Evaluation of Metabolic Changes and Treatment Outcomes Associated with Risperidone in Paediatric Patients

Risperidone is widely used in treating pediatric neuropsychiatric disorders but concerns about its metabolic side effects—especially weight gain—remain significant. This prospective observational study was conducted in a tertiary-care hospital to evaluate short-term metabolic changes and behavioral outcomes in children aged 7 to 12 years who were newly initiated on risperidone. A total of 27 antipsychotic-naïve children were followed for an average of 9.5 weeks. Baseline and follow-up assessments included anthropometric measurements, fasting laboratory tests, and behavioral evaluation using the Child Behavior Checklist (CBCL). Over the study period, children showed a significant mean weight increase of 3.59 kg, and a BMI increase of 2.21 kg/m²—reflecting more than a 12% rise in both parameters. The degree of weight and BMI gain showed moderate correlation with risperidone dosage per body weight, while no link was found between these changes and either age or treatment duration. On the positive side, notable behavioral improvements were observed, with total CBCL scores dropping by 25.9 points, marking a 34% improvement, particularly in externalizing behaviors. These results highlight a concerning but measurable trade-off: while risperidone offers clear benefits in managing behavioral issues in children, it is also associated with significant and rapid weight gain that appears to be dose dependent. The findings reinforce the importance of cautious prescribing, with emphasis on using the lowest effective dose, regular metabolic monitoring, and integrating lifestyle counselling from the start of therapy. This study contributes to the growing body of evidence urging careful risk–benefit assessment in pediatric psychopharmacology.