Double-Blind, Placebo-Controlled Study of Risperidone for the Treatment of Disruptive Behaviors in Children With Subaverage Intelligence

Aman, Michael G.; Smedt, Goedele De; Derivan, Albert T.; Lyons, Ben; Findling, Robert L.; Stu, Risperidone Disruptive Behavior

doi:10.1176/appi.ajp.159.8.1337

Cited by 415 publications

(252 citation statements)

References 41 publications

(46 reference statements)

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“…However, on balance it seems that our lack of effect on the Continuous Performance Task is consistent with the findings reported by Troost et al (2006) and by Pandina et al (2007). There is no literature on seat activity in the context of performing cognitive tasks, but the reductions seen here seem entirely consistent with clinical reports of reduced overactivity with risperidone treatment (e.g., Aman et al, 2002; Research Units on Pediatric Psychopharmacology Autism Network, 2002). On balance, the studies conducted with adults having schizophrenia showed very mixed results insofar as memory is concerned, whereas we were unable to demonstrate enhancement or worsening of memory performance.…”

Section: Cognitive-motor Effectssupporting

confidence: 88%

“…Aman et al (2002) also saw reductions on all of these subscales in children with disruptive behavior disorders, whereas Snyder et al (2002) observed reductions in all except the Overly Sensitive subscale. In a sense, this is a form of internal validation, as the same behavioral changes (except for Overly Sensitive) were seen on the same subscales across all three studies.…”

Section: Behavioral Effectsmentioning

confidence: 92%

“…Recently, researchers have investigated the therapeutic effects of novel antipsychotics in children with DBD's (e.g., Aman et al, 2002;Snyder et al, 2002). Investigators assessed cognitive function, and they found that there was either no change or beneficial effects (i.e., verbal memory, short-term memory, and attention) with the use of novel antipsychotics (Pandina et al, 2007;Troost et al, 2006;Gunther et al, 2006;MacQueen & Young, 2003;Borison, 1996;Meltzer, 1995).…”

Section: Introductionmentioning

confidence: 99%

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Effects of risperidone on cognitive-motor performance and motor movements in chronically medicated children

Aman

Hollway

Leone

et al. 2009

Research in Developmental Disabilities

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This study was designed to explore the placebo-controlled effects of risperidone on cognitive-motor processes, dyskinetic movements, and behavior in children receiving maintenance risperidone therapy. Sixteen children aged 4-14 years with disruptive behavior were randomly assigned to drug order in a crossover study of risperidone and placebo for 2 weeks each. Dependent measures included tests of sustained attention, memory, visual matching, tremor, seat activity, abnormal movements, and parent behavior ratings. Results were compared by repeated measures ANOVA Fourteen boys and 2 girls with disruptive behavior and IQ ≤ 84 all completed the protocol. Risperidone was superior to placebo on response time (p = 0.01, η P 2 = 0.43) and seat movement (p < 0.05, η P 2 = 0.29) on a short-term memory task, and on a measure of static tremor (p = 0.05, η P 2 = 0.28). There was not a significant difference between treatment conditions on the Abnormal Involuntary Movement scale. Risperidone was superior to placebo on three subscales of the Nisonger Child Behavior Rating Form [Overly Sensitive (p < 0.01, η P 2 = 0.44), Conduct Problem (p = 0.02, η P 2 = 0.36), Hyperactivity (p = 0.03, η P 2 = 0.32)] and on the Hyperactivity/Noncompliance subscale of the Aberrant Behavior Checklist (p = 0.01, η P 2 = 0.41). Significant increases in heart rate (p = 0.05, η P 2 = 0.27) and weight (p = 0.02, η P 2 = 0.36) occurred in the risperidone condition. The findings suggest a beneficial effect of risperidone after several months of treatment on efficiency of responding, activity level, static tremor, and aspects of behavior.

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Section: Cognitive-motor Effectssupporting

confidence: 88%

Section: Behavioral Effectsmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Effects of risperidone on cognitive-motor performance and motor movements in chronically medicated children

Aman

Hollway

Leone

et al. 2009

Research in Developmental Disabilities

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“…Risperidone was found to be well-tolerated and superior to placebo in reducing aggressive behaviors in children with CD [664-666]. Two large controlled trials found risperidone to be superior to placebo in ameliorating hostile and aggressive behavior in lower-functioning children with disruptive behavioral disorders [667,668]. …”

