• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia
    • Books
    • eBooks
    • ABPN SA Courses
    • Social Work Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
    • Psychiatry News Videos
    • Medication Guide Videos
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
    • Psychotherapy and Social Work
  • FAQs
  • Med Fact Book App
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Combined Treatment Works Better Than Risperidone Alone for PDD

Combined Treatment Works Better Than Risperidone Alone for PDD

February 1, 2010
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Section editor, Glen Spielmans, PhD

Combining medication and behav- ioral therapy leads to better outcomes for children with pervasive developmental disorders (PDDs), according to a recent study. Pervasive developmental disorder (PDD) is an umbrella diagnostic category that includes autism, Asperger’s syndrome, and pervasive developmental disorder-not otherwise specified (PDD–NOS). (For a basic review of PDD, see “Citalopram Not Effective for Autism in Children,” TCPR July/August 2009.) Clinicians often use risperidone to treat the aggression, tantrums and other behav- ioral issues that are common with PDD patients.This study was the first to look at whether adding behavioraltreatment to medication would improve outcomes. One hundred and twenty four children, ages 4 through 13, with PDDs and significant irritable behavior were randomly assigned either risperidone or risperidone + behavioral therapy. Risperidone was dosed according to weight and titrated to a potential maximum dose of 3.5 mg/day. Up to 17 sessions of highly structured behavioral therapy were offered by trained master’s or doctoral level therapists over 24 weeks. During therapy, patients’ parents were taught positive reinforcement, compliance, functional skills, and social skills. At the end of the study, the combined treatment group had statistically significantly higher rates of improvement on the Home Situations Questionnaire (which measures problem behaviors); and on rating scales of irritability, hyperactivity/noncompliance; and on one of two scales of repetitive behavior. There was no difference between treatments on social withdrawal or inappropriate speech.The most notable side effect was weight gain; mean BMI increased from 67th percentile to 84th percentile over 24 weeks.The combined group’s medication dose was 14% lower than the risperidone-only group, indicating that adding behavior therapy might allow physicians to moderate antipsychotic dosing, with a potential improvement in side effects (Aman MG et al., J Am Acad Child Adolesc Psychiatry 2009;48:1143–1154).

TCPR’s Take: Adding behavioral treatment to risperidone decreases irritability in children with PDDs more than using risperidone alone.The effect is moderate, so it is a judgment call whether the extra time and expense that therapy requires is worth it in all cases.The researchers plan to make the manual and other behavioral treatment materials available for public use, which should help to disseminate the method more broadly.

General Psychiatry
KEYWORDS child-psychiatry natural_medications
    www.thecarlatreport.com
    Issue Date: February 1, 2010
    SUBSCRIBE NOW
    Table Of Contents
    An Update on Natural Treatments
    When Natural Treatments are Debunked: Lessons for Practitioners
    Complementary Treatments in Psychiatry
    Combined Treatment Works Better Than Risperidone Alone for PDD
    Does Adding Psychotherapy Help Patients With Resistant Depression?
    Five Treatments for Smoking Cessation Compared
    DOWNLOAD NOW
    Featured Book
    • MFB7e_Print_App_Access.png

      Medication Fact Book for Psychiatric Practice, Seventh Edition (2024) - Regular Bound Book

      The updated 2024 reference guide covering the most commonly prescribed medications in psychiatry.
      READ MORE
    Featured Video
    • KarXT (Cobenfy)_ The Breakthrough Antipsychotic That Could Change Everything.jpg
      General Psychiatry

      KarXT (Cobenfy): The Breakthrough Antipsychotic That Could Change Everything

      Read More
    Featured Podcast
    • shutterstock_2603816031.jpg
      General Psychiatry

      A Scam for Every Woman, Child, and Man: Part 2

      1 in 3 Americans were victims of online scams in the past year. Even when you know your patient is being scammed, it is hard to pull them out. We speak with Cathy Wilson about...
      Listen now
    Recommended
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png
    • Join Our Writing Team

      July 18, 2024
      WriteForUs.png
    • Insights About a Rare Transmissible Form of Alzheimer's Disease

      February 9, 2024
      shutterstock_2417738561_PeopleImages.com_Yuri A.png
    • How to Fulfill the DEA's One Time, 8-Hour Training Requirement for Registered Practitioners

      May 24, 2024
      DEA_Checkbox.png

    About

    • About Us
    • CME Center
    • FAQ
    • Contact Us

    Shop Online

    • Newsletters
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN Self-Assessment Courses

    Newsletters

    • The Carlat Psychiatry Report
    • The Carlat Child Psychiatry Report
    • The Carlat Addiction Treatment Report
    • The Carlat Hospital Psychiatry Report
    • The Carlat Geriatric Psychiatry Report
    • The Carlat Psychotherapy Report

    Contact

    carlat@thecarlatreport.com

    866-348-9279

    PO Box 626, Newburyport MA 01950

    Follow Us

    Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

    © 2025 Carlat Publishing, LLC and Affiliates, All Rights Reserved.