Cognitive function with long-term risperidone in children and adolescents with disruptive behavior disorder

Area of Science:

• Neuroscience
• Child and Adolescent Psychiatry
• Pharmacology

Background:

• Disruptive Behavior Disorders (DBDs) are common in children and adolescents.
• Risperidone is frequently prescribed for DBDs, but its long-term cognitive effects require evaluation.
• Previous studies have focused on specific IQ ranges, necessitating broader assessment.

Purpose of the Study:

• To assess the long-term cognitive impact of risperidone in pediatric patients with DBDs.
• To compare cognitive function changes between risperidone and placebo groups over a 6-month period.
• To extend findings to a population including individuals with lower IQ.

Main Methods:

• A 6-month, randomized, placebo-controlled trial involving 284 children and adolescents (5-17 years) with DBDs and IQ ≥54.
• Cognitive function evaluated using the modified California Verbal Learning Test for Children (MVLT-C) and Continuous Performance Test (CPT) (easy and hard versions).
• Somnolence and clinically meaningful treatment effects (≥0.5 or ≥1.0 SD change) were also assessed.

Main Results:

• No significant cognitive differences were found between risperidone and placebo groups after adjusting for covariates.
• Both groups showed improvements in specific CPT parameters and MVLT-C recall; placebo showed improvements in CPT easy false alarms.
• Mild somnolence occurred in 2% of patients in both groups, with no differential impact on cognitive testing.

Conclusions:

• Risperidone treatment is not associated with cognitive decline in children and adolescents with DBDs.
• These findings support the cognitive safety of risperidone in this population, including those with lower IQ.
• The study provides evidence for the long-term cognitive tolerability of risperidone in pediatric DBD treatment.