Section: Reviewmentioning

confidence: 99%

Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings

Dichter

Damiano

Allen

2012

J Neurodevelop Disord

253

207

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This review summarizes evidence of dysregulated reward circuitry function in a range of neurodevelopmental and psychiatric disorders and genetic syndromes. First, the contribution of identifying a core mechanistic process across disparate disorders to disease classification is discussed, followed by a review of the neurobiology of reward circuitry. We next consider preclinical animal models and clinical evidence of reward-pathway dysfunction in a range of disorders, including psychiatric disorders (i.e., substance-use disorders, affective disorders, eating disorders, and obsessive compulsive disorders), neurodevelopmental disorders (i.e., schizophrenia, attention-deficit/hyperactivity disorder, autism spectrum disorders, Tourette’s syndrome, conduct disorder/oppositional defiant disorder), and genetic syndromes (i.e., Fragile X syndrome, Prader–Willi syndrome, Williams syndrome, Angelman syndrome, and Rett syndrome). We also provide brief overviews of effective psychopharmacologic agents that have an effect on the dopamine system in these disorders. This review concludes with methodological considerations for future research designed to more clearly probe reward-circuitry dysfunction, with the ultimate goal of improved intervention strategies.

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“…33,34 Those studies found that the most common adverse events were drowsiness, headache and weight gain. The symptoms of aggression were controlled in 3 to 4 weeks using a mean dose of 1.5 mg/day, which was effective in the control of aggression for the next six months when compared with the placebo group.…”

Section: Risperidonementioning

confidence: 99%

Atypical antipsychotics in the treatment of pathological aggression in children and adolescents: literature review and clinical recommendations

Teixeira

Jacintho

Celeri

et al. 2013

Trends Psychiatry Psychother.

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Objective: To review the literature about the use of atypical antipsychotics in the treatment of pathological aggression in children and adolescents. Method: The databases MEDLINE, SciELO, and LILACS were searched for publications in Portuguese or English from 1992 to August 2011 using the following keywords: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behavior, aggression, and violent behavior. Results: Sixty-seven studies of good methodological quality and clinical interest and relevance were identified. Studies including children and adolescents were relatively limited, because few atypical antipsychotics have been approved by the Food and Drug Administration (FDA). All the medications included in this review (risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole and clozapine) have some effectiveness in treating aggression in children and adolescents, and choices should be based on clinical indications and side effects. Conclusions: There are few studies about the effectiveness and safety of atypical antipsychotics for the pediatric population, and further randomized controlled studies with larger groups of patients and more diagnostic categories, such as severe conduct disorder and oppositional defiant disorder, should be conducted to confirm the results reported up to date and to evaluate the impact of long-term use. Keywords: Aggression, violence, atypical antipsychotics, behavioral disorders, children, adolescents. ResumoObjetivo: Realizar uma revisão sistemática da literatura científica sobre o uso de antipsicóticos atípicos (APAs) no tratamento da agressividade patológica em crianças e adolescentes. Método: Foi realizada busca eletrônica nas bases de dados MEDLINE, SciELO e LILACS, de 1992 a agosto 2011, considerando artigos publicados em língua inglesa e portuguesa. Foram utilizadas associações das seguintes expressões: mental disease, child, adolescent, treatment, atypical antipsychotic, aggressive behaviour, aggression e violent behavior. Resultados: Foram identificados 67 artigos de boa qualidade metodológica, de relevância e interesse clínico para o tema em foco. De modo geral, os estudos são relativamente limitados para esta faixa etária, resultado do fato de poucos APAs terem sido aprovados pela Food and Drug Administration (FDA). Dentre as medicações consideradas nesta revisão (risperidona, olanzapina, quetiapina, ziprazidona, aripiprazol e clozapina), todas elas podem ter alguma efetividade no tratamento da agressividade em crianças e adolescentes, ficando a escolha baseada na indicação clínica e perfil de efeitos colaterais. Conclusão: O número ainda limitado de estudos acerca da efetividade e segurança na população pediátrica demanda pesquisas futuras com grupos maiores de pacientes e com mais categorias diagnósticas (como, por exemplo, as formas graves de transtorno de conduta e transtorno desafiador de oposição), desenhadas de forma randomizada e controlada. Assim poderão ser confirmados os achados até o momento e o impacto do uso em lo...

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Double-Blind, Placebo-Controlled Study of Risperidone for the Treatment of Disruptive Behaviors in Children With Subaverage Intelligence

Abstract: Risperidone was effective and well tolerated for the treatment of severely disruptive behaviors in children with subaverage IQ.

Cited by 415 publications

References 41 publications

Effects of risperidone on cognitive-motor performance and motor movements in chronically medicated children

Effects of risperidone on cognitive-motor performance and motor movements in chronically medicated children

Reward circuitry dysfunction in psychiatric and neurodevelopmental disorders and genetic syndromes: animal models and clinical findings

Atypical antipsychotics in the treatment of pathological aggression in children and adolescents: literature review and clinical recommendations

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