Schizophrenia Drug Helps Autistic Kids
July 31, 2002 — The popular drug Risperdal, used to treat schizophrenia in adults, may also benefit children with autism. A new study shows that the drug safely and effectively treats an array of the serious behavioral problems exhibited by these children, including aggression, tantrums, and self-injury.
“That is not hyperbole. We saw big effects with this drug in terms of behavioral improvements in this subset of autistic children,” lead author Lawrence Scahill, MSN, PhD, tells WebMD. “The side effects were relatively mild, and we did not see the neurological side effects associated with (older drugs).”
In a large study, autistic children treated with the drug showed significant improvements in behavior compared with children treated with placebos. Researchers say the improvement was the largest ever seen for a medication used to treat the behavioral symptoms of autism.
Autistic children often exhibit an array of serious behavioral problems including aggression, hyperactivity, tantrums, and self-injury in response to routine demands of daily life. It is believed that anywhere from 1 in 500 to 1 in 200 children are autistic, but Scahill estimates that just 20% to 30% of autistic children have ongoing behavioral problems serious enough to require medication. The older schizophrenia drug Haldol has been commonly used to treat these behavioral issues. But its side effects can be severe, including muscle rigidity, abnormal movement, sedation, restlessness, or lethargy.
Like Haldol, risperidone blocks the brain chemical dopamine, but it also blocks another chemical serotonin. Drugs that have this dual blocking action have been shown to have fewer side effects than drugs such as Haldol that block dopamine alone.
In this study, published Aug. 1 in The New England Journal of Medicine, Scahill and colleagues treated 101 children (82 boys and 19 girls) with either Risperdal or placebo. All of the children had serious behavioral problems associated with autism. The drug’s effectiveness was measured with a standardized irritability score completed by a parent.
At the end of the eight-week treatment period, negative behaviors were determined to be “much” or “very much” improved in 69% of the children randomly assigned to the risperidone group, compared with just 12% of the children in the placebo group.
Few neurological side effects (such as muscle rigidity) were reported, but the children on Risperdal did gain a large amount of weight — an average of six pounds over an eight-week period. Scahill says the weight gain did not appear to be due to changes in metabolism, but rather to an increased appetite while on the drug.
“In some cases, the increase was welcomed,” he says. “Children with autism often have peculiar eating habits and limited diets. In some children, the medication appeared to expand the repertoire of what they were willing to eat.”
