Risperidone for autism spectrum disorder

Jesner, Ora S; Aref‐Adib, Mehrnoosh; Coren, Esther

doi:10.1002/14651858.cd005040.pub2

Cited by 121 publications

(44 citation statements)

References 56 publications

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“…29 Since 2006, the US Food and Drug Administration has approved 2 atypical antipsychotic medications for treatment of irritability in autistic disorder (risperidone for children 5 to 16 years and aripiprazole for those aged 6 to 17 years), and the a-agonists guanfacine and clonidine have been approved for treatment of ADHD in new extended release formulations for children aged 6 to 17 years. The evidence for effectiveness of medications is gradually accumulating, 30,31 and physician prescription of these medicines to treat ASD and comorbid psychiatric conditions will likely increase with time.…”

Section: Studies Conducted By the Researchmentioning

confidence: 99%

Use of Psychotropic Medication in Children and Adolescents With Autism Spectrum Disorders

et al. 2012

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OBJECTIVES: The goal of this study was to examine rates of psychotropic medication use and identify associated child and family characteristics among children and adolescents with autism spectrum disorder (ASD) enrolled in an autism registry maintained by the Autism Treatment Network (ATN). METHODS:The sample, derived from the ATN registry, consists of 2853 children aged 2 to 17 years with diagnoses of ASD supported by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and the Autism Diagnostic Observation Schedule with available data on medication use. As part of initial enrollment in the registry, parents completed questionnaires on current psychotropic medication use, psychiatric and medical conditions, and demographics. RESULTS:Of the 2853 children, 763 (27%) were taking $1 psychotropic medication; 15% were prescribed 1 medication, 7.4% received 2 medications, and 4.5% received $3. Among children aged 3 to 5 years, 11% were taking $1 psychotropic medication; among 6-to 11-year-old children, 46%; and 66% of adolescents aged 12 to 17 years were taking at $1 psychotropic medication. A parent report of comorbid diagnosis of attention-deficit/hyperactivity disorder, bipolar disorder, obsessive-compulsive disorder, depression, or anxiety was associated with a high rate of use, with 80% receiving $1 psychotropic medication. Only 15% of children with no comorbid psychiatric disorder were taking psychotropic medication. Psychotropic medication use was also related to sleep and gastrointestinal problems. CONCLUSIONS:The prescription of psychotropic medications in this registry sample is highly related to comorbid psychiatric disorder. Other factors associated with use include medical comorbidities, race, ethnicity, and older age. Pediatrics 2012;130:S69-S76

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Section: Studies Conducted By the Researchmentioning

confidence: 99%

Use of Psychotropic Medication in Children and Adolescents With Autism Spectrum Disorders

et al. 2012

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“…Several open trials of risperidone in autism (reviewed in 3,4 ) and three placebo double-blind randomized controlled trials, [5][6][7] reported significant improvements in at least half of the patients evaluated. 4,8 Risperidone was shown to be well tolerated and effective in treating aggressiveness, hyperactivity, irritability, self-injurious behaviours, stereotipies, social withdrawal and lack of interest. According to one study, sensorimotor functioning and affectual relations (abrupt changes in affect, crying, temper outbursts) are also improved.…”

Section: Introductionmentioning

confidence: 99%

“…According to one study, sensorimotor functioning and affectual relations (abrupt changes in affect, crying, temper outbursts) are also improved. 6,8 Though risperidone significantly improves behavioural problems in most situations, it is also associated with mild adverse effects. The most common adverse drug reactions (ADR) while taking risperidone are sedation/drowsiness, weight gain, hyperprolactinemia and extrapyramidal symptoms, especially tardive dyskinesias.…”

Section: Introductionmentioning

confidence: 99%

“…The most common adverse drug reactions (ADR) while taking risperidone are sedation/drowsiness, weight gain, hyperprolactinemia and extrapyramidal symptoms, especially tardive dyskinesias. 4,8 As with all antipsychotics, there are considerable individual differences in response to risperidone, both regarding therapeutic and adverse effects, imposing some limitations with respect to the therapeutic use of the drug. Little has been reported on the factors, genetic or other, that underlie this individual variability in response to risperidone therapy, particularly for autism.…”

Section: Introductionmentioning

confidence: 99%

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Pharmacogenetics of risperidone therapy in autism: association analysis of eight candidate genes with drug efficacy and adverse drug reactions

