Risperidone Is Safe, Effective to Treat Kids with Choreoathetoid Cerebral Palsy, Study Finds

Risperidone is a well-tolerated and efficient therapy to help manage motor symptoms in children with choreoathetoid cerebral palsy, according to researchers.

Their study, “Effect of Risperidone on the Motor and Functional Disability in Children With Choreoathetoid Cerebral Palsy,” was published in the journal Pediatric Neurology.

Children with choreoathetoid cerebral palsy exhibit disabling and abnormal movements known as chorea — jerky involuntary movements affecting the shoulders, hips, and face. However, these children have preserved cognitive skills.

While pharmacological and nonpharmacological approaches, such as botulinum toxin (Botox) and surgeries, are available to treat children with spastic cerebral palsy (the most common type of cerebral palsy, characterized by muscle spasticity), little is available for children with the choreoathetoid form of the disease.

Currently available therapies to manage chorea include benzodiazepines — a class of psychoactive therapies with sedative and relaxant properties — and tetrabenazine, used to treat Huntington’s disease-associated chorea.

However, these compounds are associated with side effects, including sedation, and are often not suitable for long-term treatment.

Risperidone, a second-generation antipsychotic, has been shown to be safe and beneficial to treat patients with rheumatic and Huntington’s chorea. The medication is also approved by the U.S. Food and Drug Administration to treat irritability associated with autism in children and adolescents ages 5-16.

Researchers investigated the effectiveness and safety of risperidone to treat chorea in 35 children (mean age of 6.35) with choreoathetoid cerebral palsy. Patients were treated with risperidone for six months, along with their standard care.

Researchers assessed improvement in choreoathetoid movements, upper-limb functions, and quality of life using the Abnormal Involuntary Movement Scale (AIM), the Quality of Upper Extremity Skill Tests (QUEST), and the Cerebral Palsy-Quality of Life questionnaire, respectively.

Among the 35 patients enrolled, 30 completed six months of risperidone therapy while five participants were excluded due to missed dosages.

After six months of treatment, abnormal movements were significantly reduced. Additionally, the functional ability of upper limbs and quality of life also increased.

Over the course of the study, researchers noted a positive change across almost all the domains evaluated, including an improvement in facial and extremity movement score. Trunk movement score slightly improved, but not in a statistically significant manner.

Less abnormal movements resulted in improved self-esteem, positive change in behavior, and improved motor skills, which, in school-going children, translated into better scholastic performance due to improvements in handwriting.

Risperidone was well-tolerated and no children developed or reported life-threatening or extrapyramidal (movement-related) side effects.

“Risperidone is a promising drug to manage children with choreoathetoid cerebral palsy and is well tolerated in children,” researchers wrote.

But the authors added that “despite the beneficial effect of risperidone in children with choreoathetoid cerebral palsy observed in the present study, these findings need to be interpreted cautiously and need further validation due to potential limitations of the study.”