Has anyone given their child Risperidone?

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My son was prescribed Risperidone for anger outbursts last August. He is on a very low dose, and for a while he was doing great. The last couple of weeks he has become aggressive like he was before he started taking it, he's complaining of constant sadness, he's having nightmares, his anxiety has increased and some OCD behavior has increased (he has to touch everything over and over again with his pointer finger and it's getting worse). He has also complained of headaches off and on, which may or may not be related, but is unusual for him. He says he can't control his body, and this was his complaint before taking the medication. At my son's school there were 2 kids that took this. Both of them were fine for a few months, it helped a lot, but then they became aggressive so the doctor increased the dose. Then they became more aggressive with the higher dose and ended up going off of the meds.

Have any of you experinced this with Risperidone? I am calling my psychiatrist and asking him to take him off of it. If I'm going to have an aggressive drugged kid, I would rather have an aggressive NOT drugged kid. I'm feeling kind of helpless. I don't know what the right thing is to do.

My husband was given that as an antidepressant once and he slept 20 hours a day.

Bad drug.

1-800-bad-drug even.

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I'm giving it another shot. We will see.
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Believe me...putting him on this was not a decision I took lightly. I'm watching him like a hawk and I'm seeing things I don't like. It really helped at first, and it was wonderful to see him have some self control and to see his self esteem come back, but it's not working anymore and I am not willing to increase the dose. It doesn't make him tired or zombie like, but it's like it's waring off and he again, cannot control his anger and impulses. The ocd stuff and anxiety is concerning me also. I haven't seen that to this degree since before the meds.

I know he needs them, therapy just isn't enough, but I'm afraid. I hate this. I feel so bad for him.

My son was put on a very low dose of risperidone because of extreme anxiety and sensory issues. It transformed him into a child that was able to be mainstreamed (they weren't going to before) and a child who was able to converse in whole sentences rather than a child who used maybe 3-4 words a day and communicated mostly by shrieking. It was only after risperidone that he called me "mommy". Still it gave him quite a pot belly and after a longer time he developed tics, full body, vocal and facial. his pdoc said they were the worst he had ever seen in a child. I think he could have done with a shorter course of the med but it did help him quite a bit for a while.

My younger brother has taken the stuff for his bipolar (something I personally believe he doesn't have or at most not to the degree my family and his doctor believe he does). The stuff is nasty and can probably screw him up mentally wise over the long term. The question i guess i want to ask is how severe is your kids anger problems and out bursts. If it is so disturbing and interfering with most of his life (and for me there is a preety high bar for you to get to that point) then keep him on the stuff and let the doctor increase the dose for now. The stuff is strong for a reason, most people who take it such as scizos or people with heavy bipolar would need it just to function and alot of times barely at that. And from my guess hes probably built up a tolerance to the stuff and thats why he would need more to get the same effect/ Personally I think if you can avoid having him on it please do.

He isn't extremely violent, but he won't hesitate to freak out on 6 teenagers by himself if they piss him off, which doesn't take much, if anything. (he's 10). He does not discriminate, he will hit his principal just as easily as a kid his size and sometimes feel no remorse because he feels it's justified, however he feels bad about himself because he can't control himself and he wants to deal with things the way he has learned is appropriate, but he can't. He has been in therapy for a long time and it was his therapist that said that he may need meds to respond to therapy. I tried everything I could to help him and nothing helps so I agreed, reluctantly. Before the meds, it was very painful to watch his self esteem tank, he is very hard on himself. When that happens he gets worse. It's a vicious circle. We planned on him being on it for a year, but I know that's not going to happen. I don't want him on anything, but I think he needs something, and he wants the help so badly. It worked really well for a while, and the weight gain wasn't all that bad, in fact he needed a few pounds, but his behavior the last 2 weeks and the conversations we have had about how sad he feels is alarming me.

