Prescribing pattern and monitoring of children with neuro developmental disorders who were treated with risperidone at Lady Ridgeway Hospital, Colombo

Abstract

Background Behavioural disturbances are a common and challenging issue in the management of neurodevelopmental disorders in children. Treatment with pharmacological methods becomes necessary when these behaviours interfere with the general wellbeing and daily activities of these children, and with therapeutic programmess. There is a growing evidence base for the use of risperidone in this context. However the use of this medication is limited by its side-effect profile and the need for consistent and regular monitoring of these side-effects. Currently there is a paucity of data on the usage patterns of risperidone and its side-effect profile in children in Sri Lanka. Aims To analyse the prescribing patterns, indications and monitoring of risperidone in children with a primary diagnosis of a neurodevelopmental disorder who were prescribed risperidone. Methods This was a retrospective study carried out in University Psychological Medicine Unit, Lady Rideway Hospital for Children, Colombo (LRH). All children diagnosed with Neurodevelopmental disorders in the years 2013 and 2014 who were commenced on risperidone were included. Results A total of 27 children, 14 in 2013 and 13 in 2014 were prescribed risperidone. This amounted to 2.1% of the total number of referrals in 2013 and 2.6% in 2014. Majority were males (77.8%) and ages ranged from 4 years and 3 months to 13 years. The main diagnosis was attention deficit hyperactivity disorder (29%) and aggression was the commonest indication (40.74%). Initial weight of the patient was not measured in 59.3% and weight gain thereafter was monitored only in two patients. Other common side effects were not monitored. Tardive dyskinesia was reported in one child. Pre-treatment investigations were not done in a majority (92.59%). Post-treatment monitoring was not done in 44.4%. Conclusion Prescription of risperidone for neurodevelopmental disorders was found to be used very sparingly in this sample. Deficiencies in monitoring for side effects were identified highlighting the need for regular monitoring.