Risperidone for the core symptom domains of autism: Results from the study by the autism network of the research units on pediatric psychopharmacology

Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202-4800, USA.
American Journal of Psychiatry (Impact Factor: 13.56). 07/2005; 162(6):1142-8. DOI: 10.1176/appi.ajp.162.6.1142
Source: PubMed

ABSTRACT Risperidone has been found efficacious for decreasing severe tantrums, aggression, and self-injurious behavior in children and adolescents with autistic disorder (autism). The authors report on whether risperidone improves the core symptoms of autism, social and communication impairment and repetitive and stereotyped behavior.
The database from an 8-week double-blind, placebo-controlled trial (N=101) and 16-week open-label continuation study (N=63) of risperidone for children and adolescents with autism was used to test for drug effects on secondary outcome measures: scores on the Ritvo-Freeman Real Life Rating Scale, the Children's Yale-Brown Obsessive Compulsive Scale, and the maladaptive behavior domain of the Vineland Adaptive Behavior Scales.
Compared to placebo, risperidone led to a significantly greater reduction in the overall score on the Ritvo-Freeman Real Life Rating Scale, as well as the scores on the subscales for sensory motor behaviors (subscale I), affectual reactions (subscale III), and sensory responses (subscale IV). No statistically significant difference was observed, however, on the subscale for social relatedness (subscale II) or language (subscale V). Risperidone also resulted in significantly greater reductions in scores on the Children's Yale-Brown Obsessive Compulsive Scale and Vineland maladaptive behavior domain. This pattern of treatment response was maintained for 6 months.
Risperidone led to significant improvements in the restricted, repetitive, and stereotyped patterns of behavior, interests, and activities of autistic children but did not significantly change their deficit in social interaction and communication. Further research is necessary to develop effective treatments for the core social and communicative impairments of autism.

1 Follower
  • [Show abstract] [Hide abstract]
    ABSTRACT: In the United States, research directed specifically at improving our understanding of the psychiatric assessment and treatment of individuals with intellectual disabilities (ID) has grown, yet lags far behind efforts for typically developing children and adults. In the United States, a lack of a national approach to the mental health problems of people with ID has likely contributed to a lack of a clear and cohesive national research agenda for “dual diagnosis” of intellectual disabilities and mental health disorders. Despite these concerns, much has been learned and important progress has been made. This article provides an overview of the latest developments in research and social policy on behalf of persons with ID and mental health needs in the United States.
    Journal of Mental Health Research in Intellectual Disabilities 04/2013; 6(2):74-105. DOI:10.1080/19315864.2012.715724
  • [Show abstract] [Hide abstract]
    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 &amp Toxicology 11/2014; 11(1):1-14. DOI:10.1517/17425255.2015.981151 · 2.93 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Abstract Objective: The objective of this study was to investigate the short-term treatment effects of atomoxetine on autism spectrum disorder (ASD) symptoms in children and adolescents with both ASD and attention-deficit/hyperactivity disorder (ADHD). Methods: A total of 97 patients 6-17 years of age, with ASD and ADHD, were treated with 1.2 mg/kg/day of atomoxetine during an 8 week double-blind placebo-controlled period. Here, we investigated effects on two parent-based secondary outcome measures, the Aberrant Behavior Checklist (ABC) and the Children's Social Behavior Questionnaire (CSBQ). Results: After 8 weeks of double-blind treatment, atomoxetine administration was associated with significant treatment effects on the ABC subscales Hyperactivity, Inappropriate Speech, and Stereotypic Behavior, and on the CSBQ subscale Fear for Changes. Conclusions: Our study results indicate no beneficial effects of atomoxetine on social functioning. However, atomoxetine may ameliorate restricted and stereotyped behaviors and communication. This study has been registered in ( ) under registration number NCT00380692.
    Journal of Child and Adolescent Psychopharmacology 11/2014; 24(9). DOI:10.1089/cap.2014.0026 · 3.07 Impact Factor