title: A long-term, multicenter, open-label study of risperidone in elderly patients with psychosis. On behalf of the Risperidone Working Group.
abstract: BACKGROUND
  Studies have shown that risperidone is safe and efficacious in young and middle-aged adults with chronic schizophrenia, but considerably fewer data are available on the treatment of elderly patients with schizophrenia or other psychotic disorders, particularly long-term outcomes.
  
  
  OBJECTIVE
  A 12-month, open-label study was conducted to assess the effects of risperidone in elderly, chronically ill, psychotic patients.
  
  
  METHODS
  This study enrolled 180 elderly, chronically ill, psychotic patients (median age, 72 years [range 54-89]), 97 of whom completed the 12-month study. At endpoint, the mean dose of risperidone was 3.7 mg/day.
  
  
  RESULTS
  Clinical improvement (> or =20% reduction in Positive and Negative Syndrome Score [PANSS] total score) was achieved by 54% of patients at endpoint. There were significant reductions in PANSS total, subscale (positive, negative, and general psychopathology), and cognition cluster scores at endpoint (p<0.001). Clinical Global Impressions severity of illness scores showed continued improvement through month 12 (p<0.001). In contrast, PANSS data from a historical comparable control group of patients receiving conventional antipsychotic agents showed no symptom improvement over a 12-month treatment period. The severity of preexisting extrapyramidal symptoms (EPS) in patients treated with risperidone decreased significantly from baseline to endpoint (p<0.001), and the use of antiparkinsonian medication decreased from 41.1% of patients before the trial to 25.6% during the trial. There were no spontaneous reports of tardive dyskinesia (TD) and the incidence of assessed TD was 4.3% in contrast to the expected 26% reported in middle-aged and elderly patients receiving conventional antipsychotic agents for 1 year.
  
  
  CONCLUSIONS
  Long-term treatment with risperidone was associated with continued symptom improvement, a decrease in the severity of preexising EPS, and a low incidence of TD in elderly psychotic patients.
authors.affiliation: Sheba Medical Center, Tel Aviv, Israel. davidson@netvision.net.il
authors.forename: M
authors.initials: M
authors.lastname: Davidson
authors.forename: P D
authors.initials: PD
authors.lastname: Harvey
authors.forename: J
authors.initials: J
authors.lastname: Vervarcke
authors.forename: C A
authors.initials: CA
authors.lastname: Gagiano
authors.forename: J D
authors.initials: JD
authors.lastname: De Hooge
authors.forename: G
authors.initials: G
authors.lastname: Bray
authors.forename: M
authors.initials: M
authors.lastname: Dose
authors.forename: Y
authors.initials: Y
authors.lastname: Barak
authors.forename: M
authors.initials: M
authors.lastname: Haushofer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002908:Chronic Disease; D003702:Delusions / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D004409:Dyskinesia, Drug-Induced / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D018967:Risperidone / Q000009:adverse effects / Q000627:therapeutic use*; D012559:Schizophrenia / Q000175:diagnosis / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D018967:Risperidone