Risperidone treatment for juvenile bipolar disorder: a retrospective chart review.
OBJECTIVE
To investigate the effectiveness and tolerability of the atypical neuroleptic risperidone in the treatment of juvenile mania.


METHODS
This is a retrospective chart review of outpatients with the diagnosis of bipolar disorder (DSM-IV) treated with risperidone at a university center. Response to treatment was evaluated using the Clinical Global Impression Scale (CGI) with separate assessments of mania, psychosis, aggression, and attention-deficit/hyperactivity disorder (ADHD).


RESULTS
Twenty-eight youths (mean +/- SD age, 10.4 +/- 3.8 years) with bipolar disorder (25 mixed and 3 hypomanic) who had been treated with risperidone were identified. These children received a mean dose of 1.7 +/- 1.3 mg over an average period of 6.1 +/- 8.5 months. Using a CGI Improvement score of < or = 2 (very much/much improved) to define robust improvement, 82% showed improvement in both their manic and aggressive symptoms, 69% in psychotic symptoms, but only 8% in ADHD symptoms.


CONCLUSIONS
Although limited by its retrospective nature, this study suggests that risperidone may be effective in the treatment of manic young people and indicates the need for controlled clinical trials of risperidone and other atypical neuroleptics in juvenile mania.
Frazier
J A
JA
Child Psychiatry Department, Massachusetts General Hospital, Harvard Medical School, Boston, USA. frazier@helix.mgh.harvard.edu
Meyer
M C
MC
Biederman
J
J
Wozniak
J
J
Wilens
T E
TE
Spencer
T J
TJ
Kim
G S
GS
Shapiro
S
S
D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications; D001714:Bipolar Disorder / Q000150:complications / Q000188:drug therapy*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000150:complications; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D018967:Risperidone / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D018967:Risperidone