- Begin with 0.25 mg twice daily.
- The dose may be increased by 0.25 mg increments after 3 to 4 weeks at each dose.
- If 1 mg twice daily is not effectively controlling anxiety, consider other medical, environmental, or behavioral problems.
- Begin with 1 mg twice daily
- The dose may be increased by 1 mg increments after 1-2 weeks at each dose.
- If 5 mg twice daily is not effectively controlling anxiety, consider other medical, environmental, or behavioral problems.
Due to the risk of weight gain and associated hyperglycemia and hyperlipidemia, a fasting plasma glucose and lipid panel should be obtained 3 months after initiation of an atypical antipsychotic and every 6 months thereafter. Consider changing to an alternative medication if a child’s weight crosses two percentile lines upward while on an antipsychotic.
- Medical problems such as chronic sinusitis or abdominal pain may lead to acute behavioral issues that would not respond to behavioral medications.
- If aggressive behaviors have been reinforced with an outcome that is desired by the patient, of if the aggressive behavior is exhibited as a means to escape an unwanted task, a decrease in the behavior may be seen initially when the patient experiences the sedating effect of an antipsyhcotic medication. In this instance, the negative behavior will generally return as the patient becomes accustomed to the medication. A psychologist or other care provider skilled in behavior modification should be involved in the care of individuals with negative behaviors that are learned.
- The maximal dose of risperidone (when used by the primary care physician) is 3 mg/day.
- The maximal dose of aripiprazole (when used by a primary care physician) is 10 mg/day.
- Note: weight gain can be a significant problem.
- The Abnormal Involuntary Movement Scale (AIMS) should be administered at follow up visits to monitor for extrapyramidal effects.
Abnormal Involuntary Movement Scale (AIMS) (HHS) ( 17 KB)
This scale may be used to monitor for extrapyramidal side effects in the individual treated with antipsychotic medications. It is intended for use with the Abnormal Involuntary Movement Scale-Instructions file; from the U.S. Department of Health, Education, and Welfare (HEW), now the U.S. Department of Health and Human Services (HHS).
Abnormal Involuntary Movement Scale (AIMS) Instructions (HHS) ( 264 KB)
Instructions for use with the Abnormal Involuntary Movement Scale (AIMS); from the U.S. Department of Health, Education, and Welfare (HEW), now the U.S. Department of Health and Human Services (HHS).
Nisonger Child Behavior Rating Form
A standardized tool used in assessing child and adolescent behaviors.
Owen R, Sikich L, Marcus RN, Corey-Lisle P, Manos G, McQuade RD, Carson WH, Findling RL.
Aripiprazole in the treatment of irritability in children and adolescents with autistic disorder.
Pediatrics. 2009;124(6):1533-40. PubMed abstract / Full Text
Stigler KA, Diener JT, Kohn AE, Li L, Erickson CA, Posey DJ, McDougle CJ.
Aripiprazole in pervasive developmental disorder not otherwise specified and Asperger's disorder: a 14-week, prospective, open-label study.
J Child Adolesc Psychopharmacol. 2009;19(3):265-74. PubMed abstract / Full Text
|Content Last Updated:||8/2009|
Crawford AH, Schorry EK.
Neurofibromatosis in children: the role of the orthopaedist.
J Am Acad Orthop Surg. 1999;7(4):217-230. PubMed abstract
Excellent review of the orthopedic manifestations of NF1 particularly for orthopedic physicians managing NF1 patients.
Luby J, Mrakotsky C, Stalets MM, Belden A, Heffelfinger A, Williams M, Spitznagel E.
Risperidone in preschool children with autistic spectrum disorders: an investigation of safety and efficacy.
J Child Adolesc Psychopharmacol. 2006;16(5):575-87. PubMed abstract
A randomized placebo-controlled trial showing safety and efficacy for risperidone in preschool children on the autism spectrum.
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Risperidone and adaptive behavior in children with autism.
J Am Acad Child Adolesc Psychiatry. 2006;45(4):431-9. PubMed abstract