Weight Gain and Metabolic Consequences of Risperidone in Young Children with Autism Spectrum Disorder

Lawrence Scahill, Sangchoon Jeon, Susan J. Boorin, Christopher J. McDougle, Michael G. Aman, James Dziura, James T. McCracken, Sonia Caprio, L. Eugene Arnold, Ginger Nicol, Yanhong Deng, Saankari A. Challa, Benedetto Vitiello

Research output: Contribution to journalArticlepeer-review

37 Scopus citations

Abstract

Objective We examine weight gain and metabolic consequences of risperidone monotherapy in children with autism spectrum disorder (ASD). Method This was a 24-week, multisite, randomized trial of risperidone only versus risperidone plus parent training in 124 children (mean age 6.9 ± 2.35 years; 105 boys and 19 girls) with ASD and serious behavioral problems. We monitored height, weight, waist circumference, and adverse effects during the trial. Fasting blood samples were obtained before treatment and at week 16. Results In 97 children with a mean of 22.9 ± 2.8 weeks of risperidone exposure, there was a 5.4 ± 3.4 kg weight gain over 24 weeks (p <.0001); waist circumference increased from 60.7 ± 10.4 cm to 66.8 ± 11.3 cm (p <.0001). At baseline, 59 of 97 children (60.8%) were classified as having normal weight; by week 24, only 25 of 85 (29.4%) remained in that group. Growth curve analysis showed a significant change in body mass index (BMI) z scores from pretreatment to week 24 (p <.0001). This effect was significantly greater for children with reported increased appetite in the first 8 weeks. From before treatment to week 16, there were significant increases in glucose (p =.02), hemoglobin A1c (p =.01), insulin (p <.0001), homeostatic model assessment-insulin resistance (HOMA-IR; p <.001), alanine aminotransferase (p =.01), and leptin (p <.0001). Adiponectin declined (p =.003). At baseline, 7 children met conventional criteria for metabolic syndrome; by week 16, 12 additional children were so classified. Conclusion Rapid weight gain with risperidone treatment may promote the cascade of biochemical indices associated with insulin resistance and metabolic syndrome. Appetite, weight, waist circumference, liver function tests, blood lipids, and glucose warrant monitoring. Clinical trial registration information - Drug and Behavioral Therapy for Children With Pervasive Developmental Disorders; http://clinicaltrials.gov/; NCT00080145.

Original languageEnglish (US)
Pages (from-to)415-423
Number of pages9
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Volume55
Issue number5
DOIs
StatePublished - May 1 2016

Keywords

  • autism spectrum disorder
  • insulin resistance
  • metabolic syndrome
  • risperidone
  • weight gain

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health

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