Risperdal Study Finds Superior Response Among Bi-Polar Children, but Cautions on Metabollic Side Effects

A new study has found that while Risperdal works well when it comes to treating childhood bi-polar disorder, the drug’s metabolic side effects need to be taken seriously. The Risperdal study, published online January 2 in the Archives of General Psychiatry, was conducted by Barbara Geller, MD, Department of Psychiatry, Washington University, St Louis, Missouri, and colleagues.

Entitled TEAM (Treatment of Early Age Mania), the study compared the efficacy of Risperdal with that of Depakote and lithium in children diagnosed with DSM-IV bipolar I disorder (manic or mixed phase). Between 2003 and 2008, 290 children, ages 6 to15 years at five U.S. sites were treated over 8-week periods with either Risperdal, lithium or Depakote. The patients were started on low doses of the drugs, with doses increased on a weekly basis if the child had minimal-to-no response, and no dose-limiting adverse effects.

Of the three drugs, Risperdal was found to be significantly superior for acute treatment of pediatric mania. After eight weeks, 68.5 percent of the children taking Risperdal showed improvement in manic symptoms, compared to 35.6 percent of those taking lithium and 24 percent of those taking Depakote.

The study also found that children responded well at relatively low doses of Risperdal, meaning clinicians can be conservative with the medication. The study authors also noted that lithium had significantly higher discontinuation rates than Risperdal, because Risperal was better tolerated by patients.

However, among the Risperdal group, the researchers saw significantly higher rates of weight gain, BMI increase, and presence of hyperprolactinemia. Children on Risperdal gained an average of more than 7 lbs compared to around 3 lbs for those taking lithium and 3.7 lbs for those taking Depakote. Those taking Risperdal were also more likely to experience other metabollic side effects, such as an increase in cholesterol levels, compared to those on the other medications.

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