Risperidone and Hepatotoxicity in Children and Adolescent: A Literature Review

Abstract

Risperidone is a second generation anti-psychotic drug that is commonly preferred in the treatment of schizophrenia, attention deficit hyperactivity disorder and bipolar disorders. Risperidone-associated hepatic adverse effects have long been investigated and continues to be unclear. In this review, our aim is to establish the possible hepatic adverse effects linked to risperidone treatment in children and adolescent in terms of severities and reversibility. We performed literature search via electronic databases (PubMed, Embase and the Cochrane Library) in August 2019. Risperidone treatment may lead to alterations in liver function test (LFT), mostly asymptomatic and reversible with the discontinuation or normalizes with time. Furthermore, there are few cases reporting risperidone-induced cholestatic hepatitis and immunoallergic hepatitis. Although exact mechanism of action of risperidone on liver remains unknown, there are growing evidences that link alterations of fatty acid biosynthesis to hepatic adverse effects. We recommend physicians to take basal LFT prior to risperidone treatment and monitor LFT during treatment. Additionally, physicians should be aware that most alterations at LFT associated with risperidone use are asymptomatic and reversible. However, more comprehensive studies investigating risperidone-associated hepatic adverse effects should be performed to reach a definitive outcome.