FDA Greenlights Risperdal for Kids and Teens

  • The FDA approved Risperdal for the treatment of schizophrenia or bipolar I disorder in kids and teens. Risperdal can now be prescribed for teens age 13 to 17 with schizophrenia, and for ages 10 to 17 for short-term (three-week) use with bipolar I disorder.

     

    I don't have a problem with that. Without breaking confidentiality, I'll make a general statement: childhood schizophrenia, though perhaps a rare form of the disorder (and I doubt it's as rare as we think), is often the most heartbreaking for mothers and fathers to experience secondhand. Seeing their son or daughter gripped by such a hell is the worst kind of hell to live in.

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    Thus, the FDA-endorsed treatment comes not a moment too soon; particularly since psychiatrists have been using it off-label for years.

     

    Dr. Thomas Laughren, director of the Division of Psychiatry Products at the FDA's Center for Drug Evaluation and Research, notes the agency has asked Janssen, the maker of Risperdal, to research how the drug might affect growth and development in adolescents.

     

    My key concern is that perhaps it could stunt growth or alter the formation of brain cells in teens, yet even here, because neuroleptics promote neurogenesis in adult brains, it's worth studying to see if cell regeneration happens in adolescent brains spiked with Risperdal.

     

    Again, I'm not terribly concerned because psychiatrists have been using medications off-label for some time, and would hopefully have the clinical experience and scrupulous judgment necessary to prescribe the Risperdal at a lower dose, or explore other dosing measures.

     

    Could the drug be used when it's not warranted? We've all heard or read stories of parents who "can't control" their wild, rebellious teens and remand them to psychiatric care, sometimes at hospitals where there's a flimsy excuse like the daughter wouldn't wear a dress. (The subject of the book, The Last Time I Wore a Dress.)

     

    It's chilling to think that this could happen in the modern world. Hope and Hell are often separated by a fine line. In retrospect, a mother could realize her daughter's moodiness or paranoia wasn't "normal" teenage mercurial blues, and wish something had been done. Yet how soon to dispense drugs is soon enough, and when is it too soon?

     

    If I were a mother, I'd hope against hope that my child would outgrow the schizophrenia, but the outcome can't be predicted. Because schizophrenia, a sly chameleon, does take on the traits of a hormone-addled adolescent, it's hard to diagnosis at first blush.

     

    That said, I'm in favor of early treatment if a psychiatrist has made, or a clinical team confers on, a diagnosis of schizophrenia. Every memoir I've read by an adult living with this condition has indicated the person lived ten or more years cycling through symptoms before a diagnosis or treatment was arrived at.

     

    In closing, I'll salute the FDA for greenlighting the use of Risperdal in kids and teens. My prayers are with those mothers and fathers whose young children live with this devastating illness.

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Published On: August 23, 2007