The role of risperidone in the treatment of children and adolescents with anorexia nervosa

Abstract

Background: Current Diagnostic and Statistical Manual of Mental Disorders (DSM)-5-based research provides limited data on the use of risperidone on children and adolescents with anorexia nervosa (AN) mainly in small-sample/case report studies. Aim: To report the use of risperidone in a group of children and adolescents with feeding and eating disorders, specifically with AN. Methods: Observational, naturalistic study. Psychopathology was assessed with Eating Disorders Inventory-3, Beck’s Depression Inventory-II, and Symptom Checklist-90-R. Data were reported for the whole sample, for patients treated with risperidone, and finally compared between patients with AN treated with risperidone and those receiving no atypical antipsychotics. Potential differences in admission–discharge changes in body mass index (BMI) and psychopathology were assessed with analyses of covariance corrected for baseline measures. Kaplan–Meier analyses were conducted to assess retention rates of risperidone (at 3 months and 1 year) and rates of rehospitalization on 1-year follow-up. Results: The study enrolled 120 patients with AN (42 treated with risperidone). Risperidone was used for 116.7 (±122.8) days (total exposure = 3979 days) and well-tolerated (nausea, asthenia in one case). No significantly different admission–discharge improvements for BMI or psychopathology were documented for patients treated with risperidone. Risperidone showed a 3-month retention rate of 50.0% (1 year: 9.5%) and was discontinued mainly for the resolution of target symptoms. Cumulative freedom from rehospitalization at 12 months was comparable for treated and untreated patients (hazard ratio = 1.088; Log-rank p = 0.908). Conclusions: This study reports real-life evidence of the use of risperidone in AN children and adolescents in the widest described sample so far. Longitudinal research should assess long-term prognostic factors and tolerability.

Nutritional Assessment of Children and Adolescents with Atypical Anorexia Nervosa: A Preliminary Longitudinal Investigation Using the 24-h Dietary Recall

“…Median %En for carbohydrates was closer to the lower limit of the recommendations (45-60%), while median %En for total fat was near the middle of the RI range (20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Regarding proteins, the comparison between the observed protein intake with the AR and PRI showed an intake value at least double that recommended.…”

“…Individuals with AN or AAN may engage in food restriction by limiting overall food intake, excluding certain food categories (e.g., reducing carbohydrates or desserts), or reducing the frequency of meals or snacks [28]. Despite targeted research in this area, specific evidence-based interventions to reduce restrictive eating behaviors remain lacking [29][30][31][32].…”

Escitalopram-induced sinus bradycardia in coronary heart disease combined with depression: a case report and review of literature

“…DRP including drug-induced ADR interferes with expected clinical treatment outcomes and should also be an important risk management factor to increase patient safety ( 16 , 17 ). Multiple studies have been devoted to evaluating the harmful effects of antipsychotic drugs during the treatment of nervous disorders ( 18 , 19 ). From the pharmacovigilance system of EudraVigilance, 8% of individual ADR reports were escitalopram, while the proportion was 13% from the Food and Drug Administration Adverse Events Reporting System ( 20 ).…”