Long-Term Effects of Risperidone in Children With Autism Spectrum Disorders: A Placebo Discontinuation Study
The short-term benefit of risperidone in ameliorating severe disruptive behavior in pediatric patients with autism spectrum disorders is well established; however, only one placebo-controlled, long-term study of efficacy is available. Thirty-six children with an autism spectrum disorder (5-17 years...
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| Veröffentlicht in: | Journal of the American Academy of Child and Adolescent Psychiatry 2005-11, Vol.44 (11), p.1137-1144 |
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| creator | Troost, Pieter W. Lahuis, Bertine E. Steenhuis, Mark-Peter Ketelaars, Cees E.J. Buitelaar, Jan K. van Engeland, Herman Scahill, Lawrence Minderaa, Ruud B. Hoekstra, Pieter J. |
| description | The short-term benefit of risperidone in ameliorating severe disruptive behavior in pediatric patients with autism spectrum disorders is well established; however, only one placebo-controlled, long-term study of efficacy is available.
Thirty-six children with an autism spectrum disorder (5-17 years old) accompanied by severe tantrums, aggression, or self-injurious behavior, started 8-week open-label treatment with risperidone. Responders (n = 26) continued treatment for another 16 weeks, followed by a double-blind discontinuation (n = 24; two patients discontinued treatment because of weight gain) consisting of either 3 weeks of taper and 5 weeks of placebo only or continuing use of risperidone. Relapse was defined as a significant deterioration of symptoms based on clinical judgment and a parent questionnaire.
Risperidone was superior to placebo in preventing relapse: this occurred in 3 of 12 patients continuing on risperidone versus 8 of 12 who switched to placebo (p = .049). Weight gain, increased appetite, anxiety, and fatigue were the most frequently reported side effects.
This study indicates the effectiveness of risperidone during a period of several months, reducing disruptive behavior in about half of the children with autism spectrum disorders. The results provide a rationale for the continuing use of risperidone beyond 6 months, although considerable weight gain can limit the use of this agent. |
| doi_str_mv | 10.1097/01.chi.0000177055.11229.76 |
| format | Article |
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Thirty-six children with an autism spectrum disorder (5-17 years old) accompanied by severe tantrums, aggression, or self-injurious behavior, started 8-week open-label treatment with risperidone. Responders (n = 26) continued treatment for another 16 weeks, followed by a double-blind discontinuation (n = 24; two patients discontinued treatment because of weight gain) consisting of either 3 weeks of taper and 5 weeks of placebo only or continuing use of risperidone. Relapse was defined as a significant deterioration of symptoms based on clinical judgment and a parent questionnaire.
Risperidone was superior to placebo in preventing relapse: this occurred in 3 of 12 patients continuing on risperidone versus 8 of 12 who switched to placebo (p = .049). Weight gain, increased appetite, anxiety, and fatigue were the most frequently reported side effects.
This study indicates the effectiveness of risperidone during a period of several months, reducing disruptive behavior in about half of the children with autism spectrum disorders. The results provide a rationale for the continuing use of risperidone beyond 6 months, although considerable weight gain can limit the use of this agent.</description><identifier>ISSN: 0890-8567</identifier><identifier>EISSN: 1527-5418</identifier><identifier>DOI: 10.1097/01.chi.0000177055.11229.76</identifier><identifier>PMID: 16239862</identifier><identifier>CODEN: JAAPEE</identifier><language>eng</language><publisher>Hagerstown, MD: Elsevier Inc</publisher><subject>Adolescent ; Antipsychotic Agents - adverse effects ; Antipsychotic Agents - therapeutic use ; Autism ; Autism Spectrum Disorders ; Autistic Disorder - diagnosis ; Autistic Disorder - drug therapy ; Autistic Disorder - psychology ; Behavior Disorders ; Biological and medical sciences ; Child ; Child Behavior Disorders - diagnosis ; Child Behavior Disorders - drug therapy ; Child Behavior Disorders - psychology ; Child clinical studies ; Child, Preschool ; Children ; Children & youth ; Developmental disorders ; Double-Blind Method ; Drug Therapy ; Female ; Follow-Up Studies ; Humans ; Infantile autism ; Male ; Medical Evaluation ; Medical sciences ; Neuropharmacology ; Outcomes of Treatment ; pervasive developmental disorder ; Pervasive Developmental Disorders ; Pharmacology ; Pharmacology. Drug treatments ; Placebo effect ; Psychiatric Services ; Psycholeptics: tranquillizer, neuroleptic ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Psychopharmacology ; Recurrence ; Risperidone ; Risperidone - adverse effects ; Risperidone - therapeutic use ; Self Destructive Behavior ; tantrums ; Treatment Outcome</subject><ispartof>Journal of the American Academy of Child and Adolescent Psychiatry, 2005-11, Vol.44 (11), p.1137-1144</ispartof><rights>2005 The American Academy of Child and Adolescent Psychiatry</rights><rights>2006 INIST-CNRS</rights><rights>Copyright Lippincott Williams & Wilkins Nov 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-1864b780c35b1ef3620c1f1aa18dd3b537de41d09ba4ee17de29e02d23d1920b3</citedby><cites>FETCH-LOGICAL-c456t-1864b780c35b1ef3620c1f1aa18dd3b537de41d09ba4ee17de29e02d23d1920b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1097/01.chi.0000177055.11229.76$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,30998,45994</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ728038$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17226978$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16239862$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Troost, Pieter W.</creatorcontrib><creatorcontrib>Lahuis, Bertine E.</creatorcontrib><creatorcontrib>Steenhuis, Mark-Peter</creatorcontrib><creatorcontrib>Ketelaars, Cees E.J.</creatorcontrib><creatorcontrib>Buitelaar, Jan K.</creatorcontrib><creatorcontrib>van Engeland, Herman</creatorcontrib><creatorcontrib>Scahill, Lawrence</creatorcontrib><creatorcontrib>Minderaa, Ruud B.</creatorcontrib><creatorcontrib>Hoekstra, Pieter J.</creatorcontrib><title>Long-Term Effects of Risperidone in Children With Autism Spectrum Disorders: A Placebo Discontinuation Study</title><title>Journal of the American Academy of Child and Adolescent Psychiatry</title><addtitle>J Am Acad Child Adolesc Psychiatry</addtitle><description>The short-term benefit of risperidone in ameliorating severe disruptive behavior in pediatric patients with autism spectrum disorders is well established; however, only one placebo-controlled, long-term study of efficacy is available.
Thirty-six children with an autism spectrum disorder (5-17 years old) accompanied by severe tantrums, aggression, or self-injurious behavior, started 8-week open-label treatment with risperidone. Responders (n = 26) continued treatment for another 16 weeks, followed by a double-blind discontinuation (n = 24; two patients discontinued treatment because of weight gain) consisting of either 3 weeks of taper and 5 weeks of placebo only or continuing use of risperidone. Relapse was defined as a significant deterioration of symptoms based on clinical judgment and a parent questionnaire.
Risperidone was superior to placebo in preventing relapse: this occurred in 3 of 12 patients continuing on risperidone versus 8 of 12 who switched to placebo (p = .049). Weight gain, increased appetite, anxiety, and fatigue were the most frequently reported side effects.
This study indicates the effectiveness of risperidone during a period of several months, reducing disruptive behavior in about half of the children with autism spectrum disorders. The results provide a rationale for the continuing use of risperidone beyond 6 months, although considerable weight gain can limit the use of this agent.