title: Weight Gain and Metabolic Consequences of Risperidone in Young Children With Autism Spectrum Disorder.
abstract: We examine weight gain and metabolic consequences of risperidone monotherapy in children with autism spectrum disorder (ASD).
  
  
  
  This was a 24-week, multisite, randomized trial of risperidone only versus risperidone plus parent training in 124 children (mean age 6.9 ± 2.35 years; 105 boys and 19 girls) with ASD and serious behavioral problems. We monitored height, weight, waist circumference, and adverse effects during the trial. Fasting blood samples were obtained before treatment and at week 16.
  
  
  
  In 97 children with a mean of 22.9 ± 2.8 weeks of risperidone exposure, there was a 5.4 ± 3.4 kg weight gain over 24 weeks (p < .0001); waist circumference increased from 60.7 ± 10.4 cm to 66.8 ± 11.3 cm (p < .0001). At baseline, 59 of 97 children (60.8%) were classified as having normal weight; by week 24, only 25 of 85 (29.4%) remained in that group. Growth curve analysis showed a significant change in body mass index (BMI) z scores from pretreatment to week 24 (p < .0001). This effect was significantly greater for children with reported increased appetite in the first 8 weeks. From before treatment to week 16, there were significant increases in glucose (p = .02), hemoglobin A1c (p = .01), insulin (p <.0001), homeostatic model assessment-insulin resistance (HOMA-IR; p < .001), alanine aminotransferase (p = .01), and leptin (p < .0001). Adiponectin declined (p = .003). At baseline, 7 children met conventional criteria for metabolic syndrome; by week 16, 12 additional children were so classified.
  
  
  
  Rapid weight gain with risperidone treatment may promote the cascade of biochemical indices associated with insulin resistance and metabolic syndrome. Appetite, weight, waist circumference, liver function tests, blood lipids, and glucose warrant monitoring. Clinical trial registration information-Drug and Behavioral Therapy for Children With Pervasive Developmental Disorders; http://clinicaltrials.gov/; NCT00080145.
authors.affiliation: Emory University School of Medicine and Marcus Autism Center, Atlanta. Electronic address: lawrence.scahill@emory.edu.
authors.forename: Lawrence
authors.initials: L
authors.lastname: Scahill
authors.affiliation: Yale University School of Nursing, West Haven, CT.
authors.forename: Sangchoon
authors.initials: S
authors.lastname: Jeon
authors.affiliation: Yale University School of Nursing, West Haven, CT.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Boorin
authors.affiliation: Harvard Medical School, Massachusetts General Hospital, and Lurie Center for Autism, Boston.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: McDougle
authors.affiliation: Nisonger Center, Ohio State University, Columbus.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Aman
authors.affiliation: Yale School of Medicine, New Haven, CT.
authors.forename: James
authors.initials: J
authors.lastname: Dziura
authors.affiliation: Division of Child Psychiatry, University of California, Los Angeles.
authors.forename: James T
authors.initials: JT
authors.lastname: McCracken
authors.affiliation: Yale School of Medicine, New Haven, CT.
authors.forename: Sonia
authors.initials: S
authors.lastname: Caprio
authors.affiliation: Nisonger Center, Ohio State University, Columbus.
authors.forename: L Eugene
authors.initials: LE
authors.lastname: Arnold
authors.affiliation: Washington University, St. Louis.
authors.forename: Ginger
authors.initials: G
authors.lastname: Nicol
authors.affiliation: Yale University.
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Deng
authors.affiliation: Emory University School of Medicine.
authors.forename: Saankari A
authors.initials: SA
authors.lastname: Challa
authors.affiliation: National Institute of Mental Health (NIMH), Bethesda, MD.
authors.forename: Benedetto
authors.initials: B
authors.lastname: Vitiello
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects*; D000067877:Autism Spectrum Disorder / Q000097:blood* / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000139:chemically induced*; D000066553:Problem Behavior; D018967:Risperidone / Q000009:adverse effects*; D015430:Weight Gain / Q000187:drug effects*
chemical_list: D014150:Antipsychotic Agents; D018967:Risperidone
keywords: autism spectrum disorder; insulin resistance; metabolic syndrome; risperidone; weight gain