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Risperdone use in children with autism may improve cognitive performance

Posted Oct 03 2008 11:31am
A review of: Aman, M.G., Hollway, J.A., McDougle, C.J., Scahill, L., Tierney, E., McCracken, J.T., Arnold, L.E., Vitiello, B., Ritz, L., Gavaletz, A., Cronin, P., Swiezy, N., Wheeler, C., Koenig, K., Ghuman, J.K., Posey, D.J. (2008). Cognitive Effects of Risperidone in Children with Autism and Irritable Behavior. Journal of Child and Adolescent Psychopharmacology, 18 (3), 227-236. DOI: 10.1089/cap.2007.0133

Risperdone is a neuroleptic antipsychotic drug that has been extensively used for the treatment of schizophrenia, and more recently bi-polar disorder. Risperdone also became the first FDA approved drug for treatment of schizophrenia and bi-polar disorder in children. This drug has significant anxiolytic (calming) proprieties and thus it has been used “off-label” (outside FDA recommendation) for the treatment of anxiety, panic disorder, and even depression. In 2006, the FDA finally approved the use of Risperdone in children with autism.

Because of its mild sedation effects, researchers and clinicians have proposed that this drug may have a negative impact of cognition. However, research with adults with schizophrenia, as well as research with children with disruptive behavior problems, has generally found Risperdone to have a beneficial effect on cognitive performance. In this study, the authors examined the effect of Risperdone on the cognitive abilities of children with autism with severe behavior problems.

The study used a double-blind, placebo controlled methodology. The study included 38 children with autism who were participating in a clinical trial of Risperdone. 20 participants had been randomly assigned to take Risperdone and 18 participants were taking the placebo. The trial lasted 8 weeks. The children were tested with several cognitive measures, including a cancellation task (attention task), a verbal learning task, a motor-eye coordination task, and a classroom task (skill-dependent math task). No detriment from the use of Risperdone was observed in any of the cognitive measures. Instead, significantly better performance was noted among children taking Risperdone compared to those taking placebo on tasks of attention and verbal learning. The authors concluded that Risperdone does not appear to have any short term detrimental effects on cognitive function and may instead facilitate cognitive performance on some children.
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