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Double-blind, placebo-controlled trial of risperidone plus topiramate in children with autistic disorder
Vala Rezaei1, Mohammad-Reza Mohammadi, Ahmad Ghanizadeh
1Research Center for Psychiatry and Behavioral Sciences, Shiraz University of Medical Sciences, Hafez Hospital, Shiraz, Iran.
Insights
Adding topiramate to risperidone treatment significantly reduced irritability, stereotypic behavior, and hyperactivity in children with autism spectrum disorder. This combination therapy shows promise for managing disruptive symptoms in autistic disorder.
Area of Science:
- Neurodevelopmental Disorders
- Pediatric Psychiatry
- Pharmacological Interventions
Background:
- Autism Spectrum Disorders (ASD) are complex neurodevelopmental conditions.
- Disruptive symptoms are common challenges in children with ASD.
- Current treatment options require further investigation for efficacy.
Purpose of the Study:
- To assess the efficacy of topiramate combined with risperidone in treating autistic disorder.
- To evaluate the impact on disruptive behaviors in children with ASD.
Main Methods:
- A double-blind, placebo-controlled study involved 40 children (4-12 years) with diagnosed autistic disorder.
- Participants received either topiramate + risperidone or placebo + risperidone for 8 weeks.
- The Aberrant Behavior Checklist-Community (ABC-C) scale measured outcomes.
Main Results:
- The topiramate + risperidone group showed significant reductions in ABC-C subscale scores.
- Improvements were noted in irritability, stereotypic behavior, and hyperactivity/noncompliance.
- The combination therapy demonstrated superior outcomes compared to risperidone monotherapy.
Conclusions:
- Topiramate combined with risperidone may offer a superior treatment option for children with autistic disorder.
- Further validation through larger randomized controlled trials is recommended.
- This combination could be a valuable therapeutic strategy for managing challenging behaviors in ASD.
Background:
Autism is a complex neurodevelopmental disorder that forms part of a spectrum of related disorders referred to as Autism Spectrum Disorders. The present study assessed the effects of topiramate plus risperidone in the treatment of autistic disorder.
Method:
Forty children between the ages of 4 and 12 years with a DSM IV clinical diagnosis of autism who were outpatients from a specialty clinic for children were recruited. The children presented with a chief complaint of severely disruptive symptoms related to autistic disorder. Patients were randomly allocated to topiramate+risperidone (Group A) or placebo+risperidone (Group B) for an 8-week, double-blind, placebo-controlled study. The dose of risperidone was titrated up to 2 mg/day for children between 10 and 40 kg and 3 mg/day for children weighting above 40 kg. The dose of topiramate was titrated up to 200 mg/day depending on weight (100 mg/day for <30 kg and 200 mg/day for >30 kg). Patients were assessed at baseline and after 2, 4, 6 and 8 weeks after starting medication. Measure of outcome was the Aberrant Behavior Checklist-Community (ABC-C) Rating Scale.
Results:
Difference between the two protocols was significant as the group that received topiramate had a greater reduction in ABC-C subscale scores for irritability, stereotypic behavior and hyperactivity/noncompliance.
Conclusion:
The results suggest that the combination of topiramate with risperidone may be superior to risperidone monotherapy for children with autistic disorder. However the results need to be further confirmed by a larger randomized controlled trial.
Related Concept Videos
01:11Blinding
01:19Autism Spectrum Disorder
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.