HOUSTON – The atypical antipsychotic aripiprazole reduced symptoms such as aggression, hyperactivity, and impulsivity in 56% of 32 children with developmental disabilities, according to Maria R. Valicenti-McDermott, M.D., and Howard Demb, M.D..
Previous studies have shown that aripiprazole (Abilify) has fewer side effects, compared with most other typical and atypical antipsychotics. In their retrospective study, the investigators assessed clinical efficacy and side effects of the drug when it was used to treat emotional and behavioral problems in children with developmental disorders, they wrote in a poster presented at the annual meeting of the American Society of Adolescent Psychiatry.
The study included the first 32 children, aged 5–19 years, treated with aripiprazole at an urban clinic for children with developmental disorders, wrote Dr. Valicenti-McDermott and Dr. Demb of the Albert Einstein College of Medicine, New York.
All but 1 child had multiple diagnoses: 18 had mental retardation, 16 had autistic disorder, and 12 had attention-deficit hyperactivity disorder. Other diagnoses included mood disorder, multiple complex developmental disorder, disruptive behavior disorder, oppositional defiant disorder, pervasive developmental disorders, reactive attachment disorder, sleep disorders, and bipolar disorder.
The initial mean daily dosage of aripiprazole was 7.1 mg (0.17 mg/kg per day). The children reported for monthly visits and had used aripiprazole for at least 6 months at the time of the study. The mean maintenance dosage was 10.55 mg (0.27 mg/kg per day).
Overall, the medication was effective in improving symptoms or maintaining improvement in 10 of the 18 children with mental retardation (56%). Improvement in symptoms occurred in 9 of the 12 children with attention-deficit hyperactivity disorder (75%), 5 of the 6 children with disruptive behavior disorder (83%), and 7 of the 19 children with pervasive developmental disorders (37%). Among children with pervasive developmental disorders, drug effectiveness was higher in those with mental retardation (38%) than in those without mental retardation (33%).
The presence of an autism spectrum disorder, however, predicted a worse outcome. In theory, higher dosages might be more effective in children with autism, Dr. Demb said in an interview.
Although more than half the children showed improvement in their side effect profiles, weight gain occurred in all the children during the course of the study, and three discontinued the medication because of weight gain. The mean body mass index increased from 22.5 to 24.1 kg/m2 during the follow-up period.