Use of Risperidone Long-Acting Injection to Support Treatment Adherence and Mood Stabilization in Pediatric Bipolar Patients

Fu‐I, Lee; Boarati, Miguel Angelo; Stravogiannis, Andreas; Wang, Yuan‐Pang

doi:10.4088/jcp.08l04487

Cited by 12 publications

(8 citation statements)

References 7 publications

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“…We used long-acting risperidone to maintain proper mood stability and compliance to oral treatment. Our patient' s clinical presentation was similar to the first case of Fu et al (5). Their case was of an 11-year-old boy with major depressive disorder and school refusal, and when an antidepressive agent was administered, he developed a manic shift; he also showed daily mood changes that were similar to those in our patient.…”

Section: Discussionsupporting

confidence: 85%

“…The definite diagnosis of early-onset BD is difficult due to overlapping symptoms of other psychiatric disorders such as anxiety disorder, attention-deficit hyperactivity disorder, and conduct disorder (1,5). The episodic pattern of BD is mostly rapid cycling in children.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have suggested that depot formulations of SGA are considered for controlling mood episodes in BD patients who have relapsed due to medication nonadherence or who failed to respond to standard therapies (3,4). Fu et al (5) reported case series with the usage of long-acting injectable risperidone in children with pediatric BD who showed treatment nonadherence.…”

Section: Introductionmentioning

confidence: 99%

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Long-acting Injectable Risperidone Use in an 11-Years-Old Bipolar Child

Demirkaya

Zoroğlu

2016

Arch Neuropsychiatr

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Early-onset bipolar disorder is difficult for child psychiatrists in terms of both diagnosis and treatment. The proper diagnostic evaluation is negatively impacted by the atypical clinical manifestation and rapid cycling pattern of the disease, together with common comorbidity with attention-deficit hyperactivity disorder and anxiety disorder. In addition to poor insight, nonadherence to treatment, poor family coping skills, and insufficient child psychiatric inpatient units make clinicians unsuccessful in following up and treating such patients. Risperidone is a commonly used atypical antipsychotic it has been approved for the treatment of manic and mixed episodes of bipolar disorder even in 10-17-year-old patients, and it is commonly used. It has a long-acting injectable formulation. Studies on its long-acting form in younger children are limited. In this case presentation, the diagnostic procedure in an 11-year old child with bipolar disorder will be presented. Long-acting injectable risperidone use in the case of nonadherence to treatment and observed side effects will be discussed.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Long-acting Injectable Risperidone Use in an 11-Years-Old Bipolar Child

Demirkaya

Zoroğlu

2016

Arch Neuropsychiatr

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“…Diagnoses contained in these publications include bipolar disorder, schizophrenia, schizoaffective disorder, and eating disorders. These studies concluded that LAI formulations may improve clinical outcomes and adherence with side effect rates similar to oral preparations in the pediatric population; however, there are significant methodological limitations including study design, sample size, and confounding variables that must be taken into consideration 8,10-13. Because of a lack of data supporting LAI antipsychotic use, the American Academy of Child and Adolescent Psychiatry recommends these dosage forms only for adolescents with schizophrenia and documented chronic psychotic symptoms with a history of poor adherence 14…”

Section: Introductionmentioning

confidence: 99%

Extent of use of long-acting injectable antipsychotics in children and adolescents within Indiana Medicaid

Modesitt

Kubascik

Ott

2018

Mental Health Clinician

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Introduction:Oral formulations of the antipsychotics aripiprazole, asenapine, lurasidone, olanzapine, paliperidone, quetiapine, and risperidone are indicated for use in pediatrics for several diagnoses. Long-acting injectable (LAI) antipsychotics are of interest in this special population because they may be used due to convenience and desire to improve adherence, despite limited support in the literature. The primary intent of this study is to provide descriptive information on the use of paliperidone palmitate, risperidone microspheres, aripiprazole extended-release injection, and olanzapine pamoate in pediatric patients within Indiana Medicaid.Methods:This study was a retrospective database analysis, which retrieved information from Indiana Medicaid over a 2-year timeframe spanning from July 1, 2012, through June 30, 2014. The study included the prescription medications filled for all children and adolescents within Indiana Medicaid who received the LAI antipsychotics paliperidone palmitate, risperidone microspheres, aripiprazole extended-release injection, and olanzapine pamoate.Results:From July 1, 2012, through June 30, 2014, 150 Indiana Medicaid patients younger than 18 years old were prescribed a LAI atypical antipsychotic. A total of 1013 LAI atypical antipsychotic doses were billed to Indiana Medicaid during the study period for pediatric patients. Paliperidone palmitate was billed most frequently.Discussion:Long-acting injectable atypical antipsychotics are being prescribed for children and adolescents within Indiana Medicaid, despite minimal clinical evidence supporting use. There is a need for further research in this area to increase generalizability of results and aid in implementation of policies to prevent inappropriate use of LAI antipsychotics in children and adolescents.

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“…Studies of LAR use in pediatric age group have been restricted to patients diagnosed with bipolar disorder and psychotic disorders; to date, only case reports and open-label small sample studies have been reported. 34 , 36 – 38) Boarati et al . 36) found that LAR can be useful for the treatment of children and adolescents with bipolar disorder who are nonresponsive or nonadherent to conventional medications.…”

Section: Introductionmentioning

confidence: 99%

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

Demirkaya

Aksu

Özgür

2017

Clin Psychopharmacol Neurosci

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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.

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Use of Risperidone Long-Acting Injection to Support Treatment Adherence and Mood Stabilization in Pediatric Bipolar Patients

Cited by 12 publications

References 7 publications

Long-acting Injectable Risperidone Use in an 11-Years-Old Bipolar Child

Long-acting Injectable Risperidone Use in an 11-Years-Old Bipolar Child

Extent of use of long-acting injectable antipsychotics in children and adolescents within Indiana Medicaid

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

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