Risperidone (Risperdal) Gets FDA Nod for Schizophrenia and Bipolar Disorder in Kids
(August 22, 2007) -- ROCKVILLE, Md. -- The FDA approved
risperidone (Risperdal) today
for
schizophrenia in adolescents and for
bipolar I disorder in pediatric
patients as young as 10.
The action marks the first time that the FDA has approved an atypical
antipsychotic medication for use in children, said Thomas Laughren, M.D.,
director of the division of psychiatry products at the FDA's Center for Drug
Evaluation and Research.
At a press briefing Dr. Laughren said the FDA was aware that risperidone
was already used off-label to treat both conditions in children. Yet, he
pointed out that the three trials submitted for approval provided evidence
that risperidone is effective in children at doses of 1 to 3 mg and
increasing the dose to 3 to 6 mg did not increase efficacy.
The indication for schizophrenia is for treatment in adolescents ages 13
to 17 and the bipolar approval is for ages 10 to 17.
Dr. Laughren said the FDA action on risperidone marks the first formal
approval of a
schizophrenia drug for children. He cited "vague wording" on
the labels of older antipyschotics such as
haloperidol (Haldol) and
chlorpromazine (Thorazine) that the drugs may be useful in treating
schizophrenia in children.
Lithium is approved for bipolar disorder for children age 10 or older.
Dianne Murphy, M.D., director of the FDA's office of pediatric
therapeutics, said that although these conditions are relatively uncommon in
children, when they occur they are "devastating to families and children."
That devastation, she said, "is a public health concern."
As in adults, risperidone was associated with weight gain in children and
it also increased prolactin levels by about 49%, which makes gynecomastia a
consideration said Dr. Laughren.
Although weight gain was reported in the trials, there was no evidence of
an increase in serum glucose, but Dr. Laughren said that all trials were
short term, which could explain that finding.
Risperidone was approved earlier this year for treatment of irritability
associated with autism. As part of that approval, the FDA requested long
term follow-up studies and Dr. Laughren said the data from those
post-marketing studies should elucidate the diabetes risk.
The FDA granted the new indications on the basis of results of two
schizophrenia studies that enrolled a total of 255 adolescents and one
bipolar trial that enrolled 109 patients. In each trial half of the
participants received risperidone and half placebo.
The schizophrenia trials evaluated six to eight weeks of treatment and
the bipolar trial investigated three weeks of treatment.
All participants in the schizophrenia trial were experiencing an acute
episode at the time of enrollment. The FDA said treated patients had a
decrease in
hallucinations,
delusional thinking, and other
symptoms.
Patients in the bipolar trial were experiencing a mixed or manic episode
at enrollment. After treatment, patients had a decrease in elevated mood and
hyperactivity and a decrease in other symptoms.
Risperidone is manufactured by Janssen of Titusville, N.J.
By Peggy Peck, Managing Editor, MedPage Today
Source: MedPage Today
Last updated: 08/07
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