The effectiveness of risperidone in the treatment of three children with feeding disorders

Children with histories of extensive medical interventions in early childhood, especially those involving the gastrointestinal tract, are at-risk for residual feeding problems long after the medical issues have resolved. This case series describes the inpatient multidisciplinary treatment of 3 consecutive preadolescent children (ages 9, 8, and 7 years) admitted to our rehabilitation facility. Each child was admitted with a severe feeding disorder and histories of failure-to-thrive (FTT) that had required enteral nutritional interventions. Each child also had comorbid anxiety and mood symptoms. The addition of risperidone to behavioral and psychopharmacologic treatments was observed to significantly increase oral intake and accelerate weight gain. In 2 of 3 patients, assistive feeding interventions were successfully discontinued; and in a 3rd patient, enteral nutritional support was reduced by 74%. These cases suggest that risperidone may be a safe and effective adjunctive treatment, when behavioral feeding therapy is not sufficiently successful for children who have chronic and complicated medical and psychiatric presentations.