</description><subject>Adolescent</subject><subject>Antipsychotic Agents - adverse effects</subject><subject>Antipsychotic Agents - therapeutic use</subject><subject>Autism</subject><subject>Autism Spectrum Disorders</subject><subject>Autistic Disorder - diagnosis</subject><subject>Autistic Disorder - drug therapy</subject><subject>Autistic Disorder - psychology</subject><subject>Behavior Disorders</subject><subject>Biological and medical sciences</subject><subject>Child</subject><subject>Child Behavior Disorders - diagnosis</subject><subject>Child Behavior Disorders - drug therapy</subject><subject>Child Behavior Disorders - psychology</subject><subject>Child clinical studies</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Children & youth</subject><subject>Developmental disorders</subject><subject>Double-Blind Method</subject><subject>Drug Therapy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Infantile autism</subject><subject>Male</subject><subject>Medical Evaluation</subject><subject>Medical sciences</subject><subject>Neuropharmacology</subject><subject>Outcomes of Treatment</subject><subject>pervasive developmental disorder</subject><subject>Pervasive Developmental Disorders</subject><subject>Pharmacology</subject><subject>Pharmacology. Drug treatments</subject><subject>Placebo effect</subject><subject>Psychiatric Services</subject><subject>Psycholeptics: tranquillizer, neuroleptic</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Psychopharmacology</subject><subject>Recurrence</subject><subject>Risperidone</subject><subject>Risperidone - adverse effects</subject><subject>Risperidone - therapeutic use</subject><subject>Self Destructive Behavior</subject><subject>tantrums</subject><subject>Treatment Outcome</subject><issn>0890-8567</issn><issn>1527-5418</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkF2P1CAUhonRuOPqPzCGbOJlK4e2QPduMjt-ZRKNu8ZLQoE6bFqYhdZk_73MTuPcys0JvM_hnDwIXQEpgbT8A4FS711J8gHOSdOUAJS2JWfP0AoayoumBvEcrYhoSSEaxi_Qq5Tun3ghXqILYLRqBaMrNOyC_13c2Tjibd9bPSUcevzDpYONzgRvsfN4s3eDidbjX27a4_U8uTTi20Om4zziG5dCNDama7zG3welbReOjzr4yflZTS54fDvN5vE1etGrIdk3S71EPz9u7zafi923T182612h64ZNBQhWd1wQXTUd2L5ilGjoQSkQxlRdU3FjazCk7VRtLeQbbS2hhlYGWkq66hJdnf49xPAw2zTJ-zBHn0dKCpQ1LanqDF2fIB1DStH28hDdqOKjBCKPniUBmT3Ls2f55FlylpvfLRPmbrTm3LqIzcD7BVBJq6GPymuXzhynlLVcZO7ticu69b94-5VTQapjfLPEWdcfZ6NM2lmvrXEx65cmuP9Z9y9sIqXT</recordid><startdate>20051101</startdate><enddate>20051101</enddate><creator>Troost, Pieter W.</creator><creator>Lahuis, Bertine E.</creator><creator>Steenhuis, Mark-Peter</creator><creator>Ketelaars, Cees E.J.</creator><creator>Buitelaar, Jan K.</creator><creator>van Engeland, Herman</creator><creator>Scahill, Lawrence</creator><creator>Minderaa, Ruud B.</creator><creator>Hoekstra, Pieter J.</creator><general>Elsevier Inc</general><general>Lippincott Williams & Wilkins</general><general>Lippincott</general><general>Elsevier BV</general><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>K9.</scope></search><sort><creationdate>20051101</creationdate><title>Long-Term Effects of Risperidone in Children With Autism Spectrum Disorders: A Placebo Discontinuation Study</title><author>Troost, Pieter W. ; Lahuis, Bertine E. ; Steenhuis, Mark-Peter ; Ketelaars, Cees E.J. ; Buitelaar, Jan K. ; van Engeland, Herman ; Scahill, Lawrence ; Minderaa, Ruud B. ; Hoekstra, Pieter J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-1864b780c35b1ef3620c1f1aa18dd3b537de41d09ba4ee17de29e02d23d1920b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Adolescent</topic><topic>Antipsychotic Agents - adverse effects</topic><topic>Antipsychotic Agents - therapeutic use</topic><topic>Autism</topic><topic>Autism Spectrum Disorders</topic><topic>Autistic Disorder - diagnosis</topic><topic>Autistic Disorder - drug therapy</topic><topic>Autistic Disorder - psychology</topic><topic>Behavior Disorders</topic><topic>Biological and medical sciences</topic><topic>Child</topic><topic>Child Behavior Disorders - diagnosis</topic><topic>Child Behavior Disorders - drug therapy</topic><topic>Child Behavior Disorders - psychology</topic><topic>Child clinical studies</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Children & youth</topic><topic>Developmental disorders</topic><topic>Double-Blind Method</topic><topic>Drug Therapy</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Infantile autism</topic><topic>Male</topic><topic>Medical Evaluation</topic><topic>Medical sciences</topic><topic>Neuropharmacology</topic><topic>Outcomes of Treatment</topic><topic>pervasive developmental disorder</topic><topic>Pervasive Developmental Disorders</topic><topic>Pharmacology</topic><topic>Pharmacology. Drug treatments</topic><topic>Placebo effect</topic><topic>Psychiatric Services</topic><topic>Psycholeptics: tranquillizer, neuroleptic</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Psychopharmacology</topic><topic>Recurrence</topic><topic>Risperidone</topic><topic>Risperidone - adverse effects</topic><topic>Risperidone - therapeutic use</topic><topic>Self Destructive Behavior</topic><topic>tantrums</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Troost, Pieter W.