QUESTION:
Dear Dr. Heller,
I am a RN working on my MSW and doing research on the use of Risperdal in adolescents with behavior problems that are so severe that they are hospitalized. I am in the beginning stages of my research and have just begun to research the literature. I am not finding much on this subject. To your knowledge, has the use of Risperdal on children been studied? I have not been able to find any. Some of the psychiatrists at work are using Risperdal on children that are not diagnosed with schizophrenia or with a psychotic disorder. They are having good actions on behavior. Any suggestions or help would be appreciated.
ANSWER:
As with most medications for children, there is very little information. Risperdal
(risperidone) clearly works, however. When the BPD is present in adolescence I have found
that Risperdal works far better as needed. The body seems to respond to both taking it and
having it leave their body. This has not been the case with other diagnoses treated with
Risperdal.
To me the most important study on the subject was reported in the Journal of Child and
Adolescent Psychopharmacology 1988;8(1):49-59, Schreier HA. It was performed at the
Department of Psychiatry at Children's Hospital - Oakland, California.
It was an open trial with 11 children and adolescents (ages 5-16, mean 9.8 years) who had
mood disorder symptoms, aggressive and violent behavior, and marked management problems -
and they had responded inadequately to several mood-stabilizing medications. The
risperidone doses were low (0.75-2.5mg daily). None of the children got worse. 8/11
responded within days. The improvement was judged to be moderate to marked in 7 of those
8. Seven of the eight responders were taking either lithium, Tegretol or Depakote in low
doses. Side effects were rarely a problem - weight gain and mild sedation.
The authors concluded that "pending controlled studies, these preliminary findings
suggest that risperidone - alone or in combination with mood stabilizers - may be of value
in treating children and adolescents with mood disorders (especially subthreshold bipolar
disorder) and aggressive behavior."
March 31, 2001
