New Drug May Help Children With Uncontrollable Aggression
April 4, 2000 (New York) -- After seven weeks of treatment with Risperdal
(risperidone), a relatively new drug usually used to treat schizophrenia, both
doctors and parents noticed that the aggressive behavior of children with
"conduct disorder" (CD) noticeably improved, according to a report in
the April issue of the Journal of the American Academy of Child and
CD is an illness diagnosed in childhood or adolescence in which kids show
uncontrolled aggression toward animals and people, destroy property, steal, are
deceitful, and have no respect for rules. "CD is one of the most difficult
psychiatric illnesses to treat," says Harold Koplewicz, MD, director of New
York University's Child Study Center. "Kids with CD are more likely to be
aggressive toward others, including physical and verbal aggression. One of the
most noteworthy characteristics is the lack of remorse for what they do,"
he tells WebMD.
CD is often a precursor to more extreme pathological behavior that worsens
as the child develops. "Quite clearly, if you look at our jails, they're
filled with adults who demonstrated CD symptoms at an early age," says
Older medications may reduce aggressive behavior in youngsters with CD, but
they are often limited by such side effects as sedation, drooling, or abnormal
movements. Since these reactions may not be acceptable to either the child or
the child's parent, alternative treatments for conduct disorders are needed.
With this in mind, investigators decided to see if Risperdal, which is
relatively free of side effects, could be used to treat CD.
Twenty children and adolescents -- 19 boys and one girl, aged 6 to 14 -- who
had been diagnosed with conduct disorder were enrolled in the study. Half the
youngsters were treated daily with Risperdal daily for 10 weeks.
The investigators found that Risperdal was superior to a placebo in reducing
aggression. The Risperdal patients' parents also reported improvements in
conduct problems and delinquency behavior.
Risperdal also did not cause too many bad side effects, but
Risperdal-treated participants gained more weight than those in the placebo
group, which may be an obstacle to long-term therapy in this population, says
author Robert L. Findling, MD, director of child and adolescent psychiatry at
University Hospitals in Cleveland.
"Risperidone may be a very powerful and effective treatment, although
larger, definitive studies need to be conducted to confirm or refute our
findings," Findling tells WebMD.
Hans Steiner, MD, professor of psychiatry at Stanford University School of
Medicine, agrees. "We're just at the beginning in finding out what
[medication] can do for conduct problems and aggression in kids. This is a very
important study. ... It's the first to report on a new [drug for this
population]," says Steiner. He notes that very few well-conducted human
trials have been published on the treatment of conduct disorder. Steiner is the
author of the American Academy of Child and Adolescent Psychiatry's guidelines
concerning the proper assessment and treatment of children and adolescents with