Their study showed that 17 patients (29.

3%) developed a
major depressive disorder. Of these, nine cases were
relapses in patients with a previous history of depression,
which was the only significant predictor of depression onset
during risperidone therapy. In the 13 patients (22.4%) who
became dysphoric while taking risperidone, use of
anticholinergics was a risk factor for dysphoria. Of the 30
patients who became depressed or dysphoric, 71.4%
stopped risperidone because of that side effect, including
one patient who committed suicide.

The authors concluded that depression and dysphoria may

be common among patients with TS who are given
risperidone and that the risk may be heightened in those
with a previous history of depression.

***

Low-Dose Risperidone Combination Treatment of

Irritable
Aggression in PTSD

Psychiatrists associated with Boston University School of

Medicine, the National Center for PTSD and the Veterans
Affairs Boston Health Care System in Boston reported the
results of a double-blind, placebo-controlled study
examining low-dose adjunctive risperidone and its potential
to reduce aggression and posttraumatic stress disorder
(PTSD)-related symptoms in combat veterans.

The subjects were male combat veterans who met DSM-IV

criteria for PTSD and scored 20 or more on Cluster D
(hyperarousal) of the PTSD Checklist, Military Version
(PCL-M). Subjects were randomly assigned to either
risperidone or placebo treatment groups. Drugs were
administered over a six-week treatment period following a
double-blind design. Subjects received either risperidone
0.5 mg/day (n=7) or matched placebo tablets (n=8) during
the first two weeks of the treatment period. Thereafter, the
dose of risperidone could be increased up to 2.0 mg/day,
based on the patients’ clinical response. Subjects were
continued on their pre-randomization psychotropic
regimen. They were evaluated using the PCL-M and the
Overt Aggression Scale, Modified for Outpatients (OAS-
M).

Data at the end of the trial indicated, “Administration of

low-dose risperidone may reduce symptoms of irritability
and intrusive thoughts in PTSD patients who exhibit high
levels of irritable aggression. The possibility remains that