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Published on: September 20, 2024
No seizure exacerbation from risperidone in youth with comorbid epilepsy and psychiatric disorders: a case series
Joseph Gonzalez-Heydrich1, Gahan J Pandina, Carl A Fleisher
1Children's Hospital Boston, Fegan 8, 300 Longwood Avenue, Boston, MA 02115, USA. joseph.gonzalezheydrich@tch.harvard.edu
Objective:
The aim of this study was to study risperidone use in pediatric patients with comorbid epilepsy and psychiatric disorders.
Method:
We retrospectively reviewed the outpatient psychopharmacology medical records of patients with epilepsy, aged 19 and younger, who received risperidone for psychiatric disorders.
Results:
Twenty-one (21) youths (mean age, 12.0 +/- 4.2 years) met our criteria for review. Mean risperidone dosage was 2.4 +/- 3.5 mg/day. Target symptoms included severe aggression, severe agitation, psychosis, and self-injurious behavior. Diagnoses included attention-deficit hyperactivity disorder (ADHD), learning disorder, and impulse control disorder. Seizure type was partial complex in 12 patients, generalized in 6 patients, neonatal in 1 patient, myoclonic in 1 patient, and unclassified in 1 patient. The average number of previous psychotropic trials was 3.5 +/- 3.0. Using a definition of response of a Clinical Global Impressions (CGI) improvement score of 2 or less, 15 patients (71%) were considered responders. Adverse effects were none to slight in 16 patients, moderate in 4 patients, and severe in 1 patient. Seizures did not worsen in any patient.
Conclusions:
Risperidone was associated with a clinically significant global improvement, without seizure exacerbation in youths with epilepsy and psychiatric disorders. Despite the limitations of the study design, the 71% responder rate is noteworthy in this treatment-refractory group.
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