Fortunately he is in a very small private school where all of the kids are challenged in some way. If he were in public school he'd be expelled by now. He could not handle public school, not at all. So, to answer your question, the aggression does interfere with his life, he cannot be left to his own devices, particularly in competitive or unstructured settings, but the set up I have for him now is willing to help work around that and they are very understanding, and non punitive which is a huge blessing. He would get by without meds in this situation, but his lack of self control eats away at him terribly. He is fully aware of his difficulties and differences, he is extremely intelligent with his maturity falling way behind that, and I think that really messes with his head and that is part of the problem.

I know I don't want to increase his dose or put him on abilify or something else like it. I don't know what else will help him, but I know that an antipsychotic is not on my list. Like I said, I'd rather have an aggressive kid not on drugs than an aggressive kid on them. This is the only medication he has tried, but I'm even more hesitant now than I was at the beginning.

Thank you all for the information. My son has been on Prozac, Vyvanse, Intuniv, Abilify, and Straterra. He has both ADHD and AS/HFA. We have been trying different things to help with focus, anxiety, mood swings, etc. So far, nothing has seemed to work and we just end up with side effects. The developmental pediatrician and his regular pediatrician have given up trying medications and feel that they are out of their comfort zone. So, they have both decided that he needs to be seen by a child psychiatrist to see if that Dr. has other medication ideas.

I thought long and hard about Abilify and so did the developmental pediatrician. It isn't something taken lightly. Especially since I took it for bipolar and had tics and difficulty swallowing and finally had to stop it because even on the smallest dose I was still getting side effects. And, by that point, it wasn't helping at all.

I will have to think VERY carefully about Risperidone. I would prefer to see him on nothing, but I think he may need something for a while until we can get things settled down some. 10 years old and 4th grade has been a nightmare. He was able to function at or above grade level in a regular classroom through 3rd grade. But now, he is really having trouble and was asked to leave the private school that he had attended since he was 22 months old.

Hopefully, we can find something that helps while we working on other therapies to make some longer-term changes for him.

Don't blame you for being hesitant. Nasty stuff, not to be used lightly. Kudos for the caution.

I don't know what to tell you, except that a different antipsychotic might work better. Might not, but might. With the same degree of caution you're applying to risperidone, it's at least not much more likely to do more harm.

I think those things have the effect of aggravating depression, myself, but that's based on my experience. I don't know if there are any studies to back that up.

**hugs** Hang in there. Something will work out, even if we don't know what yet.

I have a call into my psychiatrist, but what if he says to add an antidepressant with it? Now there are 2 drugs He mentioned this before, maybe having to go on one because of my son saying he can't get to his happy place, but at the time the aggression was still under control and he wasn't alarming me. I think the anger stems from depression and a very low self esteem, which I believe is due to extreme perfectionism. I have an appointment tomorrow with his therapist to talk abou totally changing the focus of his therapy from emotional control to what I believe is the root, perfectionism, and see if that helps him.


Thank You for the hugs BuyerBeware. I really need that I'm kind of a mess right now.

I think thats a great idea. I know from looking back at myself at that age alot of what i was feeling was shame and embarrassment from being looked on as defective by teachers and a lot of kids at school. For me, every time i had to go talk to my therapist or doctor I would get really upset and never try to work with them even why they wanted to genially help me. It was even worse when I got shipped off with the 3 or 4 other kids who had "special needs" to go with a tutor for help I didn't want or frankly need. It would make me really mad because I wanted to be like everyone else and not be coddled. Maybe this doesn't apply to your son, but has he ever mentioned that he doesn't like going to a special private school, and if he hasn't said that has he really ever said that he enjoys it and want help from it?

