Head-to-Head Comparison of Aripiprazole and Risperidone in the Treatment of ADHD Symptoms in Children with Autistic Spectrum Disorder and ADHD: A Pilot, Open-Label, Randomized Controlled Study

Lamberti, Marco; Siracusano, Rosamaria; Italiano, Domenico; Alosi, N.; Cucinotta, Francesca; Rosa, Gabriella Di; Germanò, Eva; Spina, Edoardo; Gagliano, Antonella

doi:10.1007/s40272-016-0183-3

Cited by 32 publications

(29 citation statements)

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“…In particular, three patients in the aripiprazole group had PRL level below the normal range (2-18 ng/mL). This is consistent with findings obtained by a previous investigation (31).…”

Section: Monitoring Of Parameters Over Timesupporting

confidence: 94%

“…Our study has found no statistically significant differences in patients treated continuously for 1 year with risperidone or aripiprazole in relation to fasting glucose, total cholesterol, and triglycerides, as well as in white blood cell concentration and neutrophil percentage. These findings are in agreement with scientific literature (25,31) and support the relative safety of these two APs in terms of these metabolic parameters.…”

Section: Monitoring Of Parameters Over Timesupporting

confidence: 92%

“…Our results show a slight but statistically significant increase in heart rate values for both treatment groups. The increase was more noticeable at 6 months, in line with previously reported literature (31). These changes in heart rate associated with the administration of APs are unlikely to be clinically significant.…”

Section: Monitoring Of Parameters Over Timesupporting

confidence: 91%

“…Concerning anthropometric variables, we observed a statistically significant increase in BMI for both risperidone and aripiprazole treatment groups. This is in line with results from a previous open-label, randomized controlled study (31) and a number of retrospective observational investigations (32)(33)(34). A higher mean BMI was observed in patients treated with aripiprazole.…”

Section: Monitoring Of Parameters Over Timesupporting

confidence: 90%

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Safety and Tolerability of Antipsychotic Drugs in Pediatric Patients: Data From a 1-Year Naturalistic Study

Cicala

Santoro

Tata³

et al. 2020

Front. Psychiatry

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Background: Antipsychotic drugs (APs) are increasingly used to treat a variety of psychiatric disorders in children and adolescents. However, their safety and tolerability profiles, when used in a developmental age context, show different characteristics from the ones observed in adult patients. Treatment with APs in pediatric patients is often long-term. However, the tolerability data regarding these patients mostly derive from short-term studies.Methods: Starting from April 2017, for a 1-year period, patients between 4 and 18 years of age followed by five units of developmental age neuropsychiatry, who initiated a treatment with at least an AP (ATC class N05A) were included into the study. Patient-related data have been collected at baseline and regularly thereafter, as allowed by the clinical routine. Changes to continuous variables over time have been analyzed using a linear mixed model in subsamples of our population treated with risperidone or aripiprazole.Results: During the observation period, 158 patients were initially enrolled, but only 116 completed 12 months of therapy with an AP. Risperidone was the most used AP (n = 52) followed by aripiprazole (n = 44) and olanzapine (n = 7). For both the aripiprazole and risperidone groups, the mean body mass index (BMI) (P < 0.001 for both groups) and heart rate (P = 0.026 for aripiprazole group and P < 0.001 for the risperidone one) values significantly increased over time. The mean prolactin concentration value significantly increased over time only in the risperidone group (P = 0.04). Eighty-six patients experienced at least one adverse drug reaction (ADR), accounting for a total of 238 specific reactions, with the most frequent being weight gain (n = 34), increased serum prolactin levels (n = 21), hyperphagia (n = 20), and hypercholesterolemia (n = 14). Among these, only 24 ADRs were classifiable as serious.Cicala et al. Antipsychotic Drugs in Pediatric PatientsConclusions: The results of this study confirm that risperidone and aripiprazole are relatively well-tolerated therapeutic options for the treatment of a variety of psychiatric disorders in pediatric patients. However, in findings such as statistically significant increments of BMI and heart rate mean values, the variations over time in prolactin levels observed with risperidone and the differences between the two drugs remark the necessity of systematic monitoring.

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“…In particular, three patients in the aripiprazole group had PRL level below the normal range (2-18 ng/mL). This is consistent with findings obtained by a previous investigation (31).…”

Section: Monitoring Of Parameters Over Timesupporting

confidence: 94%

Section: Monitoring Of Parameters Over Timesupporting

confidence: 92%

Section: Monitoring Of Parameters Over Timesupporting

confidence: 91%

Section: Monitoring Of Parameters Over Timesupporting

confidence: 90%

See 2 more Smart Citations

Safety and Tolerability of Antipsychotic Drugs in Pediatric Patients: Data From a 1-Year Naturalistic Study

Cicala

Santoro

Tata³

et al. 2020

Front. Psychiatry

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“…Lamberti et al compared risperidone and aripiprazole in the treatment of attention deficit hyperactivity (ADHD) symptoms in children with ASD, with 37 of the children completing the 24 weeks of treatment. They suggested that both aripiprazole and risperidone are effective in ameliorating the ADHD symptoms in ASD (Lamberti et al 2016). Moreover, Ghanizadeh and Sahraeizadah (2014) reported that the safety and efficacy of aripiprazole and risperidone were comparable in their head-to-head comparison study.…”

