Risperidone treatment of motor restlessness following anoxic brain injury

Primary objective: This paper examined the use of an atypical neuroleptic medication, risperidone, in reducing the excessive motor activity of an adolescent with an anoxic brain injury following cardiac arrest from a lightning strike. Lower extremity restlessness caused the patient to develop skin breakdown and interfered with healing of existing burns.

Research design: Single-blind, placebo-controlled single-subject experimental design.

Experimental intervention: Escalating doses of risperidone up to 1 mg and in combination with methylphenidate (10 mg) and amantidine (100 mg).

Main outcomes and results: The patient demonstrated a reduction in restlessness in response to the use of risperidone, which permitted wound healing. The addition of methlphenidate to risperidone led to a slight increase in attention to task.

Conclusions: The use of the atypical neuroleptic medication, risperidone, may be considered as part of the armamentarium available to physicians treating restlessness in severe brain injuries.