDs) and subaverage intelligence quotient (IQ) were assessed.
Data from two 6-week, double-blind, placebo-controlled studies (n = 228) were combined, as were three 1-year, open-label studies (n = 688). Patients with DBDs and subaverage IQ, 5 to14 years, received placebo or risperidone .02 to .06 mg/kg/day. Cognitive measures included the Continuous Performance Task (CPT) and Verbal Learning Test for Children (VLT-C). Efficacy was assessed using the Nisonger Child Behavior Rating Form (NCBRF). Adverse events were collected via spontaneous report; sedation was assessed using visual analog scale.
Improvements on the NCBRF Conduct Problem subscale were significantly greater for risperidone- versus placebo-treated patients (-15.8 vs. -6.4, p < .0001) in short-term studies; significant reductions were observed in long-term studies (-16.3, p < .0001). No overall decline and some significant improvement in attention (CPT) and memory (VLT-C) were noted regardless of treatment in short-term studies. VLT-C improved significantly (p < .0001) for both groups, with no difference between treatment groups. Improvements in memory (VLT-C) and attention (CPT) were noted in long-term studies. Somnolence/sedation did not affect cognitive function.
Cognitive function was not altered by risperidone in short-term studies and was maintained or improved with one year of treatment in children with DBDs and subaverage IQ, potentially representing age-appropriate gains.

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    • "Atypical antipsychotic drugs, called second-generation antipsychotics (SGAs), have been shown to be effective in controlling aggressive and externalizing behaviors, as well as bipolar disorder in pediatric populations (Bishop and Pavuluri 2008; Pandina et al. 2007, 2009). All SGAs target the thalamic–striatal–frontal loop, which has been shown to be important in several cognitive functions such as rewardbased learning (Schultz 2002), cognitive flexibility (Cools 2006), and working memory (Kellendonk et al. 2006). "
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    • "However, in Troost et al. (2006) and in the present study, aspects of memory and attention did improve (Troost et al., characterized their divided attention task as an index of working memory.) Findings for the Verbal Learning test differed from the Pandina (2007) study in that we observed enhanced word recognition with risperidone, but Pandina et al. did not. (However, Pandina et al. did report improvements in uncontrolled one year open-label extension studies.) "
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    Journal of child and adolescent psychopharmacology 06/2008; 18(3):227-36. DOI:10.1089/cap.2007.0133 · 3.07 Impact Factor
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    • "Although associated with cognitive benefits in adults with schizophrenia , the cognitive effects of these agents in children and adolescents have not been systematically evaluated (Pandina et al. 2003). A 6-week trial comparing risperidone and placebo in 118 children and adolescents with disruptive behavioral disorders evaluated memory, using the Modified Verbal Learning Test—Children's Version (MVLT-CV), and attention and vigilance using the Continuous Performance Test (CPT) (Pandina et al. 2003). Both the risperidone and placebo groups showed significant improvements in memory from baseline to endpoint, with no significant differences between groups. "
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