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Objectives: To describe efficacy of risperidone in young people with PDD and to identify predictive parameters for prolonged use (36 months).
Methods: PDD children and adolescent according to the DSM-IV R criteria, 3 to 18 years of age, taking risperidone for at least 8 months and 36-month follow-up were retrospectively studied. Outcome measures included the Children's Psychiatric Rating Scale (CPRS) and Child Autism Rating Scale (CARS). Subjects were stratified in three groups: still on risperidone, shifted to other medication (SSRI, mood stabilizers, other antipsychotics), or drug-free. Clinical / demographic variables and efficacy of treatments were compared within the groups by mean of chi square and paired t-test.
Results: 29 children and adolescents (average age of 10.9 year; risperidone average dose 2,43 ± 1.45 mg, range 1-6 mg/day) were studied: after 36 months, 9 were still on risperidone, and 10 have replaced risperidone with other psychopharmacological treatments. 10 were free of medications. All showed a significant improvement after 2 and 8 months of treatment CPRS (p=0.022 and p=0.014 respectively) and CARS (p=0.0001 and p=0.014) and improvement persists for 36 months in all three groups of patients. The group on treatment with risperidone at 36 months had a significant lower IQ (p= 0.016) and more associated disorders (p=0.016). Within the subjects who have discontinued risperidone at 36 months, lower IQ (<50) and comorbidity for psychiatric and neurological diseaseas were associated with the use of others medication at 36 months.
Conclusions: These results suggest that in patients with higher IQ and without associated disorders, the improvement observed with risperidone can be maintained also after discontinuation.