Demirkaya Sevcan Karakoç, Aksu Hatice, Özgür Börte Gürbüz
Department of Child and Adolescent Psychiatry, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.
Clin Psychopharmacol Neurosci. 2017 Nov 30;15(4):328-336. doi: 10.9758/cpn.2017.15.4.328.
Risperidone has been widely used to control aggression and conduct disorder (CD) in youth; however, treatment compliance is a major problem in CD. Our aim is to evaluate the effectiveness and tolerability of long-acting risperidone (LAR) in treating nonadherent cases.
The medical records of children and adolescents who had CD and were nonadherent to conventional drugs and psychosocial interventions (and therefore taking LAR) were reviewed. Informed consent on offlabel use of LAR was obtained from the parents. Clinical Global Impression (CGI) Severity (CGI-S) and CGI-Improvement scales were used and baseline and end points were compared.
The study comprised 14 children and adolescents (5 girls, 9 boys). All had comorbid disorders: substance use disorder (n=8), attention deficit hyperactivity disorder (n=6), and major depression (n=2). Mean duration of LAR use was 3.1 months (1.5-8 months). We observed significant improvements in the baseline and endpoint CGI-S scores for CD in all but one patient (Z=-3.198; ＜0.001). Only mild adverse effects were observed: weight gain (n=2), sedation (n=1), leg cramps (n=1), and increased appetite with no weight gain (n=1).
LAR is effective and tolerable for patients with CD who can't be medicated with oral preparations due to nonadherence to treatment. Even short-term LAR use is effective to get compliance. As CD predicts numerous problems in adulthood, appropriate treatment is crucial. To our knowledge, this is the first study on LAR use in youth with CD. The use of LAR deserves careful consideration and further controlled studies are needed to confirm our findings.
利培酮已被广泛用于控制青少年的攻击行为和品行障碍（CD）；然而，治疗依从性是CD治疗中的一个主要问题。我们的目的是评估长效利培酮（LAR）治疗不依从病例的有效性和耐受性。
回顾了患有CD且不依从传统药物和心理社会干预（因此服用LAR）的儿童和青少年的病历。已获得家长对LAR超说明书用药的知情同意。使用临床总体印象（CGI）严重程度量表（CGI-S）和CGI改善量表，并比较基线和终点。
该研究包括14名儿童和青少年（5名女孩，9名男孩）。所有人都有共病：物质使用障碍（n = 8）、注意力缺陷多动障碍（n = 6）和重度抑郁症（n = 2）。LAR的平均使用时间为3.1个月（1.5 - 8个月）。除一名患者外，我们观察到所有患者CD的基线和终点CGI-S评分均有显著改善（Z = -3.198；P＜0.001）。仅观察到轻微不良反应：体重增加（n = 2）、镇静（n = 1）、腿部痉挛（n = 1）和食欲增加但体重未增加（n = 1）。
对于因治疗不依从而无法口服制剂给药的CD患者，LAR是有效且耐受性良好的。即使短期使用LAR也能有效提高依从性。由于CD预示着成年期的众多问题，适当的治疗至关重要。据我们所知，这是第一项关于LAR用于患有CD的青少年的研究。LAR的使用值得仔细考虑，需要进一步的对照研究来证实我们的发现。
