New Drug May Help Children With Uncontrollable Aggression
He suggests that longer-term studies are needed to evaluate whether children
and adolescents can tolerate Risperdal for months or years and to see whether
its effect wears off with time.
"This is a preliminary study that is certainly noteworthy because
risperidone has not been thought of as a first-line medicine for the treatment
of CD. What's wonderful about this study is that there may be a medicine that
can be helpful," he says. However, he points out that other medications
that have been thought to be effective have been proven later not to be.
According to Koplewicz, psychological treatments and social interventions
for CD do not seem to be very effective. Many children end up in costly
residential treatment centers. Children with CD should be treated with a
variety of approaches including family therapy, psychotherapy, and social
skills building, as well as medication.
Findling says that he would recommend that Risperdal be used cautiously for
conduct disorder in addition to other therapy. "Right now there aren't many
proven treatments for this population. ... We continue to use risperidone for
[only] these well-described, extremely aggressive young people."
Findling emphasizes that Risperdal is not a treatment for aggression per se,
but rather is a potential treatment for this carefully defined population with
serious, chronic, impulsive, and aggressive behavior. It is not for those with
mood disorders, anxiety disorders, or substance abuse.
Koplewicz says that there are currently about 2 million children in the U.S.
under the age of 18 who have CD. "As a nation, this is a disorder that
really needs a lot more research and attention -- as evidenced by school
shootings and school violence. The cost to society of ... these kids left
untreated is astronomical."
- Conduct disorder is diagnosed in children and adolescents and is
characterized by aggression toward animals and people, destruction of property,
theft, deceitfulness, a lack of respect for rules, and a lack of remorse.
- Typically this condition is difficult to treat, but a new drug called
Risperdal was shown to be effective, at least in the short term.
- In addition to medication, children with conduct disorder may require a
variety of other interventions, such as family therapy, psychotherapy, and
social skills building.