Risperidone for controlling aggressive behavior in a mentally retarded child: a case report.

Risperidone is an atypical antipsychotic agent with dopamine and serotonin antagonistic effects. It is an effective treatment for reducing aggressive behavior in adults with mental retardation. The use of risperidone in a severely mental retarded child with aggression is described. Risperidone was able to reduce the aggressive behavior in this patient. No serious side effect was found. This case illustrated that risperidone is effective and well tolerated in treating aggressive behavior in children with severe mental retardation. However, the anti-aggressive effect of risperidone in mentally retarded children remains to be seen in a larger sample-size study.

Tricyclic antidepressants for depressive disorders in children and adolescents: a meta-analysis of randomized-controlled trials.

The tricyclic antidepressants (TCAs) are effective for the treatment of adult depression. However, their efficacy of these in the treatment of children and adolescents with depression is equivocal. Therefore, it is necessary to determine the efficacy and acceptability of TCAs in the treatment of depressive disorders in children and adolescents. The databases of MEDLINE (from 1966 to October 1999) and Controlled Clinical Trials Registered (from 1980 to October 1999) were searched for randomized-controlled trials relevant to the use of TCAs for treating depressed children and adolescents. The reviewers also examined the reference lists of identified papers and that of a previous meta-analysis. In each trial, both nonresponse rates and dropout rates were taken into account and extracted on an intention-to-treat basis. The nonresponse-rate and dropout-rate odd ratios (ORs) with 95 per cent confidence intervals (95% CIs) of each trial and the pooled non-response-rate and dropout-rate ORs (95% CIs) of all trials were computed. Nine trials included in this meta-analysis were 2 amitriptyline, 3 desipramine, 2 imipramine, and 2 nortriptyline studies. By using a fixed-effect model, the pooled nonresponse-rate OR (95% CI) and the pooled dropout rate OR (95% CI) of antidepressant-treated group were 0.92 (0.57 to 1.47) and 2.14 (1.12 to 4.09), respectively. In summary, the evidence so far does not support that TCAs are more effective or more acceptable than placebo in the treatment of depressive disorders in children and adolescents. However, the studies of selective serotonin reuptake inhibitors and newer antidepressants for the treatment of these disorders should be further investigated.

Comparison of the efficacy and acceptability of atypical antipsychotic drugs: a meta-analysis of randomized, placebo-controlled trials.

Knowing the clinical differences of olanzapine, quetiapine, and risperidone would be of benefit for choosing an atypical antipsychotic drug. In order to compare their efficacy and acceptability, we conducted a meta-analysis of published, randomized, placebo-controlled trials by comparing the response and dropout rates of an atypical antipsychotic drug group and those of a placebo group. After a comprehensive search of study reports, the response and dropout rates of patients treated with an atypical antipsychotic drug and those treated with placebo were extracted on the intention-to-treat basis. The effect size with 95 per cent confidence interval (CI) of pooled data comparing the response and dropout rates of an atypical antipsychotic drug group and those of a placebo group were calculated by using the Peto method. The response-rate effect sizes (95% CIs) of olanzapine, quetiapine, and risperidone were 1.75 (1.06 to 2.89), 1.71 (1.20 to 2.42), and 3.28 (1.98 to 5.44), respectively. The dropout-rate effect sizes (95% CIs) of olanzapine, quetiapine, and risperidone were 0.55 (0.35 to 0.88), 0.65 (0.46 to 0.91), and 0.39 (0.24 to 0.62), respectively. In conclusion, olanzapine, quetiapine, and risperidone are more effective and more acceptable than placebo in treating schizophrenic patients. However, they are not different from each other in the respect of efficacy and acceptability. The cost of these agents should play an important role in choosing an atypical antipsychotic drug.