ABSTRACT
Antipsychotic medications are commonly prescribed to children and adolescents. These medications, however, are not only prescribed for young patients with psychosis, but are often prescribed for youths with a variety of psychiatric disorders. Despite the fact that psychiatric illness in the pre-adult era is not rare, few controlled clinical trials have examined the short-term safety and efficacy of these agents in youths with psychosis. There are even fewer data regarding the long-term safety and efficacy of these agents in psychotic children and adolescents. As new antipsychotics become available, the study of these agents in youngsters with a variety of psychiatric illnesses may become an exciting new avenue for research.
Subject(s)
Antipsychotic Agents/therapeutic use , Mental Disorders/drug therapy , Adolescent , Adult , Age Factors , Antipsychotic Agents/administration & dosage , Autistic Disorder/drug therapy , Child , Child, Preschool , Clinical Trials as Topic , Drug Administration Schedule , Humans , Male , Mental Disorders/psychology , Mood Disorders/drug therapy , Risperidone/therapeutic use , Schizophrenia/drug therapy , Tic Disorders/drug therapy , Treatment OutcomeABSTRACT
Risperidone is a newly available atypical antipsychotic agent that has been reported to be associated with fewer extrapyramidal side effects (EPS) than conventional neuroleptics in adults with schizophrenia. This study assessed the safety and efficacy of risperidone in 16 children and adolescents (aged 9-20 years, mean 14.9 years) who were clinically diagnosed with psychotic disorders: 13 patients met DSM-III-R criteria for schizophrenia, 2 met criteria for schizoaffective disorder, and 1 had schizophreniform disorder. Eleven of the 16 patients had previous unsuccessful neuroleptic trials. Patient charts were reviewed by the patients' child and adolescent psychiatrist for diagnoses, clinical changes, and adverse events. Clinical response was assessed retrospectively using the Brief Psychiatric Rating Scale (BPRS) and the Clinical Global Impression (CGI) scale. With the risperidone dose titrated gradually, an optimal clinical response was found at a mean daily risperidone dose of 5.93 mg (range 2-10 mg). All but one of the 16 patients had an adequate clinical response to risperidone therapy. Statistically significant improvements were found in the CGI (p < 0.0001), the BPRS Total Score (p < 0.0001), and the BPRS Negative Symptom Score (p < 0.001). In general, only mild drug-induced side effects were experienced, with 5 patients developing mild sedation and 3 developing EPS. Risperidone appeared to be safe and effective in ameliorating symptoms of schizophrenia in this age group. It is speculated that the gradual titration of risperidone was crucial in achieving a relatively low rate of EPS.
