Risperidone nel controllo dei sintomi negativi nell'anoressia nervosa in adolescenza

The aim of this study was to compare the efficacy of haloperidol and risperidone in controlling the negative symptoms of anorexia nervosa. The secondary aim was to verify the possible diminution of extrapyramidal symptoms (EP) which are clearly present in these patients when using other types of neuroleptics (haloperidol) facilitated by their poor physical conditions. The study was carried out in 20 patients (17 F, 3 M) with a diagnosis of anorexia nervosa according to the criteria of DSM.IV. The participants were treated after being admitted to the Psychiatric and Psychotherapy Department of 'Bambino Gesu' Hospital in Rome. The tests consisted in a preliminary psychopathological evaluation using a self- administered questionnaire, SCL-90 followed by a clinical interview; haloperidol was then gradually replaced by risperidone; having completed this phase, treatment was continued using risperidone alone for about 2 weeks. The stability of the results obtained was evaluated at a follow-up after 6- months. Patients were asked to fill in the questionnaire for a second time and attended a clinical interview. The results obtained were encouraging; after 2 weeks' treatment with risperidone it was noted that patients were more aware of their physical conditions and started to eat autonomously. EP signs were relatively slight in terms of intensity and duration. The results obtained were confirmed at the follow-up after 6 months at which the overall score of the pathology using SCL-90 (GSI) diminished. The authors regard the results of the study was being positive from two points of view: 1) the improved control of negative symptoms accelerates the phase of reacquiring nutritional 'autonomy'; 2) the slight presence of EP signs simplifies the administration itself (avoiding the presence of an anticholinergic drug) and increasing compliance with treatment.