Clinical and pharmacokinetic evaluation of risperidone for the management of autism spectrum disorder.
BACKGROUND
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.


METHODS
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.


CONCLUSIONS
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.
University of Groningen, University Medical Center Groningen, Department of Child and Adolescent Psychiatry , Hanzeplein 1, 9713 GZ Groningen , The Netherlands +31 50 3681100 ; +31 50 3681120 ; m.dinnissen@umcg.nl.
Mariken
M
Dinnissen
Andrea
A
Dietrich
Barbara J
BJ
van den Hoofdakker
Pieter J
PJ
Hoekstra
D000818:Animals; D014150:Antipsychotic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism; D019468:Disease Management; D004341:Drug Evaluation / Q000379:methods; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D018967:Risperidone / Q000493:pharmacokinetics* / Q000627:therapeutic use*
D014150:Antipsychotic Agents; D018967:Risperidone
antipsychotic; autism spectrum disorder; efficacy; pharmacokinetics; predictors; risperidone; tolerability