Comparison of Risperidone and Methylphenidate for Reducing ADHD Symptoms in Children and Adolescents With Moderate Mental Retardation

J Am Acad Child Adolesc Psychiatry. 2005 Aug;44(8):748-55. doi: 10.1097/01.chi.0000166986.30592.67.


Objective: To evaluate the short-term efficacy and tolerability of risperidone and methylphenidate for reducing symptoms related to attention-deficit/hyperactivity disorder (ADHD) in children and adolescents with moderate mental retardation.

Method: In a 4-week, single-blind, parallel-group trial, 45 subjects with moderate mental retardation and ADHD were randomized to risperidone or methylphenidate and assessed using objective rating scales for efficacy (SNAP [Swanson, Nolan, and Pelham]-IV and Nisonger Child Behavior Rating Form) and side effects (Barkley's Side Effects Rating Scale and Udvalg for Kliniske Undersøgelser).

Results: Both groups had reduced ADHD symptoms during the trial. Repeated-measures analysis of variance yielded a significant effect for the interaction between time and group assignment in SNAP-IV Total scores (F = 3.26; p = .05), suggesting a more pronounced effect for risperidone. There was a significant weight reduction in the methylphenidate group and a weight gain in the risperidone group.

Conclusions: Our findings suggest that risperidone is associated with greater reductions in ADHD Total score than methylphenidate in children with moderate mental retardation and ADHD. Comorbidity and the side effects profile might be of importance in choosing between the medications, although it is usually prudent to try stimulants before antipsychotics in such children.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Antipsychotic Agents / therapeutic use*
  • Attention Deficit Disorder with Hyperactivity / drug therapy*
  • Attention Deficit Disorder with Hyperactivity / epidemiology*
  • Central Nervous System Stimulants / therapeutic use*
  • Child
  • Comorbidity
  • Female
  • Humans
  • Intellectual Disability / epidemiology*
  • Male
  • Methylphenidate / therapeutic use*
  • Risperidone / therapeutic use*


  • Antipsychotic Agents
  • Central Nervous System Stimulants
  • Methylphenidate
  • Risperidone