Michael Aman, PhD, Ohio State University, Columbus, Ohio, and colleagues randomised 38 children aged 5 to 17 to receive either risperidone 0.5-3.5 mg/day or placebo for an 8-week period. All of the children had autism spectrum disorder and serious behaviour problems.

The children were assessed at the beginning of the study, at 4 weeks, and at 8 weeks to determine changes in their cognitive skills.

The researchers found that most of the children taking risperidone responded to the medication. The children showed significantly improved cognitive skills in aspects of attention and memory.

There was no change in some skills, such as hand-eye coordination and simple math. A previous study indicated that risperidone also was associated with reduced irritability, disruptive behaviour, and hyperactivity. The authors suggested that this calming effect may have enabled the participants to perform better on the assessments.

The researchers caution that the study's implications are limited because so many of the initial participants were unable to complete the study. Initially, 101 children were enrolled in the study, but many were determined to be too severely impaired by their illness or too disruptive in their behaviour to be adequately assessed.

The 38 final participants tended to be older and to have higher IQs than the children who did not complete the study.

Nonetheless, risperidone was associated with some important gains in cognitive skills and no indications of functional loss. Additional research is needed to determine the extent to which risperidone may improve cognitive skills in children with autism, said the authors.

Clinicians can be reassured that prescribing risperidone to children with autism likely will not harm cognitive skills, but the authors recommend prescribing with caution because the medication is still associated with potentially serious metabolic side effects.

SOURCE: National Institute of Mental Health

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