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Risperidone-associated steatohepatitis and excessive weight-gain.

M Holtmann, D Kopf, M Mayer

    Pharmacopsychiatry
    |October 23, 2003
    PubMed
    Summary

    Risperidone treatment in adolescents may cause significant weight gain and non-alcoholic steatohepatitis. Regular monitoring of weight, liver function, and metabolic parameters is crucial during therapy.

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    Area of Science:

    • Psychiatry
    • Hepatology
    • Pediatrics

    Background:

    • Risperidone is an atypical antipsychotic used to treat psychosis.
    • Weight gain and metabolic disturbances are known side effects of atypical antipsychotics.
    • Hepatotoxicity is a less common but serious adverse effect.

    Purpose of the Study:

    • To report a case of steatohepatitis and significant weight gain in an adolescent treated with risperidone.
    • To discuss potential mechanisms linking risperidone, weight gain, and liver injury.
    • To emphasize the importance of monitoring in pediatric patients.

    Main Methods:

    • Case report of a 17-year-old female patient.
    • Exclusion of viral, metabolic, and other causes of liver disease.
    • Review of potential mechanisms of risperidone-associated weight gain and hepatotoxicity.

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    Main Results:

    • The patient developed non-alcoholic steatohepatitis and marked weight gain during risperidone therapy.
    • Other potential causes of liver disease were ruled out.
    • Potential mechanisms involving the serotonergic system, neuropeptide Y, and hyperleptinemia were discussed.

    Conclusions:

    • Risperidone may be associated with steatohepatitis and significant weight gain in adolescents.
    • Close monitoring of body weight, liver function, glucose, and lipids is recommended at the initiation and during maintenance of risperidone therapy in children and adolescents.
    • Physicians should be vigilant for these adverse effects in pediatric patients.