Almeida²,

et al. 2009

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Little has been reported on the factors, genetic or other, that underlie the variability in individual response, particularly for autism. In this study we simultaneously explored the effects of multiple candidate genes on clinical improvement and occurrence of adverse drug reactions, in 45 autistic patients who received monotherapy with risperidone up to 1 year. Candidate genes involved in the pharmacokinetics (CYP2D6 and ABCB1) and pharmacodynamics (HTR2A, HTR2C, DRD2, DRD3, HTR6) of the drug, and the brain-derived neurotrophic factor (BDNF) gene, were analysed. Using the generalized estimating equation method these genes were tested for association with drug efficacy, assessed with the Autism Treatment Evaluation Checklist, and with safety and tolerability measures, such as prolactin levels, body mass index (BMI), waist circumference and neurological adverse effects, including extrapyramidal movements. Our results confirm that risperidone therapy was very effective in reducing some autism symptoms and caused few serious adverse effects. After adjusting for confounding factors, the HTR2A c.-1438G4A, DRD3 Ser9Gly, HTR2C c.995G4A and ABCB1 1236C4T polymorphisms were predictors for clinical improvement with risperidone therapy. The HTR2A c.-1438G4A, HTR2C c.68G4C (p.C33S), HTR6 c.7154-2542C4T and BDNF c.196G4A (p.V66M) polymorphisms influenced prolactin elevation. HTR2C c.68G4C and CYP2D6 polymorphisms were associated with risperidone-induced increase in BMI or waist circumference. We thus identified for the first time several genes implicated in risperidone efficacy and safety in autism patients. Although association results require replication, given the small sample size, the study makes a preliminary contribution to the personalized therapy of risperidone in autism.

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“…Thus, we included 17 systematic reviews. 4,[10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Results from systematic reviews A summary of each systematic review is presented narratively below. In addition, Table 2 4,10-25 presents the issues addressed, the main findings from each systematic review and the quality of the evidence (based on the GRADE approach).…”

Section: Search Resultsmentioning

confidence: 99%

What do Cochrane systematic reviews say about interventions for autism spectrum disorders?

et al. 2017

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CONTEXT AND OBJECTIVE: Autism spectrum disorders (ASDs) include autistic disorder, Asperger's disorder and pervasive developmental disorder. The manifestations of ASDs can have an important impact on learning and social functioning that may persist during adulthood. The aim here was to summarize the evidence from Cochrane systematic reviews on interventions for ASDs. DESIGN AND SETTING: Review of systematic reviews, conducted within the Discipline of Evidence-Based Medicine, Escola Paulista de Medicina, Universidade Federal de São Paulo. METHODS:We included and summarized the results from Cochrane systematic reviews on interventions for ASDs. RESULTS: Seventeen reviews were included. These found weak evidence of benefits from acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups, Theory of Mind cognitive model, aripiprazole, risperidone, tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRI); this last only for adults. No benefits were found for sound therapies, chelating agents, hyperbaric oxygen therapy, omega-3, secretin, vitamin B6/ magnesium and SSRI for children. CONCLUSION: Acupuncture, gluten and casein-free diets, early intensive behavioral interventions, music therapy, parent-mediated early interventions, social skill groups and the Theory of Mind cognitive model seem to have benefits for patients with autism spectrum disorders (very low to low-quality evidence). Aripiprazole, risperidone, tricyclic antidepressants and SSRI (this last only for adults) also showed some benefits, although associated with higher risk of adverse events. Experimental studies to confirm a link between probable therapies and the disease, and then high-quality long-term clinical trials, are needed. RESUMO MÉTODOS:Nós incluímos e resumimos os resultados de revisões sistemáticas Cochrane sobre intervenções para TEA. RESULTADOS: Foram incluídas 17 revisões que encontraram evidências fracas de benefícios da acupuntura, dietas isentas de glúten e caseína, intervenção comportamental intensiva precoce, musicoterapia, intervenção precoce mediada pelos pais, grupos de habilidades sociais, modelo cognitivo de Teoria da Mente, aripiprazol, risperidona, antidepressivos tricíclicos, inibidores seletivos da recaptação da serotonina (ISRS); o último apenas para adultos. Nenhum benefício foi encontrado com terapias sonoras, agentes quelantes, oxigenoterapia hiperbárica, ômega-3, secretina, vitamina B6/magnésio e ISRS para crianças. CONCLUSÃO: Acupuntura, dietas sem glúten e caseína, intervenção comportamental intensiva precoce, musicoterapia, intervenção precoce mediada pelos pais, grupos de habilidades sociais e modelo cognitivo de Teoria da Mente parecem ter benefícios para pacientes com TEA (evidência de qualidade muito baixa a baixa). Aripiprazol, risperidona, antidepressivos tricíclicos e ISRS (o último apenas para adultos) também apresentam algum benefício, embora estejam associados a maior risco de event...

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Risperidone for autism spectrum disorder

Cited by 121 publications

References 56 publications

Use of Psychotropic Medication in Children and Adolescents With Autism Spectrum Disorders

Use of Psychotropic Medication in Children and Adolescents With Autism Spectrum Disorders

Pharmacogenetics of risperidone therapy in autism: association analysis of eight candidate genes with drug efficacy and adverse drug reactions

What do Cochrane systematic reviews say about interventions for autism spectrum disorders?

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