Table 4

Pharmacological treatment descriptions and evaluation findings

Medication
(daily dose)*
Sample size
(country)
Ages at post-testDuration
(setting)
Child behaviour outcomesChild
adverse
events†
Carbamazepine
(400–800 mg) w94
24
(USA)
5–11 years6 weeks
(hospital)
• 5 of 5 symptomsWeight gain 77%; dizziness 54%; headache 46%; leucopenia 46%; rash 46%; diplopia 38%; drowsiness 31%; nausea 31%; left study due to adverse events 8%
Haloperidol
(1–12 mg)
64
(USA)
5–12 years4 weeks
(hospital)
↓ 5 of 6 symptoms‡Any adverse event 100%; sedation 80%; dystonia 50%; drooling 30%; tremor 25%; left study due to adverse events not reported
Lithium
(500–2000 mg) w95
↓ 5 of 6 symptoms‡Any adverse event 81%; weight gain not reported§; abdominal pain 33%; headache 29%; left study due to adverse events not reported
Lithium
(600–2100 mg) w96
55
(USA)
5–12 years6 weeks
(hospital)
↓ 3 of 6 symptomsWeight gain 76%; vomiting 48%; abdominal pain 32%; tremor 28%; left study due to adverse events not reported
Lithium
(900–2100 mg) w97
40
(USA)
9–17 years4 weeks
(hospital)
↓ 3 of 3 symptomsWeight gain 85%; nausea 60%; excessive thirst 60%; urinary frequency 55%¶; vomiting 55%¶; abdominal pain 35%; headache 30%; tremor 25%; left study due to adverse events 0%
Quetiapine
(200–600 mg) w98
19
(USA)
12–17 years6 weeks
(clinic)
↓ 2 of 4 symptomsIrritability 78%; restlessness 78%; agitation 67%; anxiety 67%; sedation 67%; pacing 44%; social withdrawal 44%; reduced energy 33%; reduced alertness 33%; weight gain 33%; tachycardia not reported¶; left study due to adverse events 11%
Risperidone**
(1.5–4 mg) w99
38
(Netherlands)
12–18 years††6 weeks
(hospital)
↓ 1 of 3 symptomsFatigue 58%; physical slowing 26%; problems swallowing or talking 21%¶ ; increased prolactin levels not reported*; weight gain not reported¶; left study due to adverse events 0%
Risperidone
(0.75–1.5 mg) w100
20
(USA)
6–14 years10 weeks
(clinic)
↓ 5 of 6 symptomsAny side effect 80%; weight gain not reported¶; increased appetite 30%; sedation 30%; left study due to adverse events 10%
Risperidone**
(1.2 mg)‡‡ w101
119
(USA)
5–12 years††6 weeks
(clinic)
↓ 3 of 3 symptomsAny side effect 98%; sedation 51%¶; headache 29%; weight gain 15%¶; increased prolactin levels 13%¶ §§; left study due to adverse events 4%
  • • denotes no significant differences between intervention and placebo control groups; ↓ statistically significant reductions in symptoms.

  • *Reported doses include widest range that children received; dosing is not equivalent across medications.

  • †Adverse events only reported where ≥25% of children were affected or where significantly more children on medication versus placebo were affected; not all studies assessed whether medication and placebo adverse events differed significantly.

  • ‡In addition to both lithium and haloperidol showing significant symptom reductions over placebo on 5 of 6 measures, lithium showed significant benefits over haloperidol on 1 symptom measure.

  • §While authors did not report proportion of children experiencing weight gain, they noted that it was considerable (ranging from means of 31.7–35.0 kg).

  • ¶Adverse events experienced by significantly more children on medication than placebo.

  • **All children had below-average IQs.

  • ††Ages reflect children eligible for the study.

  • ‡‡Average daily dose; range not reported.

  • §§Significantly more boys (but not girls) experienced increased prolactin levels on medication versus placebo.