S. Fisman et M. Steele, USE OF RISPERIDONE IN PERVASIVE DEVELOPMENTAL DISORDERS - A CASE SERIES, Journal of child and adolescent psychopharmacology, 6(3), 1996, pp. 177-190
A series of 14 children and adolescents (ages 9-17 years, 10 males) we
re treated with risperidone for pervasive developmental disorder. The
rationale for using an atypical neuroleptic agent is based on its abil
ity to target both positive and negative symptoms of schizophrenia. It
was postulated that symptoms similar to the positive and negative sym
ptoms of schizophrenia may be observed in the pervasive developmental
disorders and might respond favorably to risperidone. Twelve of the 14
youths had been treated previously with several psychotropic drugs, o
ften concurrently. Risperidone was initiated at a starting dose of 0.2
5 mg twice daily and increased in 0.25 mg/day increments every 5-7 day
s. Optimal dosages ranged from 0.75 to 1.5 mg daily in divided doses.
Thirteen of the 14 youths appeared to benefit from risperidone. Improv
ement in functionality on the Children's Global Assessment Scale was d
emonstrated in 13 of 14 cases. Disruptive behaviors, when present, mar
kedly decreased on risperidone. Ten patients showed a marked reduction
in agitation and anxiety. Social awareness improved markedly in 10 pa
tients, moderately in 3, and only slightly in 1. All but 1 patient dem
onstrated a lessening in obsessional behaviors. Effects on attention w
ere uniformly positive. Side effects were minimal at the dosages used
in this study; 5 patients had initial sedation. Neither extrapyramidal
side effects nor agitation was observed in any case. Ten of 14 youths
could be managed with risperidone monotherapy. During the follow-up p
eriod (mean 7 months), none of the patients experienced a major relaps
e while taking risperidone. Positive and negative symptoms, as typical
ly characterized in schizophrenia, were both found to improve equally
well with risperidone treatment. Based on these findings, a prospectiv
e clinical trial with a randomized controlled design is warranted.