I have given him the choice to try public school, and told him that if he doesn't like it I can put him back where he is. He does not want to do that, and I still ask every now and then. He goes to a daycamp with a lot of kids in the summer, and he can get overwhelmed easily, particularly with the competition, and I think he knows that. The school he goes to is really nurturing, and VERY small and warm, like a family. It really is the best place for him and he is happy there. It's not a school for kids with learning disabilities necessarily, they take gifted as well, and high school kids that want to graduate early. It's for people who need more individual attention, for whatever reason. He loves the principal too and she loves him. They were actually playing with facetime on hers and my new iPhones last night. Who's kid calls their principal in the evening It's a wonderful place.

My son very much wants help. He asks for it. When he told me about never being able to get to his happy place, it's not just at night now, I asked if he wants more one on one time with his therapist (he's in group right now and loves it) and he said yes. He knows I can't help him, but I will get him with people who can. He is totally aware of his difficulties, he wants to please very badly, and it makes him feel like he's a bad kid when he can't control himself. A big challenge for him at this age is his maturity. He is so intelligent, so analytical and very self aware and his maturity has not caught up with that. Intellectually he understands what his therapist is trying to tell him, but the lack of maturity and self esteem make it hard for him to hear what he knows is right and he shuts down easily. You have to be very careful how you word things.

The incidents of aggression that you describe and your son's description of not being able to control his body sounds like it could be an impulse control issue. He knows what to do but isn't able to stop himself from being aggressive.

How about asking his doc about an ADHD medication instead of the risperidone? Difficulty with impulse control being a symptom of ADHD.

Obviously ADHD meds have their own issues, but just another line of possibility since you feel he needs something.

It is impulse control, totally. That is why I stopped social skills therapy, because he was getting frustrated because he knows what to do, and it got to the point where it just reminded him of what he couldn't control. That's when I went to a psychologist. He is in a social skills group now, but it's with kids his age or older and it's to help him deal with the frustration of playing with other kids (without hitting them), particularly where competition is a factor, not so much with pragmatics and appropriate responses to certain things. I think I'm going to keep him in the group, but maybe alternate with one on one therapy, as well as changing the focus.

I'm going to ask his psychiatrist about trying something other than an antipsychotic, because I have a feeling he's going to want to try abilify or put him on an antidepressant along with the risperidone. I don't know how comfortable I am with that, particularly when I read about how horrible the withdrawls are. He doesn't have attention issues, but I think his mind needs to slow down so he can respond in a way that he wants to, not what his body dictates. Whatever does that is what he needs, chemical or not. I'm so dissapointed too. He had a time where his self esteem was really coming back becasue of his new found control and it was wonderful to see....not anymore

Dunno if you've tried this, and I'm too lazy to refer back to the OP, but...

This fixed A LOT of stuff for me, and there is at least one study (which my DH found after the fact) to bear it out.

Tried moderate doses of risperidone. Gave it eight months. Ended up going from depressed with suicide ideation to in the hospital following an aborted suicide attempt.

They gave me mirtazepine at a moderate dose (30 mg at bedtime) and fluoxetine at a low dose (20 mg in the morning). It worked. Like magic. Depression-- almost gone. Rage-- suddenly controllable (but I note I was only violent towards myself, dunno if that makes a difference or not).

Dropped the mirtazepine after about seven weeks-- would have continued it longer but I turned up pregnant. Dropped the fluoxetine at the same time.

Went completely raving nuts again-- seemed to be anxiety-driven. Was actually on the point of putting myself back in the hospital, but they wouldn't admit me because I was neither suicidal nor homicidal. Went back on the fluoxetine-- same dosage, same schedule. Took about three or four weeks to really feel better, but I feel better now. Depression-- controllable. Rage-- fairly easily controllable.

Study is thus: Low doses of Prozac (fluoxetine) are actually more effective at treating depression and anxiety associated with AS than risperidone (the current preferred treatment-- tells you whose preference is reflected, doesn't it??) with fewer side effects.

Mirtazepine wasn't part of the study. I bring it up because it worked almost instantaneously, and had enough of a sedating effect to get me to sleep of a night (and therefore might take the edge off anxiety-driven aggression faster).

