Treatment of nonpsychotic relatives of patients with schizophrenia: four case studies.
BACKGROUND
Substantial evidence now shows that the genetic vulnerability to schizophrenia can be manifested clinically in first-degree relatives of people with schizophrenia, even without the full manifestations of the disorder. One pattern of problems observed involves the combination of negative symptoms and neuropsychological deficits. We have investigated whether a low dose of a novel antipsychotic medication, risperidone, could attenuate these clinical problems in non-psychotic, first-degree relatives, and report here findings from our first 4 cases.


METHODS
Twelve adults who were first-degree relatives of patients with schizophrenia were evaluated for the presence of negative symptoms and neuropsychological deficits (in attention and working memory, long-term verbal memory and executive functions). Four subjects who met our predetermined criteria, and who did not demonstrate medical contraindications, were enrolled in a 6-week trial of risperidone. Clinical and medical measures were assessed before, during and after treatment. Doses of risperidone started at 0.25 mg and were increased to 1.0-2.0 mg/day.


RESULTS
These subjects showed substantial reductions in negative symptoms, and one subject showed modest reductions. All four subjects showed substantial improvements on some tests of attention and working memory. Side effects of risperidone were temporary and mainly mild.


CONCLUSIONS
These initial findings support two conclusions. First, clinical deficits in non-psychotic first-degree relatives of people with schizophrenia are identifiable, and to a significant extent, reversible. Second, risperidone may eventually serve as an effective treatment for people whose lives are impaired by similar or related problems.
Tsuang
M T
MT
Harvard Medical School, Department of Psychiatry, Massachusetts Mental Health Center (MMHC), Boston 02115, USA.
Stone
W S
WS
Seidman
L J
LJ
Faraone
S V
SV
Zimmet
S
S
Wojcik
J
J
Kelleher
J P
JP
Green
A I
AI
D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D001288:Attention / Q000187:drug effects; D001526:Behavioral Symptoms / Q000188:drug therapy* / Q000235:genetics; D003072:Cognition Disorders / Q000188:drug therapy* / Q000235:genetics; D005192:Family Health; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008568:Memory / Q000187:drug effects; D009483:Neuropsychological Tests; D010865:Pilot Projects; D018967:Risperidone / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy / Q000235:genetics*; D013997:Time Factors; D016896:Treatment Outcome; D014836:Volition / Q000187:drug effects
D014150:Antipsychotic Agents; D018967:Risperidone