title: A case series of eight aggressive young children treated with risperidone.
abstract: The aim of this study was to examine the use of risperidone in routine clinical care for very aggressive young children. This is a retrospective medical chart review of patients age less than 6 years 11 months who were treated with risperidone for 1 to 10 months during the 1-year study period. Treatment response, side effects, and Clinical Global Impression (CGI) scores were identified. One hundred and five such young children were identified; 8 had been treated with risperidone (6 boys, 2 girls: mean age 4.9 +/- 0.8 years). Risperidone was used in combination with other psychotropic medications in 7 of the 8 children. The mean daily dose of risperidone was 1.25 +/- 0.27 mg. Seventy-five percent of the children were on concomitant lithium, valproate, or carbamazepine; 63% were on stimulants or alpha adrenergics. This was a highly comorbid group, with 7 children presenting with attention deficit hyperactivity disorder and 5 children with bipolar disorder not otherwise specified. The average baseline CGI severity was 5.5 (SD = 0.5), and at last visit it was 3.5 (SD = 0.5), p < 0.0001. Mean CGI improvement score was 1.9 (SD = 0.6). Adverse effects included significant weight gain (mean 5.5 +/- 4.9 kg, p < 0.05) in 6 patients. One child had hyperprolactinemia. Given the potential development of atherosclerosis in obesity and endocrine response in hyperprolactinemia, risperidone should be reserved for those children with severe aggressive behavior who failed multiple trials with other agents. Further controlled trials are needed.
authors.affiliation: Department of Psychiatry, Children's Hospital, Boston, Harvard Medical School, Boston, Massachusetts 02115, USA. marthace1@juno.com
authors.forename: Martha
authors.initials: M
authors.lastname: Cesena
authors.forename: Joseph
authors.initials: J
authors.lastname: Gonzalez-Heydrich
authors.forename: Eva
authors.initials: E
authors.lastname: Szigethy
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Kohlenberg
authors.forename: David Ray
authors.initials: DR
authors.lastname: DeMaso
mesh_terms: D000374:Aggression / Q000187:drug effects* / Q000523:psychology; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001921:Brain / Q000473:pathology; D002648:Child; D002653:Child Behavior Disorders / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D002675:Child, Preschool; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use*; D015430:Weight Gain / Q000187:drug effects
chemical_list: D014150:Antipsychotic Agents; D011388:Prolactin; D018967:Risperidone