A Retrospective Study of Long Acting Risperidone Use to Support Treatment Adherence in Youth with Conduct Disorder

Abstract

ObjectiveRisperidone has been widely used to control aggression and conduct disorder (CD) in youth; however, treatment compliance is a major problem in CD. Our aim is to evaluate the effectiveness and tolerability of long-acting risperidone (LAR) in treating nonadherent cases.MethodsThe medical records of children and adolescents who had CD and were nonadherent to conventional drugs and psychosocial interventions (and therefore taking LAR) were reviewed. Informed consent on offlabel use of LAR was obtained from the parents. Clinical Global Impression (CGI) Severity (CGI-S) and CGI-Improvement scales were used and baseline and end points were compared.ResultsThe study comprised 14 children and adolescents (5 girls, 9 boys). All had comorbid disorders: substance use disorder (n=8), attention deficit hyperactivity disorder (n=6), and major depression (n=2). Mean duration of LAR use was 3.1 months (1.5–8 months). We observed significant improvements in the baseline and endpoint CGI-S scores for CD in all but one patient (Z=−3.198; p<0.001). Only mild adverse effects were observed: weight gain (n=2), sedation (n=1), leg cramps (n=1), and increased appetite with no weight gain (n=1).ConclusionLAR is effective and tolerable for patients with CD who can’t be medicated with oral preparations due to non-adherence to treatment. Even short-term LAR use is effective to get compliance. As CD predicts numerous problems in adulthood, appropriate treatment is crucial. To our knowledge, this is the first study on LAR use in youth with CD. The use of LAR deserves careful consideration and further controlled studies are needed to confirm our findings.

Eating cognitions, emotions and behaviour under treatment with second generation antipsychotics: A systematic review and meta-analysis

“… Appetite decrease: -1, 4%. Demirkaya et al (2017) 14 Conduct disorder 13.9 ± 2.9 Retrospective Initial dose 25 mg/d risperidone Mean 3.1 months 1.5–8 months Appetite Reported Appetite increase (# 1) with no weight gain. Moore et al (2013) 115 Eating disorder 13 ± 1.60 Retrospective 56 mg/d quetiapine, 6.8 mg/d olanzapine & 1 mg/d risperidone 2 ± 1.52 years Binge eating Routine assessment using a standardised assessment document -SGAs associated with new onset of binge eating.…”

Antipsychotics in the Management of Disruptive Behavior Disorders in Children and Adolescents: An Update and Critical Review

“…However, it must be borne in mind that these results were obtained in the context of low-dose antipsychotic use in carefully selected and monitored study populations; it is possible that extrapyramidal or cognitive adverse effects could appear when antipsychotics are prescribed for DBDs at higher doses or longer durations [ 70 ]. Adverse effects, such as sedation and enuresis, though not listed as “severe” by study authors, can also cause significant distress and social and academic dysfunction in this age group and should also be taken into account when prescribing antipsychotics to children with DBDs [ 71 , 72 ].…”

Antipsychotics in the Management of Disruptive Behavior Disorders in Children and Adolescents: An Update and Critical Review

“…This is a welcome trend, as there is an urgent need to examine the safety and efficacy of these drugs in ethnically diverse populations. Given that antipsychotics are often used "off-label" in these countries, sometimes in formulations that are not approved in this age group [61], the results of this research should stimulate more rational prescribing practices in these settings.…”