An open study of risperidone liquid in the acute phase of schizophrenia.
An open-label study was performed to investigate the clinical efficacy and mechanisms of risperidone liquid in ameliorating positive symptoms in the acute phase of schizophrenia. Eighty-eight patients (M/F: 50/38; age: 18-74 years;, mean +/- SD =32 +/- 16 years) meeting DSM-IV criteria for schizophrenia and treated with risperidone liquid (14 patients also used lorazepam) were evaluated with regard to their clinical improvement and extrapyramidal side effects using the positive and negative syndrome scale (PANSS) and the Simpson and Angus scale (SAS), while plasma concentrations of HVA and MHPG were analysed by HPLC-ECD before and 4 weeks after risperidone liquid administration. Patients showing a 50% or greater improvement in PANSS scores were defined as responders. An improvement in the PANSS scores related to excitement, hostility and poor impulse control was seen within 7 days after administration of risperidone liquid, and an improvement with regard to hallucinatory behaviour and uncooperativeness was seen within 14 days after its administration. Finally, 68% of patients were classified as responders 4 weeks after risperidone liquid administration. The scores of SAS were not changed after risperidone liquid administration. Pretreatment plasma homovanillic acid (HVA) levels in the responders (8.1 +/- 2.9 ng/ml) were higher than those in nonresponders (5.9 +/- 1.9 ng/ml). In addition, a negative correlation was seen between the changes in plasma HVA levels and the percentage of improvement in PANSS scores. On the other hand, there were no differences between pretreatment plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) levels and those of nonresponders. These results suggest that risperidone liquid is effective and well tolerated for the treatment of acute phase schizophrenic patients, and that efficacy is related to its affects on dopaminergic activity, not noradrenergic activity.
Yoshimura
Reiji
R
Department of Psychiatry, University of Occupational and Environmental Health, Kitakyushu, Japan. yoshi621@med.uoeh_u.ac
Nakamura
Jun
J
Shinkai
Koji
K
Goto
Makiko
M
Yamada
Yasuhisa
Y
Kaji
Kyoko
K
Kakihara
Shingo
S
Ueda
Nobuhisa
N
Kohara
Kimio
K
Ninomiya
Hideaki
H
Egami
Hideaki
H
Maeda
Hisao
H
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D002851:Chromatography, High Pressure Liquid; D004563:Electrochemistry; D005260:Female; D006212:Hallucinations / Q000188:drug therapy; D006719:Homovanillic Acid / Q000097:blood; D006791:Hostility; D006801:Humans; D007175:Impulsive Behavior; D008297:Male; D008875:Middle Aged; D019999:Pharmaceutical Solutions; D011569:Psychiatric Status Rating Scales; D011595:Psychomotor Agitation / Q000188:drug therapy; D018967:Risperidone / Q000008:administration & dosage* / Q000627:therapeutic use*; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology
D014150:Antipsychotic Agents; D019999:Pharmaceutical Solutions; D018967:Risperidone; D006719:Homovanillic Acid