Further caveat: The study in question was done with adults. There's the whole antidepressant increasing risk of suicide in kids and young adults thing (which I think is due to the fact that antidepressants get rid of physical symptoms first, and suddenly very depressed people have the energy to die) and the fact that neither drug is actually approved for use in children (though it happens often enough, at least with fluoxetine).

The study was done with adults. And I'm eight days shy of being 34, which is a long way from 10. And I always had a strong tendency to turn my aggression inward (which I think is a she-Aspie thing).

I was on it when I was 14. It made me feel tired and made me hungry all the time.

Instead of the Risperdone, try a TCA (like Anafranil), possibly together with a stimulant (like Concerta or amphetamines) if the anafranil makes him drowsy or doesn't get his focus up to where it needs to be.

Anafranil (clomipramine) is officially an antidepressant, but it acts kind of like a very, very mild antipsychotic. It has a long history of use with OCD, and the TCA+stimulant combination has gotten good results for years for many.

TCAs aren't "sexy" anymore because their patents expired decades ago, they're no longer actively marketed, and they aren't quite as nice for straight-up depression as SSRIs and SNRIs, but there's abundant evidence that they can help the bundle of symptoms associated with AS+ADD in ways that newer SSRIs/SNRIs don't.

The worst side effect of them tends to be drowsiness, but they synergize nicely with drugs like Concerta. The TCA potentiates the Concerta & makes a lower dose do more & last longer, the Concerta neutralizes the drowsiness, and the drowsiness takes the "raw edge" off of methylphenidate (Concerta's active ingredient) that normally makes a lot of aspies dislike it.


Looking into my own insight, I can pretty much tell you why your son is attacking others. The Risperidone is making his ADD worse (it has almost the exact opposite effect of drugs like Ritalin), and he's feeling overwhelmed by people trying to forcibly pull his attention in multiple directions at once. It might be something as minor as an adult forcibly taking his attention away from something he's interested in, or multiple kids vying for his attention simultaneously, but the effect is the same -- he feels like he's getting pulled in multiple different directions at once, it's stressing him out badly, and he's fighting back to defend himself the only way he can.

Stimulant meds will increase his ability to process two or more conflicting demands upon his attention, or at least ignore them when they outstrip his ability to process them all at once. He'll quit fighting, because he won't have a *reason* to fight. He'll stop feeling like he's getting ripped apart by every human interaction, and the pain will mostly go away.

You mentioned that he's becoming depressed and has anxiety problems. That's hardly surprising. If you spent your day getting emotionally kicked and beaten up, then were subjected to punishment whenever you dared to fight back and defend yourself, you'd eventually spend your day consumed by fear of the next round of harm & punishment, and get depressed about the hopelessness your situation, too.

Ditto, for OCD. His rituals give him a brief, fleeting moment of relief. He doesn't particularly enjoy them (the way he'd enjoy a perseverative special interest), but they allow him to feel a sense of control that he doesn't normally get to feel. If the OCD remains after the stimulant meds help with his ability to filter out distractions and focus, the Anafranil will likely help quite a bit with that particular problem (it's the traditional treatment for OCD).


OK, now for the required disclaimer: in theory, not every child with ASD has ADD (or ADD-like symptoms) or benefits from stimulant meds. However, you'll have to search really hard to find ANYBODY with ADD (or ADD symptoms comorbid with AS) who took an antipsychotic as a child and has *anything* good to say about it. Antipsychotic drugs are more or less the polar opposite of stimulant meds, and usually make the underlying symptoms of ADD worse. They're basically the ultimate ADD "anti-medication".


Just to add, an earlier poster mentioned the benefits of mirtazepine. That's unsurprising. Mirtazepine isn't technically a TCA, but it's very TCA-like in its behavior. I don't know whether I'd necessarily recommend it as a first choice instead of something like Anafranil, but I'd certainly keep it in mind as "Plan B" if Anafranil doesn't quite do the job.