A postal survey was undertaken of the parents of 326 patients with severe and complex forms of attention deficit hyperactivity disorder (ADHD) to obtain their views of the efficacy and safety of risperidone augmentation therapy. Replies were received from parents of 170 patients (mean age: 14.3; SD: 4.4; range: 4–27 years). The results revealed an overall symptomatic improvement resulting from the risperidone therapy: 92% of parents and 100% of the prescribing clinician’s ratings indicated a net benefit of treatment (on a visual analogue rating scale); a good adherence rate (81%); low rates of significant adverse effects (8%); and a reduction of reported offending rates (overall 93% reduction comparing rates before and during risperidone therapy in 30 patients). Furthermore, most parents feared that their offspring would become ‘uncontrollably aggressive’ (84%) and ‘un- manageable’ (74%) should the risperidone therapy be stopped abruptly. It is concluded that risperidone augmentation appears to represent a well-tolerated and effective means of helping children and young adults with complex and severe forms of ADHD. However, its ‘off-label’ use in this context requires a high level of clinical caution at present.
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