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Risperidone-induced enuresis in two children with autistic disorder.
J Child Adolesc Psychopharmacol. 2007 Aug; 17(4):527-30.JC

Abstract

INTRODUCTION

Risperidone appears to be effective in treating behavioral problems in children with autistic disorder. Although increased appetite, weight gain, and sedation are among the most common side effects, risperidone-induced enuresis is rarely reported.

METHOD

We will present two cases with risperidone-induced enuresis, and discuss our findings in the context of current literature.

RESULTS

Two children aged 11 and 10 years, diagnosed with autism and mental retardation, have developed new-onset diurnal and nocturnal enuresis respectively on their first and second weeks of risperidone monotherapy (1.5 and 1 mg/day). They did not experience sedation, and their medical history and workup were unremarkable. As enuresis did not resolve spontaneously, we decided to substitute risperidone with olanzapine. Enuresis ceased rapidly after discontinuation of risperidone with no emergence when patients were treated with olanzapine 5 mg/day for a period of 6 months and 1 year, respectively.

DISCUSSION

Although the pathophysiology of antipsychotic-induced enuresis remains unclear, a number of mechanisms including alpha(1)-adrenergic blockade, dopamine blockade, and antimuscarinic effects has been proposed. Olanzapine has lower alpha(1)-adrenergic and dopaminergic blockade properties, thus changing risperidone to olanzapine may be an alternative modality in risperidone-induced enuresis when antipsychotic treatment is crucial. Clinicians should be more vigilant about screening for this side effect, especially in younger population with developmental disabilities.

Authors+Show Affiliations

Department of Child and Adolescent Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. cocukergen@yahoo.comNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

17822346

Citation

Hergüner, Sabri, and Nahit Motavalli Mukaddes. "Risperidone-induced Enuresis in Two Children With Autistic Disorder." Journal of Child and Adolescent Psychopharmacology, vol. 17, no. 4, 2007, pp. 527-30.
Hergüner S, Mukaddes NM. Risperidone-induced enuresis in two children with autistic disorder. J Child Adolesc Psychopharmacol. 2007;17(4):527-30.
Hergüner, S., & Mukaddes, N. M. (2007). Risperidone-induced enuresis in two children with autistic disorder. Journal of Child and Adolescent Psychopharmacology, 17(4), 527-30.
Hergüner S, Mukaddes NM. Risperidone-induced Enuresis in Two Children With Autistic Disorder. J Child Adolesc Psychopharmacol. 2007;17(4):527-30. PubMed PMID: 17822346.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risperidone-induced enuresis in two children with autistic disorder. AU - Hergüner,Sabri, AU - Mukaddes,Nahit Motavalli, PY - 2007/9/8/pubmed PY - 2007/11/14/medline PY - 2007/9/8/entrez SP - 527 EP - 30 JF - Journal of child and adolescent psychopharmacology JO - J Child Adolesc Psychopharmacol VL - 17 IS - 4 N2 - INTRODUCTION: Risperidone appears to be effective in treating behavioral problems in children with autistic disorder. Although increased appetite, weight gain, and sedation are among the most common side effects, risperidone-induced enuresis is rarely reported. METHOD: We will present two cases with risperidone-induced enuresis, and discuss our findings in the context of current literature. RESULTS: Two children aged 11 and 10 years, diagnosed with autism and mental retardation, have developed new-onset diurnal and nocturnal enuresis respectively on their first and second weeks of risperidone monotherapy (1.5 and 1 mg/day). They did not experience sedation, and their medical history and workup were unremarkable. As enuresis did not resolve spontaneously, we decided to substitute risperidone with olanzapine. Enuresis ceased rapidly after discontinuation of risperidone with no emergence when patients were treated with olanzapine 5 mg/day for a period of 6 months and 1 year, respectively. DISCUSSION: Although the pathophysiology of antipsychotic-induced enuresis remains unclear, a number of mechanisms including alpha(1)-adrenergic blockade, dopamine blockade, and antimuscarinic effects has been proposed. Olanzapine has lower alpha(1)-adrenergic and dopaminergic blockade properties, thus changing risperidone to olanzapine may be an alternative modality in risperidone-induced enuresis when antipsychotic treatment is crucial. Clinicians should be more vigilant about screening for this side effect, especially in younger population with developmental disabilities. SN - 1044-5463 UR - https://www.unboundmedicine.com/medline/citation/17822346/Risperidone_induced_enuresis_in_two_children_with_autistic_disorder_ L2 - https://www.liebertpub.com/doi/full/10.1089/cap.2006.0056?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -