Open-Label Risperidone for Asperger's Disorder: Negative Symptom Spectrum Response
J Clin Psychiatry 2005;66(12):1592-1597
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Asperger's disorder consists
of negative symptoms similar to those seen in schizophrenia, autism, schizoid personality
disorder, and schizotypal personality disorder. We investigated whether risperidone, which is
effective in treating the negative symptoms of
schizophrenia, would improve such symptoms
observed in Asperger's disorder in a prospective,
Method: Thirteen male patients aged 6 to
18 years who were diagnosed with Asperger's disorder by DSM-IV criteria were enrolled in a
12-week, prospective, open-label pilot study from March 13, 2002 to August 11, 2003. All
subjects were started on risperidone 0.25 mg twice
per day. Doses were increased based on clinical
indication and tolerability. The primary efficacy
variable was the Scale for the Assessment of Negative Symptoms (SANS). Each subject's
baseline score served as his control. Secondary
efficacy measures included the Positive and Negative
Syndrome Scale, Brief Psychiatric Rating Scale, Montgomery-Asberg Depression Rating
Scale, Global Assessment Scale, and a modified Asperger Syndrome Diagnostic Scale.
Results: We found a statistically
significant improvement from baseline for
last-observation-carried-forward (LOCF) analyses as well as
for analyses of 12-week completers (N = 9) in our primary outcome measure, SANS
scores (F = 13.41, p < .0001 for 12-week
completers; F = 9.64, p < .0001 for LOCF). We also found
statistically significant improvement in all
secondary efficacy measurements (F values range, 8.41 to 15.73, p values range, < .0001 for LOCF).
Conclusions: Subjects' symptoms
significantly improved after risperidone. The
open-label nature of this small pilot study suggests
caution in interpreting these data, but the results
suggest that placebo-controlled trials should follow.