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

Abstract

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.

Risperidone Added to Psychostimulant in Children with Severe Aggression and Attention-Deficit/Hyperactivity Disorder: Lack of Effect on Attention and Short-Term Memory

“…In these comparisons, none of the variables showed treatment effects, leading to the conclusion that measurable changes in cognition were not occurring in the context of this portion of the clinical trial. Our present findings regarding the combination of risperidone and stimulant are consistent with the majority of reports on the cognitive effects of antipsychotic monotherapy in children with various psychiatric disorders, which found no meaningful effects (Aman et al 1991;Aman et al 2009) or improvements (Werry and Aman 1975;Troost et al 2006;Aman et al 2008).…”

“…Most measures showed no effect of risperidone, whereas the participants performed better with risperidone on a cancellation task (more correct detections) and on recognition of previously presented words. Aman et al (2009) compared risperidone and placebo in a crossover study that involved 16 children with IQ <84 (the majority with borderline IQ) who had been maintained on risperidone for disruptive behavior disorders. Accuracy was unaffected on two measures of short-term memory, and omission and commission errors were unchanged on a continuous performance task (CPT); however, hand steadiness was improved with risperidone on a measure of static tremor.…”

“…Accuracy was unaffected on two measures of short-term memory, and omission and commission errors were unchanged on a continuous performance task (CPT); however, hand steadiness was improved with risperidone on a measure of static tremor. Importantly, the participants in two of these studies had previously shown behavior changes in response to medication (Troost et al 2006;Aman et al 2009), which raises the question of whether performance was secondarily improved solely because of better behavioral compliance rather than any direct effect on cognition.…”

Efficacy of risperidone in children with disruptive behavioural disorders

“…and Snyder et al 21,22 . Aman et al 23 . examined cognitive and motor performances and dyskinetic movements of children on maintenance risperidone.…”

Pharmacological Intervention for Disruptive Behaviors in Intellectual and Developmental Disabilities

“…Aman et al (2009) compared risperidone and placebo effects on measures of sustained attention, memory, visuospatial matching, tremor, and seat activity and found significantly faster response times during the memory test and less tremor with risperidone in a mixed sample of children with ID and ASD. Aman et al (2009) compared risperidone and placebo effects on measures of sustained attention, memory, visuospatial matching, tremor, and seat activity and found significantly faster response times during the memory test and less tremor with risperidone in a mixed sample of children with ID and ASD.…”