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. 2009 Apr 15;2009(2):CD007011.
doi: 10.1002/14651858.CD007011.pub2.

Risperidone for attention-deficit hyperactivity disorder in people with intellectual disabilities

Alex Thomson  1 , Stefanos Maltezos, Elena Paliokosta, Kiriakos Xenitidis
Affiliations

Risperidone for attention-deficit hyperactivity disorder in people with intellectual disabilities

Alex Thomson et al. Cochrane Database Syst Rev. .

Abstract

Background: Attention deficit hyperactivity disorder (ADHD) is increasingly recognised as occurring in people with intellectual disability (ID), although treatment of ADHD in this population has not ben tested widely. Risperidone has been used to treat ADHD in people with ID, although the evidence for its effectiveness is unclear.

Objectives: To examine the effectiveness of risperidone for the treatment of attention deficit hyperactivity disorder in people with intellectual disabilities.

Search strategy: In February 2009, MEDLINE, PsycINFO, EMBASE, AMED, ISI Web of Science and WorldCat Dissertations were searched using an extensive list of synonyms for ADHD and ID. CENTRAL, CCDPLP, Current Controlled Trials meta-register (mRCT), CenterWatch, NHS National Research Register, clinicaltrials.gov were searched, pharmaceutical companies and experts in the field were contacted. Reference lists of review articles were examined and citation searches were performed in ISI Web of Knowledge.

Selection criteria: All randomised controlled trials (RCTs), both published and unpublished, in any language, in which children or adults with ADHD and ID were treated with risperidone.

Data collection and analysis: Data collection and analyses were planned but not performed due to a lack of suitable studies.

Main results: Eleven studies were considered but none were suitable for inclusion.

Authors' conclusions: There is no evidence from RCTs that risperidone is effective for the treatment of ADHD in people with ID. Prescribing in this population can only be based on open-label studies or extrapolation from research in people with autism and disruptive behaviour disorders; however these studies have not investigated people with ID separately so there are reservations regarding the applicability of these findings. Research into effectiveness and tolerability is urgently needed.

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Conflict of interest statement

None known.

Update of

References

References to studies excluded from this review

Aman 2002 {published data only}
    1. Aman M, Buitelaar J, Smedt G, Wapenaar R, Binder C. Pharmacotherapy of disruptive behavior and item changes on a standardized rating scale: pooled analysis of risperidone effects in children with subaverage IQ. Journal of Child and Adolescent Psychopharmacology 2005;15(2):220‐32. - PubMed
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Arman 2003 {published data only}
    1. Arman AR, Yazgan Y, Berkem M. The effects of risperidone on behaviors seen in children with pervasive developmental disorder and mental retardation in an educational setting [Turkish]. Klinik Psikofarmakoloji Buelteni 2003;13:174‐8.
Armenteros 2007 {published data only}
    1. Armenteros JL, Lewis JE, Davalos M. Risperidone augmentation for treatment‐resistant aggression in attention‐deficit/hyperactivity disorder: a placebo‐controlled pilot study. Journal of the American Academy of Child and Adolescent Psychiatry 2007;46(5):558‐65. - PubMed
Correia Filho 2005 {published data only}
    1. Correia Filho AG, Bodanese R, Silva TL, Alvares JP, Aman M, Rohde LA. Comparison of risperidone and methylphenidate for reducing ADHD symptoms in children and adolescents with moderate mental retardation. Journal of the American Academy of Child & Adolescent Psychiatry 2005;44:748‐55. - PubMed
Croonenberghs 2005 {published data only}
    1. Croonenberghs J, Fegert JM, Findling RL, Smedt G, Dongen S. Risperidone in children with disruptive behavior disorders and subaverage intelligence: A 1‐year, open‐label study of 504 patients. Journal of the American Academy of Child and Adolescent Psychiatry 2005;44(1):64‐72. - PubMed
    1. Fegert JM, Findling R, deSmedt G. Risperidone for treatment of aggressive‐impulsive behaviour in children and adolescents with low‐average‐intelligence, learning disability and mild mental disorder [Risperidon zur behandlung aggressiv‐impulsiven verhaltens bei kindern und jugendlichen mit intelligenz im unteren durchschnittsbereich, lernbehinderung und leichter geistiger behinderung]. Nervenheilkunde 2003;22(2):93‐7.
Dartnall 1999 {published data only}
    1. Dartnall NA, Holmes JP, Morgan SN, McDougle CJ. Brief report: two‐year control of behavioral symptoms with risperidone in two profoundly retarded adults with autism. Journal of Autism & Developmental Disorders 1999;29:87‐91. - PubMed
Gagiano 2005 {published data only}
    1. Gagiano C, Read S, Thorpe L, Eerdekens M, Hove I. Short‐ and long‐term efficacy and safety of risperidone in adults with disruptive behavior disorders. Psychopharmacology 2005;179:629‐36. - PubMed
Günther 2006 {published data only}
    1. Günther T, Herpertz‐Dahlmann B, Jolles J, Konrad K. The influence of risperidone on attentional functions in children and adolescents with attention‐deficit/hyperactivity disorder and co‐morbid disruptive behavior disorder. Journal of Child and Adolescent Psychopharmacology 2006;16:725‐35. - PubMed
Snyder 2002 {published data only}
    1. Aman M, Buitelaar J, Smedt G, Wapenaar R, Binder C. Pharmacotherapy of disruptive behavior and item changes on a standardized rating scale: pooled analysis of risperidone effects in children with subaverage IQ. Journal of Child and Adolescent Psychopharmacology 2005;15(2):220‐32. - PubMed
    1. Aman MG, Binder, C, Turgay A. Risperidone effects in the presence/absence of psychostimulant medicine in children with ADHD, other disruptive behavior disorders, and subaverage IQ. Risperidone effects in the presence/absence of psychostimulant medicine in children with ADHD, other disruptive behavior disorders, and subaverage IQ 2004;14:243‐54. - PubMed
    1. Leblanc JC, Binder CE, Armenteros JL, Aman MG, Wang JS, Hew H, Kusumakar V. Leblanc JC, Binder CE, Armenteros JL, Aman MG, Wang JS, Hew H, Kusumakar V. International Clinical Psychopharmacology 2005;20:275‐83. - PubMed
    1. Snyder R, Turgay A, Aman M, Binder C, Fisman S, Carroll A. Effects of risperidone on conduct and disruptive behavior disorders in children with subaverage IQs. Journal of the American Academy of Child & Adolescent Psychiatry 2002;41(9):1026‐1036. - PubMed
van Bellinghen 2001 {published data only}
    1. Bellinghen M, Troch C. Risperidone in the Treatment of Behavioral Disturbances in Children and Adolescents with Borderline Intellectual Functioning: A Double‐Blind, Placebo‐Controlled Pilot Trial. Journal of Child and Adolescent Psychopharmacology 2001;11(1):5‐13. - PubMed
Vanden Borre 1993 {published data only}
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