Long-acting injectable risperidone in the treatment of subjects with recent-onset psychosis: a preliminary study.
Using a long-acting antipsychotic to improve adherence early in the illness may reduce relapse rates and promote sustained remission, thereby improving the long-term outcome of schizophrenia. We assessed whether risperidone long-acting injection (RLAI) could be used safely and effectively in the treatment of recent-onset psychosis. Fifty patients aged 15 to 43 years with newly diagnosed schizophreniform disorder or schizophrenia were treated with RLAI 25 to 50 mg every 2 weeks for 2 years. Thirty-six patients (72%) completed the trial. Of 39 (78%) who showed a clinical response of 50%, 4 relapsed. Thirty-two patients (64%) achieved remission. Mean maximum increase in Extrapyramidal Symptoms Rating Scale total score was 1.4 (95% confidence interval, 0.61-2.10; n = 50); 10 patients required anticholinergic medication, and 1 subject developed persistent dyskinesia. Prolactin levels were elevated in 18 patients, 4 of whom reported possible prolactin-related adverse events. Mean increase in body mass index to last visit for all patients was 4.8 kg/m (SD, 3.8 kg/m). The final RLAI dose was 25 mg for 54% of patients, 37.5 mg for 30%, and 50 mg for 16%. This preliminary study suggests that RLAI was overall well tolerated and appears to be effective in recent-onset psychosis. Further investigation is warranted.
Emsley
Robin
R
University of Stellenbosch, Tygerberg, Cape Town, South Africa. RAE@sun.ac.za
Medori
Rossella
R
Koen
Liezl
L
Oosthuizen
Petrus Paulus
PP
Niehaus
Dana J H
DJ
Rabinowitz
Jonathan
J
D000293:Adolescent; D000328:Adult; D000928:Antidepressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000627:therapeutic use*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004359:Drug Therapy, Combination; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007267:Injections; D008140:Lorazepam / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D010865:Pilot Projects; D011388:Prolactin / Q000097:blood; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011618:Psychotic Disorders / Q000097:blood / Q000188:drug therapy*; D018967:Risperidone / Q000008:administration & dosage / Q000627:therapeutic use*; D012559:Schizophrenia / Q000097:blood / Q000188:drug therapy; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects
D000928:Antidepressive Agents; D001786:Blood Glucose; D002784:Cholesterol; D003692:Delayed-Action Preparations; D006442:Glycated Hemoglobin; D008140:Lorazepam; D011388:Prolactin; D018967:Risperidone