RISPERIDONE EFFECTS IN TREATMENT-RESISTANT ADOLESCENTS - PRELIMINARY CASE-REPORTS

Many children and adolescents with a variety of chronic psychiatric disorders receive long-term therapy with antipsychotic medications, Clinical case reports are presented of seven such adolescents, aged 11-17 years, who were treated with risperidone, All but one patient had prior unsuccessful treatments with various psychotropic medications, The use of risperidone seemed effective in six of the seven adolescents in a dose range of 1-4 mg daily,with a significant therapeutic response appearing in 1 to 3 weeks, The length of risperidone treatment ranged from 3 to 15 months, Some sedation/drowsiness was observed in two patients at the maximum recommended adult dose (6 mg/day), but this was resolved by a reduction in the daily dosage, There were no other significant adverse effects, including extrapyramidal reactions, Two adolescents received concomitant medication, including d-amphetamine and clomipramine, Risperidone appeared to be effective in relieving a variety of symptoms across a range of diagnoses, including schizophrenia, pervasive developmental disorder (PDD), and attention deficit disorder (ADD), but not obsessive compulsive disorder (OCD), Risperidone administration seemed most useful in treating paranoid ideation, aggressive and impulsive behavior, and mood swings, Controlled studies are needed to determine the efficacy and safety of risperidone in adolescents, If risperidone proves to be safe and effective over the long term; then clinicians may have a relatively nontoxic ''antipsychotic'' agent that could relieve disabling symptoms in nonpsychotic as well as psychotic children and adolescents.