Risperdal PBS listing change to provide relief for families with autistic children

Antipsychotic medication Risperdal (also known as risperidone) has recently had its listing with the Pharmaceutical Benefits Scheme (PBS) altered. New 3mg and 4mg Quicklet forms of the medication are now listed, and it is now approved for use in the treatment of some of the behaviours associated with autism.

Risperdal is what is known as an ‘atypical’ or second generation antipsychotic agent due to the lower rate of certain side effects. While no one knows exactly how it works, it is thought to alter the chemical balance within the brain. It is thought that dopamine is the most important chemical on which Risperdal has an effect, where Risperdal acts to lower the effect of dopamine on chemical sensors (called receptors) that are present on brain cells.

Autism is a condition in which children are often described as ‘living in their own world’. They have delays in social interaction, language used for communication as well as symbolic and imaginative play. It occurs in around 125 per 20,000 children between the ages of six and twelve. This means that, on average, there is one child with an autism spectrum disorder in every 160 children in this age group, representing 10,625 children Australia-wide.

Risperdal has just recently entered the PBS as a treatment for some of the behaviours of autistic children who display behavioural disturbances such as severe aggression and injuries to self or others. Studies have shown that Risperdal improves features of autism such as lethargy and social withdrawal, stereotypic behaviour, hyperactivity, and inappropriate speech. This is great news, as it allows another possible avenue of treatment for the reduction in some of the symptoms of autism. Risperdal may only be used in conjunction with non-pharmacological methods, and under the supervision of a trained paediatrician or psychiatrist.

It should be noted that this PBS listing applies only to Risperdal’s use in autism. Although Risperdal is listed as a treatment for conduct disorder (a disorder where the child repeatedly violates societal rules and norms), patients with this disorder will still not be able to access the drug through the PBS.

Beyond this new use, the actions on dopamine mean that Risperdal continues to be a very common medication for schizophrenia. Schizophrenia is a mental disorder in which the sufferer experiences ‘positive symptoms’ such as delusions (beliefs in things that are not real), hallucinations (often hearing things that aren’t there) and disorganised thinking. They can also suffer from what are known as ‘negative symptoms’, where the person can appear ‘flat’ with little emotion or motivation. Around 15 people per 100,000 suffer from schizophrenia at any one time. Risperdal is a very common and useful medication in the treatment of schizophrenia, as it helps not only relieve the positive symptoms but also the negative symptoms.

Risperdal is useful for other conditions as well, including bipolar disorder, a condition in which people experience extremes of mood. Sufferers of bipolar can have moods that swing between ‘mania’ — where people experience lots of energy and drive, often leading them to act irresponsibly with money or substances — to very severe depression. Bipolar is fairly common, and can affect around 2.5% of people at some time in their life. Risperdal can be a very useful short-term treatment during the manic phase of this condition.

Risperdal recently become available in 3mg and 4mg Quicklets, which are small and quickly soluble tablets that quickly disintegrate when placed on the tongue, making them easier to swallow and reducing the difficultly in administering the medication.

The addition of Risperdal to the PBS as a treatment for some of the symptoms associated with autism will help lighten the load for parents of autistic children, both financially and emotionally.