Long-term effects of risperidone in children with autism spectrum disorders: A placebo discontinuation study
ABSTRACT The short-term benefit of risperidone in ameliorating severe disruptive behavior in pediatric patients with autism spectrum disorders is well established; however, only one placebo-controlled, long-term study of efficacy is available.
Thirty-six children with an autism spectrum disorder (5-17 years old) accompanied by severe tantrums, aggression, or self-injurious behavior, started 8-week open-label treatment with risperidone. Responders (n = 26) continued treatment for another 16 weeks, followed by a double-blind discontinuation (n = 24; two patients discontinued treatment because of weight gain) consisting of either 3 weeks of taper and 5 weeks of placebo only or continuing use of risperidone. Relapse was defined as a significant deterioration of symptoms based on clinical judgment and a parent questionnaire.
Risperidone was superior to placebo in preventing relapse: this occurred in 3 of 12 patients continuing on risperidone versus 8 of 12 who switched to placebo (p = .049). Weight gain, increased appetite, anxiety, and fatigue were the most frequently reported side effects.
This study indicates the effectiveness of risperidone during a period of several months, reducing disruptive behavior in about half of the children with autism spectrum disorders. The results provide a rationale for the continuing use of risperidone beyond 6 months, although considerable weight gain can limit the use of this agent.
SourceAvailable from: Ellen Broelz
Chapter: Neurofeedback and Epilepsy[Show abstract] [Hide abstract]
ABSTRACT: This chapter introduces the published research on neurofeedback and epilepsy, followed by a description of the clinical protocols typically used and illustrated with case examples when appropriate. Then, the use of qEEG (electroencephalography) to improve outcome is described. The research on neurofeedback and epilepsy has historically been limited (of necessity) to small sample sizes and only a single group for which pre- and post-treatment effects are determined. One exception was a study using SCP, which was a controlled study with between-group comparisons. Despite these limitations, results have been consistent across studies, generally suggesting that neurofeedback leads to reduction in seizures. The chapter argues that the studies utilizing SCP training, though not as numerous, also show positive outcomes.Neurofeedback and Neuromodulation Techniques and Applications, Edited by Robert Coben and James R. Evans, 10/2010: chapter 7: pages 183-203; Academic Press., ISBN: 978-0-12-382235-2
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ABSTRACT: Abstract Objective: The purpose of this study was to investigate the course of autistic symptoms, using a quantitative measure of core autistic traits, among risperidone-treated children who participated in a 10 year life course longitudinal study. Methods: Parents completed surveys of intervention history, as well as serial symptom severity measurements using the Social Responsiveness Scale (SRS), on their autism spectrum disorder (ASD)-affected children. Fifty participants (out of a total of 184 with full intervention histories) were reported to have been treated with risperidone during the course of the study. Serial SRS scores during risperidone treatment were available for a majority of children whose parents reported a positive effect from risperidone. Results: Two thirds of risperidone-treated children (n=33) were reported by parents to have improved by taking the medication, with the principal effects described being that children were calmer, better focused, and less aggressive. SRS scores of children reported to have responded positively to risperidone did not improve over time. Conclusions: Risperidone's beneficial effect on aggression and other elements of adaptive functioning were not necessarily accompanied by reduction in core ASD symptoms, as serially assessed by the same caregivers who reported improvement in their children. These results reflect the distinction between reduction in core symptom burden and improvement in adaptive functioning. Given the cumulative risks of atypical neuroleptics, the findings underscore the importance of periodic re-evaluation of medication benefit for children with ASD receiving neuroleptic treatment.Journal of Child and Adolescent Psychopharmacology 10/2014; 24(9). DOI:10.1089/cap.2014.0055 · 3.07 Impact Factor
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ABSTRACT: Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder that is often accompanied by psychiatric comorbidity. Although there is no medication currently available to treat the core symptoms of ASD, risperidone was the first drug to be approved for use in ASD and is still the best established psychopharmacological option for the treatment of irritability and behavioral problems in ASD. Areas covered: This article gives an overview of the pharmacokinetic profile of risperidone and a comprehensive review of treatment studies regarding the use of risperidone in ASD. Expert opinion: Ample evidence supports the short-term use of risperidone for treating irritability and behavioral problems in ASD. Risperidone also shows promise in treating symptoms often associated with ASD, such as stereotypical behavior, social difficulties, hyperactivity and cognitive problems. However, several adverse effects have been identified; most are mild or moderate and well manageable, but weight gain and metabolic changes are a considerable concern. Therefore, risperidone should in our view be seen as 'a last resort', only justified for the short-term treatment of serious behavioral problems, which have failed to respond sufficiently to behavioral interventions. Future studies should investigate long-term effects of risperidone and factors that facilitate individual risk-benefit analyses before treatment.Expert Opinion on Drug Metabolism & Toxicology 11/2014; 11(1):1-14. DOI:10.1517/17425255.2015.981151 · 2.93 Impact Factor