Use of risperidone in children with epilepsy.
OBJECTIVE
Although the atypical antipsychotic medications appear to be safe in patients with epilepsy, few studies have specifically addressed the use of risperidone in children with seizures. The objective of this study was to evaluate behavior improvement and seizure outcome in children with epilepsy and behavioral disorders (self-injurious, aggressive, or destructive behavior) after introduction of risperidone.


METHODS
In this prospective study, 54 patients were evaluated, 38 boys and 16 girls, aged 2-18 (mean=10). The dose of risperidone ranged from 0.01 to 0.14 mg/kg/day (mean=0.038 mg/kg/day). Risperidone was introduced gradually. The titration rate was determined by clinical response. The data were collected from patients' follow-up visits and clinical files. Exacerbation of seizures was established as an increase in seizure frequency after introduction of risperidone, with return to baseline seizure frequency after risperidone withdrawal.


RESULTS
Seizure frequency was not affected by risperidone in 51 patients (94.5%). Only two (4%) patients experienced seizure exacerbation after the introduction of risperidone. In one patient, the effect of risperidone on seizure control could not be established. After introduction of the risperidone, 38 (70.4%) patients manifested improvement in behavior.


CONCLUSIONS
Our data suggest that risperidone can be used in pediatric patients with epilepsy and that seizure outcome is not changed in most children with epilepsy and psychiatric comorbidity. In addition, behavior improvement is usually achieved in most patients.
Holzhausen
Stefan Padial Ferri
SP
Department of Neurology, State University of Campinas, FCM/Unicamp, PO Box 6111, 13083-970 Campinas, SP, Brazil.
Guerreiro
Marilisa Mantovani
MM
Baccin
Carlos Eduardo
CE
Montenegro
Maria Augusta
MA
D000293:Adolescent; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012189:Retrospective Studies; D018967:Risperidone / Q000627:therapeutic use*; D012640:Seizures / Q000188:drug therapy / Q000209:etiology
D014150:Antipsychotic Agents; D018967:Risperidone