Weight Gain in a Controlled Study of Risperidone in Children, Adolescents and Adults with Mental Retardation and Autism

Abstract

As part of an ongoing, prospective, ABA design, double-blind crossover study of risperidone versus placebo for the treatment of aggressive, destructive and self-injurious behavior in persons aged 6-65 years with mental retardation (MR) and autism, we measured the weight of 19 subjects at each study visit. We compared mean weight gain during the 16-week acute phase and 24-week open maintenance phase with that during the initial and middle placebo phases statistically, using a linear mixed model procedure. Results of the linear mixed model analysis showed that relative weight gain observed during the acute and maintenance drug phases was significantly greater than that observed during the initial and middle placebo phases respectively (p = .0001 and p = .0001). Over approximately a year, children aged 8-12 (n = 5) gained a mean of 8.2 kg (range = 2.7-17.7 kg); adolescents (n = 6) aged 13-16 gained a mean of 8.4 kg (range 3.6-15.5 kg); adults aged 21-51 (n = 8) gained a mean of 5.4 kg (range 0-9.5 kg). Weight gain observed in this controlled study of risperidone treatment in children, adolescents, and adults with MR and autism was significant. It may be greater in this population than in others reported and in this study was not limited to an acute effect only. Rate of weight gain diminished rapidly on tapering and stopping the drug. Further studies are urgently needed, including those incorporating diet and exercise programming.

Risperidone Treatment in 12 Children With Developmental Disorders and Attention-Deficit/Hyperactivity Disorder

“…The most common side effect reported was sedation in 2 patients, followed by tiredness and weight gain in 1 patient each. Earlier studies have reported weight gain, 20 chorea and dyskinesia, 21 reversible withdrawal dyskinesia, 22 and facial dystonia and amenorrhea 23 with the use of risperidone. However, in a study by Simon and colleagues, 24 traditional antipsychotics were substituted with risperidone in 10 individuals with mental retardation, and all participants evidenced improvement or resolution in side effects attributed to previous antipsychotic medication, with no worsening in behavioral or psychiatric status.…”

Risperidone-Induced Weight Gain in Referred Children with Autism Spectrum Disorders Is Associated with a Common Polymorphism in the 5-Hydroxytryptamine 2C Receptor Gene

“…For example, risperidone dose, concomitant medication use, age, pubertal status, gender, and baseline weight and body mass index (BMI) have not been predictive of weight gain in controlled studies (Hellings et al 2001;Aman et al 2005) and a retrospective chart review . A recent study, however, suggested that baseline BMI was negatively correlated with weight gain through long-term use of risperidone (Calarge et al 2009).…”

Effects of sub-chronic antipsychotic drug treatment on body weight and reproductive function in juvenile female rats

“…A 6-week double-blind study by Kumra et al (1996) in early-onset schizophrenic patients (mean age 14) reported an average weight increase of 6.5 kg after clozapine treatment. Furthermore, Hellings et al (2001) noted that parents and caregivers of children, adolescents and adult patients with mental retardation and autism described increased appetite in those receiving risperidone.…”