Clinical and economic aspects of risperidone treatment in adults with mental retardation and behavioral disturbance.

Risperidone, in conjunction with behavioral interventions, was used to reduce aggression and assault, self-injury, and property destruction in 33 institutionalized adults with mental retardation. Target behavior frequencies, global assessments by staff, wages earned by patients, and the institution's costs for assault-related injury to staff and lost work time were evaluated before and after initiation of risperidone treatment. Risperidone (1-8 mg/day) was associated with a 50 percent or greater reduction in at least one target behavior frequency in 61 percent of patients. After 6 months of treatment, 85 percent of patients were rated "improved" and 15 percent were rated "unchanged." Treated patients' wage earnings increased by 37 percent. The number of staff work days lost because of assault by treated patients decreased from 444 during the 6 months before initiation of risperidone to 29 during the 6 months after initiation. Sedation, pseudoparkinsonism, possible akathisia, and weight gain were noted in 9-12 percent of patients. No patients were withdrawn from risperidone because of intolerable side effects or lack of efficacy. The results of this evaluation suggest that risperidone is effective and well tolerated in this population.