A crossover study of risperidone in children, adolescents and adults with mental retardation.
Low-dose risperidone can slash irritability in half for many with ID, but waistlines grow.
01Research in Context
What this study did
Doctors gave low-dose risperidone to 40 people with mental retardation. Ages ranged from kids to adults.
It was a crossover study. Each person got real pills over the study period, then fake pills over the study period, or the other way around.
They tracked irritability using the ABC-I scale. A meaningful improvement counted as better.
What they found
Eight out of ten people calmed down at least a large share. Half of them calmed a large share or more.
Side effects showed up fast. Most gained weight and felt hungrier.
How this fits with other research
Crossman et al. (2018) tested riluzole the same way and saw zero benefit. The drugs differ, not the kids.
Hattier et al. (2011) looked at 25 risperidone trials. All were small and used different rulers, so results are shaky.
Calamari et al. (1987) tried fenfluramine in a similar crossover and found nothing. Risperidone beats an older dud.
Why it matters
If a client with ID and big meltdowns is unsafe, risperidone can cut irritability fast. Expect weight gain. Track food intake and add exercise from day one. Combine the pill with behavior plans so you can taper later.
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02At a glance
03Original abstract
Risperidone has shown safety and efficacy for aggressive and destructive behaviors in short-term studies. This longer-duration study includes a broad sample. Forty subjects, aged 8-56 years (mean=22), all with mental retardation and 36 with autism spectrum disorders participated in this 22-week crossover study, with 24 weeks of open maintenance thereafter. Of 40 subjects, 23 (57.5%) responded fully (50% decrease in Aberrant Behavior Checklist-Community Irritability subscale score), while 35 subjects (87.5%) showed a 25% decrease. Gender, mood disorder, and antiseizure medications did not alter response. Increased appetite and weight gain were common. Low dose risperidone was effective for aggressive behavior in persons with MR. More long-term studies are needed, incorporating weight control interventions.
Journal of autism and developmental disorders, 2006 · doi:10.1007/s10803-006-0078-1