Alterations of appetite-regulating hormones in risperidone treated children and adolescents—a post hoc analysis of the SPACe study

Weight gain and metabolic disruptions are common in children and adolescents treated with antipsychotics, but the underlying mechanisms are unclear, complicating prevention and treatment. This study examines the impact of risperidone on appetite-regulating hormones (insulin, leptin and bioleptin) and their relationship to body weight changes over time. In a post hoc analysis, we evaluated the correlation of appetite-regulating hormones with BMI z-scores during treatment and at a 6-month follow-up. The sample consisted of 10 participants (80% male, median age 9.7 years). A significant increase in bioleptin (p <.05) and BMI z-scores was observed over the 6 month period. At baseline, HOMA-IR, insulin, leptin, and bioleptin were significantly correlated with the BMI z-score; however, these associations were no longer observed after 6 months of treatment. Additionally, higher risperidone exposure correlated with lower appetite-regulating hormone levels at the 6-month mark. These findings indicate that risperidone significantly affects appetite-regulating hormones in children and adolescents, potentially contributing to antipsychotic-induced weight gain.