No seizure exacerbation from risperidone in youth with comorbid epilepsy and psychiatric disorders: a case series.
OBJECTIVE
The aim of this study was to study risperidone use in pediatric patients with comorbid epilepsy and psychiatric disorders.


METHODS
We retrospectively reviewed the outpatient psychopharmacology medical records of patients with epilepsy, aged 19 and younger, who received risperidone for psychiatric disorders.


RESULTS
Twenty-one (21) youths (mean age, 12.0 +/- 4.2 years) met our criteria for review. Mean risperidone dosage was 2.4 +/- 3.5 mg/day. Target symptoms included severe aggression, severe agitation, psychosis, and self-injurious behavior. Diagnoses included attention-deficit hyperactivity disorder (ADHD), learning disorder, and impulse control disorder. Seizure type was partial complex in 12 patients, generalized in 6 patients, neonatal in 1 patient, myoclonic in 1 patient, and unclassified in 1 patient. The average number of previous psychotropic trials was 3.5 +/- 3.0. Using a definition of response of a Clinical Global Impressions (CGI) improvement score of 2 or less, 15 patients (71%) were considered responders. Adverse effects were none to slight in 16 patients, moderate in 4 patients, and severe in 1 patient. Seizures did not worsen in any patient.


CONCLUSIONS
Risperidone was associated with a clinically significant global improvement, without seizure exacerbation in youths with epilepsy and psychiatric disorders. Despite the limitations of the study design, the 71% responder rate is noteworthy in this treatment-refractory group.
Children's Hospital Boston, Fegan 8, 300 Longwood Avenue, Boston, MA 02115, USA. joseph.gonzalezheydrich@tch.harvard.edu
Joseph
J
Gonzalez-Heydrich
Gahan J
GJ
Pandina
Carl A
CA
Fleisher
Olivia
O
Hsin
Darcy
D
Raches
Blaise F
BF
Bourgeois
Joseph
J
Biederman
D000293:Adolescent; D000328:Adult; D000374:Aggression; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000150:complications / Q000188:drug therapy / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D011618:Psychotic Disorders / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D012189:Retrospective Studies; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use; D012640:Seizures / Q000139:chemically induced*
D014150:Antipsychotic Agents; D018967:Risperidone