Risperidone-induced hepatotoxicity in children and adolescents? A chart review study

Risperidone is an atypical antipsychotic drug that has been used in the tre atment of numerous psychiatric disorders in children and adolescents. The q uestion of whether risperidone-induced weight gain is associated with steat ohepatitis has recently been raised. The purpose of this chart review was t o ascertain: (1) the rate of liver dysfunction observed during risperidone treatment in children and adolescents; and (2) the clinical factors associa ted with liver dysfunction. For purposes of this chart review study, abnorm al liver function was defined by serum transaminase or bilirubin values fal ling outside the normal laboratory ranges. Chart reviews were completed on 38 youths with ages ranging from 5-17 years with a variety of psychiatric d iagnoses. The mean length of risperidone treatment was 15.2 months at a mea n dose of 2.5 mg/day. It was found that 37 of the 38 youths treated with ri speridone had no liver enzyme abnormalities at the end of study. One subjec t had an alanine aminotransferase (ALT) level of 46 U/L which was 7 U/L abo ve the upper limit of normal for this laboratory test. This isolated value was not considered clinically significant. These data were noted in spite o f weight gain and the use of numerous concomitant psychotropic medications. These findings suggest that risperidone in short term treatment does not c ommonly lead to evidence of abnormal liver function at therapeutic doses in children and adolescents. Larger-scale, prospective studies are needed in order to confirm these findings.