</creatorcontrib><creatorcontrib>Lahuis, Bertine E.</creatorcontrib><creatorcontrib>Steenhuis, Mark-Peter</creatorcontrib><creatorcontrib>Ketelaars, Cees E.J.</creatorcontrib><creatorcontrib>Buitelaar, Jan K.</creatorcontrib><creatorcontrib>van Engeland, Herman</creatorcontrib><creatorcontrib>Scahill, Lawrence</creatorcontrib><creatorcontrib>Minderaa, Ruud B.</creatorcontrib><creatorcontrib>Hoekstra, Pieter J.</creatorcontrib><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Journal of the American Academy of Child and Adolescent Psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Troost, Pieter W.</au><au>Lahuis, Bertine E.</au><au>Steenhuis, Mark-Peter</au><au>Ketelaars, Cees E.J.</au><au>Buitelaar, Jan K.</au><au>van Engeland, Herman</au><au>Scahill, Lawrence</au><au>Minderaa, Ruud B.</au><au>Hoekstra, Pieter J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ728038</ericid><atitle>Long-Term Effects of Risperidone in Children With Autism Spectrum Disorders: A Placebo Discontinuation Study</atitle><jtitle>Journal of the American Academy of Child and Adolescent Psychiatry</jtitle><addtitle>J Am Acad Child Adolesc Psychiatry</addtitle><date>2005-11-01</date><risdate>2005</risdate><volume>44</volume><issue>11</issue><spage>1137</spage><epage>1144</epage><pages>1137-1144</pages><issn>0890-8567</issn><eissn>1527-5418</eissn><coden>JAAPEE</coden><abstract>The short-term benefit of risperidone in ameliorating severe disruptive behavior in pediatric patients with autism spectrum disorders is well established; however, only one placebo-controlled, long-term study of efficacy is available.
Thirty-six children with an autism spectrum disorder (5-17 years old) accompanied by severe tantrums, aggression, or self-injurious behavior, started 8-week open-label treatment with risperidone. Responders (n = 26) continued treatment for another 16 weeks, followed by a double-blind discontinuation (n = 24; two patients discontinued treatment because of weight gain) consisting of either 3 weeks of taper and 5 weeks of placebo only or continuing use of risperidone. Relapse was defined as a significant deterioration of symptoms based on clinical judgment and a parent questionnaire.
Risperidone was superior to placebo in preventing relapse: this occurred in 3 of 12 patients continuing on risperidone versus 8 of 12 who switched to placebo (p = .049). Weight gain, increased appetite, anxiety, and fatigue were the most frequently reported side effects.
This study indicates the effectiveness of risperidone during a period of several months, reducing disruptive behavior in about half of the children with autism spectrum disorders. The results provide a rationale for the continuing use of risperidone beyond 6 months, although considerable weight gain can limit the use of this agent.</abstract><cop>Hagerstown, MD</cop><pub>Elsevier Inc</pub><pmid>16239862</pmid><doi>10.1097/01.chi.0000177055.11229.76</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Antipsychotic Agents - adverse effects Antipsychotic Agents - therapeutic use Autism Autism Spectrum Disorders Autistic Disorder - diagnosis Autistic Disorder - drug therapy Autistic Disorder - psychology Behavior Disorders Biological and medical sciences Child Child Behavior Disorders - diagnosis Child Behavior Disorders - drug therapy Child Behavior Disorders - psychology Child clinical studies Child, Preschool Children Children & youth Developmental disorders Double-Blind Method Drug Therapy Female Follow-Up Studies Humans Infantile autism Male Medical Evaluation Medical sciences Neuropharmacology Outcomes of Treatment pervasive developmental disorder Pervasive Developmental Disorders Pharmacology Pharmacology. Drug treatments Placebo effect Psychiatric Services Psycholeptics: tranquillizer, neuroleptic Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychopharmacology Recurrence Risperidone Risperidone - adverse effects Risperidone - therapeutic use Self Destructive Behavior tantrums Treatment Outcome |
| title | Long-Term Effects of Risperidone in Children With Autism Spectrum Disorders: A Placebo Discontinuation Study |
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