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Children with autism respond favorably to the antipsychotic Risperidone

A study found children with autism characterized by tantrums, aggression, and/or self-injury respond favorably to the antipsychotic drug Risperidone ( Risperdal ) for up to six months.

Research, sponsored by the National Institute of Mental Health ( NIMH ), found the medication not only decreased aggression but also reduced repetitive behaviors and increased social interaction – all with limited side effects. The two-part study also found discontinuation after six months prompted rapid return of disruptive and aggressive behavior in most cases.

Atypical antipsychotic medications such as Risperidone are of interest to doctors who treat children with autism because studies show the newer medications benefit adults with schizophrenia with fewer neurological side effects than older options.

“A variety of treatments, including medication, are used to manage aggressive behaviors in autistic children, but controlled medication trials are limited,” said James McCracken, lead author and at the Semel Institute for Neuroscience and Human Behavior at UCLA. “ Our findings support adding Risperidone to the small arsenal of intermediate-term medication options for the tens of thousands of children with autism who display aggressive and destructive behaviors.

“ The response to Risperidone ranks among the most positive ever observed in children with autism for a drug treatment,” said McCracken, director of the Division of Child and Adolescent Psychiatry at the David Geffen School of Medicine at UCLA.

Autism is a chronic condition that appears in early childhood. Core symptoms include impaired social interaction, delayed language development and restricted patterns of behavior. The disorder affects as many as 20 in 10,000 children. Although the causes of autism are unknown, scientific evidence point to abnormalities in brain development and a strong genetic component.

In addition to core symptoms, children with autism frequently exhibit serious behavior disturbances in response to routine environmental demands. For these disturbances, behavior therapy and medications are the two main forms of treatment.

In the multi-site study, researchers randomly assigned 101 subjects – 82 boys and 19 girls – ages 5 to 17 to receive either placebo or Risperidone.
Subjects who improved substantially after eight weeks continued treatment for up to six months. Researchers observed a small sample of subjects at the end of the study during the withdrawal of the medication.

Previously, the largest extended studies of medication for autism with Haloperidol, an older antipsychotic, showed the drug to be modestly effective but accompanied by neurological and other side effects.

Past research into the effect of Risperidone on children with autism found the medication effective for short-term treatment of aggressive behaviors related to autism in children. Side effects to Risperidone are usually well-tolerated, with some complaints of weight gain.

Source: University of California, Los Angeles ( UCLA ), 2005