Effects of Risperidone on Conduct and Disruptive Behavior Disorders in Children With Subaverage IQs

Snyder, R. E.; Turgay, Atilla; Aman, Michael G.; Binder, Carin; Fisman, Sandra; Carroll, Alan M.

doi:10.1097/00004583-200209000-00002

Cited by 304 publications

(218 citation statements)

References 19 publications

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“…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: 90%

“…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: Behavioral Effectsmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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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“…ADHD affects 1-4% of children, representing a social burden (Biederman, 1998). Beside core symptoms of hyperactivity, impulsivity and impaired sustained attention, which are also found in other syndromes, ADHD children often display accompanying behavioral difficulties, including a disinhibited conduct and obsessive-compulsive symptoms (Snyder et al, 2002). According to the dominant model, ADHD is viewed as an executive dysfunction (Doyle, 2006;Castellanos et al, 2006;Willcutt et al, 2005), but alternative accounts present ADHD as a motivational dysfunction (Sonuga-Barke, 2005), arising from altered reward processes within fronto-striatal circuits (Sagvolden and Sergeant, 1998;Oades, 1998).…”

mentioning

confidence: 99%

Increased impulsive behavior and risk proneness following lentivirus-mediated dopamine transporter over-expression in rats' nucleus accumbens

et al. 2009

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Abstract-Multiple theories have been proposed for sensation seeking and vulnerability to impulse-control disorders [Zuckerman M, Kuhlman DM (2000) Personality and risk-taking: Common biosocial factors. J Pers 68:999 -1029], and many of these rely on a dopamine system deficit. Available animal models reproduce only some behavioral symptoms and seem devoid of construct validity. We used lentivirus tools for over-expressing or silencing the dopamine transporter (DAT) and we evaluated the resulting behavioral profiles in terms of motivation and self-control. Wistar adult rats received stereotaxic inoculation of a lentivirus that allowed localized intra-accumbens delivery of a DAT gene enhancer/ silencer, or the green fluorescent protein, GFP. These animals were studied for intolerance to delay, risk proneness and novelty seeking. As expected, controls shifted their demanding from a large reward toward a small one when the delivery of the former was increasingly delayed (or uncertain). Interestingly, in the absence of general locomotor effects, DAT over-expressing rats showed increased impulsivity (i.e. a more marked shift of demanding from the large/ delayed toward the small/soon reward), and increased risk proneness (i.e. a less marked shift from the large/uncertain toward the small/sure reward), compared with controls. Rats with enhanced or silenced DAT expression did not show any significant preference for a novel environment. In summary, consistent with literature on comorbidity between attentiondeficit/hyperactivity disorder and pathological gambling, we demonstrate that DAT over-expression in rats' nucleus accumbens leads to impulsive and risk prone phenotype. Thus, a reduced dopaminergic tone following altered accumbal DAT function may subserve a sensation-seeker phenotype and the vulnerability to impulse-control disorders.

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“…Some of the few studies reporting stimulant-antipsychotic co-treatment effects did not find that stimulants reduced side effects when combined with antipsychotics. One such study pooled data from two placebo-controlled, 8-week trials Snyder et al 2002) of risperidone in 155 children aged 5-12 years with disruptive behaviors and subaverage intelligence, and compared, in a post hoc analysis, those children who had risperidone added to ongoing stimulant treatment (47.1%) to children taking risperidone alone (52.9%) (Aman et al 2004). In this study, 91% of patients in the stimulant co-treated group, as well as in the nonstimulant group, reported at least one side effect.…”

mentioning

confidence: 99%

“…In a related, open-label extension study, 77 completers from the two short-term studies noted above Snyder et al 2002) were followed on risperidone for up to 1 year . All but 1 of those youths (98.7%) experienced at least one adverse event, with somnolence remaining the most common (51.9%), followed by headache (37.7%) and weight gain (36.4%).…”

mentioning

confidence: 99%

Lack of Effect of Stimulant Combination with Second-Generation Antipsychotics on Weight Gain, Metabolic Changes, Prolactin Levels, and Sedation in Youth with Clinically Relevant Aggression or Oppositionality

Penzner

Dudas

Saito

et al. 2009

Journal of Child and Adolescent Psychopharmacology

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Background: Second-generation antipsychotics (SGAs) are associated with weight gain, metabolic abnormalities, sedation= sleep disturbance, and prolactin abnormalities, especially in youths. Although stimulants have opposing dopamine receptor and adverse effects, it is unclear whether stimulant co-treatment counteracts the therapeutic or side effects of antipsychotics. Methods: This was a naturalistic cohort study including 153 antipsychotic trials in youths aged 4-19 (mean, 11.3 AE 3.0) years, started on an SGA for clinically significant aggression or oppositionality associated with oppositional defiant disorder, conduct disorder, disruptive behavior disorder not otherwise specified (NOS), impulse control disorder NOS, intermittent explosive disorder, Tourette's disorder, autistic disorder, and pervasive developmental disorder NOS. Patients underwent fasting assessments of body composition, lipids, glucose, insulin, prolactin, sedation, and general efficacy at baseline, weeks 4, 8, and 12, comparing patients co-prescribed stimulants (n ¼ 71) with those not co-prescribed stimulants (n ¼ 82). Results: Patients received risperidone (33.3%), aripiprazole (29.4%), quetiapine (18.4%), olanzapine (11.8%), ziprasidone (5.9%), or clozapine (0.7%). With and without adjustment for differences in baseline variables (sex, prior stimulant use, primary Diagnostic and Statistical Manual of Mental Disorders, 4 th edition [DSM-IV] disorders, co-morbid attentiondeficit=hyperactivity disorder [ADHD], present in 46.3% of youths not receiving stimulants, and some body composition parameters), patients on versus off stimulants did not differ on any of the assessed outcomes (all p values ! 0.1). Conclusions: In contrast to guidelines, stimulant use did not precede or accompany antipsychotic use during the current episode of aggression=oppositionality in almost half of those youths who had aggressive=oppositional behavior and a DSM-IV diagnosis of ADHD. At the clinically prescribed doses, stimulant co-treatment of SGAs did not seem to significantly reduce antipsychotic effects on body composition, metabolic parameters, prolactin, sedation, and broad efficacy.

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Effects of Risperidone on Conduct and Disruptive Behavior Disorders in Children With Subaverage IQs

Cited by 304 publications

References 19 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

Increased impulsive behavior and risk proneness following lentivirus-mediated dopamine transporter over-expression in rats' nucleus accumbens

Lack of Effect of Stimulant Combination with Second-Generation Antipsychotics on Weight Gain, Metabolic Changes, Prolactin Levels, and Sedation in Youth with Clinically Relevant Aggression or Oppositionality

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