Treating Aggression

Table of Contents

The treatment of aggression in children and adolescents is a complex issue because of the limited number of medications approved by the Food and Drug Administration (FDA). To treat aggressive behavior in a 15-year-old male person, risperidone should be prescribed (Mann, Li, Radwan, Karnik, & Keenan, 2017). This paper is aimed at describing the dosage, administration of the medication, adverse effects, and off-label use of drugs.

Dose and Administration

Treatment starts with prescribing the initial dose of 0.5 mg of risperidone per day. If there are no adverse reactions, the client is prescribed to take 1-1.5 mg orally per day depending on monitored changes. If required, the dose can be increased to 2 mg per day. Risperidone should be administered orally once daily without dependence on meals. Dizziness, nausea, and agitation are among common side effects.

The mechanism of action is based on the affinity for D2, 5HT2A, α1, α2, and specific H1 receptors (Mauri et al., 2014). The drug absorbs quickly, and high levels of concentration are noticed in one hour. Bioavailability is over 70%, and the urine and feces are the means of excretion.

Side Effects and Reactions

Side effects reported by patients usually include anxiety, drowsiness, dizziness, agitation, nausea, diarrhea, changes in vision, and abdominal pain among others. Adverse reactions associated with taking risperidone can include sedation, dyslipidemia, hyperglycemia, and hyperprolactinemia (Mauri et al., 2014; Morin, 2014). These metabolic changes should be actively monitored by physicians and nurses with the help of blood tests to prevent their development and adjust the dose.

Definition of Off-Label Prescription

The off-label use of psychotropic medications is associated with prescribing a certain drug that was not approved by the FDA to treat this specific condition. Thus, such a psychotropic medication as risperidone is approved to treat schizophrenia, bipolar mania, and irritability related to autism (Mann et al., 2017). However, the FDA does not officially recommend risperidone to cope with aggressive behaviors in children and adolescents.


While explaining the off-label prescription of risperidone to the client’s parents, one should accentuate that this practice is typical in psychiatry with reference to children’s cases. To select the most appropriate drug, medical workers refer to trials and case studies on the treatment of aggression in children and adolescents (Mann et al., 2017). Despite its off-label use for treating aggressive behavior, risperidone is commonly prescribed to address this state because of minimal side effects.

A Sound Clinical Decision and Conclusion

Although off-label use of medications is a controversial topic, this practice is common for pediatrics and psychiatry. The reason is that only about 50% of all drugs are approved by the FDA for being used in children and adolescents (Mann et al., 2017). If such medications as risperidone have proved their efficacy in treating similar psychiatric conditions (bipolar mania and irritability in children with autism), it is a sound decision to use this drug in the case of treating aggression. This decision is usually based on the analysis of evidence available for a certain diagnosis.


Mann, A., Li, A., Radwan, K., Karnik, N. S., & Keenan, K. (2017). Factors associated with management of teen aggression: Child psychiatric clinical decision making. Journal of Child and Adolescent Psychopharmacology, 27(5), 445-450.

Mauri, M. C., Paletta, S., Maffini, M., Colasanti, A., Dragogna, F., Di Pace, C., & Altamura, A. C. (2014). Clinical pharmacology of atypical antipsychotics: An update. EXCLI Journal, 13, 1163-1191.

Morin, A. K. (2014). Off-label use of atypical antipsychotic agents for treatment of insomnia. Mental Health Clinician, 4(2), 65-72.

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