Section: İlker Tascimentioning

confidence: 99%

Symposium Oral Presentations

Çeri

Aykutlu

Görker

et al. 2018

Psychiatry and Clinical Psychopharmacology

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Objective: It has been proposed that anything does not kill you make you stronger. Although it might be true in adult cases, children whose psychological life begin in the parental mind and shaped by the experiences during the early period of life are not as strong as adult against adverse effects of stressful events. Internalization of objects and emerging of internally working models, concept of normality and abnormality that will be the main ground for the understanding of the world in later life are emerged during childhood. That is why anything does not kill a child will shape its mind that might have everlasting effects on child. The clinical characteristics and pharmacological treatment process of a 10-yearold boy with Autism Spectrum Disorder who had drug refractory self-injurious behaviour Hasan Cem Aykutlu and Işık GörkerDepartment of Child and Adolescent Psychiatry, Trakya University School of Medicine, Edirne, Turkey E-mail address: hasancemay@hotmail.com ABSTRACT Objective: Irritability is the most common co-occurring symptom and common target of pharmacotherapy in children with Autism Spectrum Disorders (ASD) [1][2][3]. FDA-approved agents risperidone and aripiprazole are commonly used in irritability and became the firstline treatment, but the growing evidence has shown that a group of children with ASD comorbid, especially with intellectual disability, do not respond to the treatment [1,3]. In a recent research, drug refractory behaviours in children with ASD defined as aggression, selfinjury, and tantrums requiring medication adjustment despite trials of risperidone and aripiprazole or three or more psychotropic drugs targeting irritability [1]. In this presentation, it is aimed to review current literature with the case report of a child with ASD who had drug refractory self-injurious behaviour. Case presentation: Ten-year-old boy, who diagnosed with ASD and attention-deficit/hyperactivity disorder (ADHD) and intellectual disability, has been followed in our outpatient clinic since he was 3 years old. He had been prescribed risperidone up to 2 mg/day for irritability and hyperactivity between 3 and 9 years old, and had responded well to the treatment. At age 10, his family described the increase in irritability, aggression, tantrums, and severe self-injurious behaviour with his ongoing treatment. His Clinic Global Impression (CGI)-Severity score was 7/7, Aberrant Behaviour Checklist (ABC)-Irritability score was 41/45 and ABC-Hyperactivity score was 40/48. Neurological and medical comorbidities were not detected in the examination. There was limited or no response to the treatment with various trials of risperidone, aripiprazole, haloperidol, zuclopenthixol, benzodiazepines, methylphenidate, atomoxetine, valproate, and PSYCHIATRY AND CLINICAL PSYCHOPHARMACOLOGY, 2018 VOL. 28, NO. S1, 297-391 https://doi.org/10.1080/24750573.2018 naltrexone. After the combined treatment of risperidone 2 mg/day with clonidine 0.3 mg/day, well and sustainable treatment response of irritability and self-in...

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Risperidone versus aripiprazole fracture risk in children and adolescents with autism spectrum disorders

et al. 2021

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Risperidone and aripiprazole, commonly used antipsychotics in children with autism spectrum disorder (ASD), have previously been associated with elevated fracture risk in other populations. The aim of this study was to evaluate and compare the risk of fracture among children with ASD using risperidone or aripiprazole. This was a retrospective, propensity‐score matched cohort study, set between January 2013 and December 2018. We used the MarketScan Medicaid insurance data, which covers multiple states of the United States. We included ASD children aged 2–18 years, who were new users of aripiprazole or risperidone and with no prior history of antipsychotic use or fractures. The main exposure was the continued use of aripiprazole or risperidone. The incidence rates of any fracture during follow‐up were evaluated, and the risk between aripiprazole and risperidone was compared via Cox‐proportional hazard models. Results were stratified by age, sex, duration of exposure and fracture site. In total, 3312 patients (78% male; mean [SD] age 11.0 [3.7] years) were identified for each cohort. Over the full duration of follow‐up, fracture incidence rates per 1000 patient‐years were 23.2 for risperidone and 38.4 for aripiprazole (hazard ratio and 95% confidence interval: 0.60 [0.44–0.83]). Risks were similar between cohorts throughout the first 180 days on treatment, but significantly higher in the aripiprazole group thereafter. Extremity fractures drove most of the increased risk, with the biggest differences in lower leg and ankle fractures. Differences widened for children aged 10 years or younger (HR [95% CI]: 0.47 [0.30–0.74]). In conclusion, compared to aripiprazole, risperidone was associated with 40% lower risk of fracture. Further analysis on the mechanism and long‐term bone health of antipsychotic‐treated children with ASD is warranted. Lay summary We compared the risk of bone fractures among 6624 children with autism spectrum disorder (ASD), half of whom used risperidone and half of whom used aripiprazole. Taking other factors into account, risks were similar between the two groups throughout the first 180 days on treatment, but significantly higher in the aripiprazole group thereafter. The biggest differences were in lower leg and ankle fractures. Overall, compared with aripiprazole, risperidone was associated with 40% lower risk of fracture.

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Head-to-Head Comparison of Aripiprazole and Risperidone in the Treatment of ADHD Symptoms in Children with Autistic Spectrum Disorder and ADHD: A Pilot, Open-Label, Randomized Controlled Study

Abstract: Our study confirms the efficacy of both aripiprazole and risperidone in ameliorating ADHD symptoms of children also presenting with ASD.

Cited by 32 publications

References 64 publications

Safety and Tolerability of Antipsychotic Drugs in Pediatric Patients: Data From a 1-Year Naturalistic Study

Safety and Tolerability of Antipsychotic Drugs in Pediatric Patients: Data From a 1-Year Naturalistic Study

Symposium Oral Presentations

Risperidone versus aripiprazole fracture risk in children and adolescents with autism spectrum disorders

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