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Objective: Risperidone is widely prescribed for aggression and self-injury in children, adolescents, and adults with mental retardation (MR) and pervasive developmental disorders (PDD). Risperidone elevates prolactin more than other atypical antipsychotic medications. Females may show greater prolactin elevation than males.Method: In this relatively long-term study of risperidone efficacy and safety for aggression and self-injury in children, adolescents, and adults with MR and PDDs, serum prolactin was measured in a 21-subject subset during the course of a double-blind, placebo-controlled trial. Prolactin was measured in ng/mL at baseline, once during acute treatment, and once during maintenance.Results: In children and adolescents (n = 10), mean age of 12.5 years, prolactin increased from mean 13.2 ± 8.6 at baseline to 31.0 ± 11.6 acutely and remained elevated at 37.9 ± 10.4 in maintenance. In adults, mean age of 35.3 years, prolactin increased more markedly from 11.6 ± 7.4 baseline (n = 11) to 93.3 ± 54.2 acutely but decreased to 67.8 ± 62.9 in maintenance (n = 7). Prolactin remained significantly elevated above normal in all subjects for at least 26 weeks. Mean prolactin of adult females, while similar to that of adult males at baseline, was 2.2 times male levels acutely and 3.7 times greater in maintenance.Conclusion: In this small subset, mean prolactin elevation persisted for at least 26 weeks. In adults, females showed significantly greater elevations than males.

Objective: The aim of this study was to study valproate efficacy and safety for aggression in children and adolescents with pervasive developmental disorders (PDD).Methods: In this prospective double-blind, placebo-controlled study, 30 subjects (20 boys, 10 girls) 6–20 years of age with PDD and significant aggression were randomized and received treatment with valproate (VPA) or placebo (PBO) for 8 weeks as outpatients. Mean VPA trough blood levels were 75.5 mcg/mL at week 4 and 77.8 mcg/mL at week 8.Results: No treatment difference was observed statistically between VPA and PBO groups. The Aberrant Behavior Checklist—Community Scale (ABC-C) Irritability subscale was the primary outcome measure (p = 0.65), and CGI—Improvement (p = 0.16) and OAS (p = 0.96) were secondary outcome measures. Increased appetite and skin rash were significant side effects. Only 1 subject was dropped from the study owing to side effects, notably a spreading skin rash, which then resolved spontaneously. Two subjects receiving VPA developed increased serum ammonia levels, one with an associated parent report of slurred speech and mild cognitive slowing. Poststudy, of 16 VPA and PBO subjects receiving VPA, 10 subjects demonstrated sustained response, 4 of whom later attempted taper, with significant relapse of aggression.Conclusion: The present negative findings cannot be viewed as conclusive, partly owing to the large placebo response, subject heterogeneity, and size of the groups. Larger studies are needed to expand upon these findings.

Values rather than science are often unrecognized as an impetus for policy development; a reasonable role of science is to determine how the intent of policy can best be realized. In recent years, the policy of educating all handicapped students has been reevaluated primarily because of two factors: (a) costs associated with providing educational services and (b) disagreement among professionals concerning whether all handicapped students can benefit from an education. A review of the educability litigation reaffirms that equal educational opportunity is still valued, and education can be defined broadly. Rather than questioning the value of equal educational opportunity, we suggest that research and curriculum development should focus on three areas: First, apply the criteria of educational validity (Voeltz & Evans, 1983) to demonstrate that education is appropriate; second, investigate student variance in learning associated with specific student characteristics and interventions; and third, evaluate valid curricular approaches for efficiency and cost-effectiveness.