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Risperidone
Kinds of Risperidone Terms modified by Risperidone Selected AbstractsEffectiveness and tolerability of risperidone in Asian patients with first-episode psychosisACTA PSYCHIATRICA SCANDINAVICA, Issue 2002S. Verma Objectives, To evaluate the effectiveness and tolerability of risperidone in Asian patients with first-episode psychosis and to examine correlates of response in a naturalistic study. Method, Patients with first-episode psychosis were evaluated at baseline and weekly for 6 weeks with the Positive and Negative Scale for Schizophrenia (PANSS), Simpson,Angus Rating Scale (SARS), Barnes Akathisia Rating Scale (BARS), Rating Scale for Side-effects (RSSE), and the Abnormal Involuntary Movement Scale (AIMS). Results, 42 patients with a mean age of 24.85 ± 9.68 years and mean duration of untreated illness of 11.91 ± 22.04 months were recruited. The mean dose of risperidone was 1.82 ± 0.77 mg. The mean reduction in PANSS score was from 67.97 ± 20.02 at baseline to 42.53 ± 14.08 at week 6 (P < 0.005). The incidence of extrapyramidal symptoms was 9.5% and akathisia was 7.1%. 45.2% of patients showed more than or equal 40% reduction in the PANSS score (responders). When responders were compared to nonresponders, the responders had a significantly higher total and positive PANSS score at baseline. Conclusion, Risperidone is an effective and safe antipsychotic in first-episode psychosis. [source] Comparative study of sexuality-related characteristics in young adults with schizophrenia treated with novel neuroleptics and in normal young adultsACTA PSYCHIATRICA SCANDINAVICA, Issue 2002P. Fortier This study compared characteristics related to sexual history, sexual activities, sexual functioning and psychological tendencies associated with sexuality in 45 young adults with schizophrenia treated with novel neuroleptics and 61 control young adults. A smaller proportion of young adults with schizophrenia currently had a sexual partner or had ever engaged in sexual relations. They also had sexual relations and sexual desires less often. Whether affected by schizophrenia or not, a smaller proportion of women had ever masturbated. They felt less sexual desire and desired sexual relations less often. Compared to controls, a higher proportion of men with schizophrenia treated with Risperidone or Olanzapine had at least one sexual dysfunction, lacked sexual desire and reported problems with sexual arousal and ejaculation. Women with schizophrenia were more likely to report problems with sexual arousal and galactorrhea. Finally, young adults with schizophrenia develop more negative psychological tendencies associated with sexuality than were normal young adults. Sexual problems are highly prevalent among young adults with schizophrenia. Sexuality should occupy the space it deserves within psychosocial rehabilitation programs and the treatment of schizophrenia. [source] Plasma Concentrations of Risperidone and Olanzapine during Coadministration with OxcarbazepineEPILEPSIA, Issue 5 2005Maria Rosaria Muscatello Summary:,Purpose: Oxcarbazepine (OZC) is a second-generation antiepileptic drug (AED) that also may be used as a mood stabilizer. Unlike carbamazepine (CBZ), which is an inducer of the cytochrome P-450 isoforms and may accelerate the elimination of several therapeutic agents, OXC seems to have only a modest inducing action. The aim of this investigation was to evaluate the effect of a treatment with OXC on plasma concentrations of the new antipsychotics risperidone and olanzapine. Methods: OXC, at a dosage of 900,1,200 mg/day, was administered for 5 consecutive weeks to 25 outpatients, 10 men and 15 women, aged 25 to 64 years, with bipolar or schizoaffective disorder. Twelve patients were stabilized on risperidone therapy (2,6 mg/day) and 13 on olanzapine (5,20 mg/day). Steady-state plasma concentrations of risperidone and its active metabolite 9-hydroxyrisperidone (9-OH-risperidone) and olanzapine were measured by high-pressure liquid chromatography (HPLC) before addition of OXC and after 5 weeks from the start of adjunctive treatment. Results: OXC caused only minimal and no significant changes in the mean plasma levels of risperidone (from 5.6 ± 3.6 ng/ml at baseline to 4.8 ± 2.6 ng/ml at week 5), 9-OH-risperidone (from 23.6 ± 7.5 to 24.7 ± 7.4 ng/ml), and olanzapine (from 26.5 ± 5.7 ng/ml at baseline to 27.8 ± 5.1 ng/ml). OXC coadministration with either risperidone or olanzapine was well tolerated. Conclusions: Our findings indicate that OXC does not affect the elimination of risperidone and olanzapine, thus confirming its weak inducing effect on hepatic drug-metabolizing enzymes. [source] Risperidone versus olanzapine for the treatment of deliriumHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 4 2010Sung-Wan Kim Abstract Objective This study compared the effectiveness of risperidone and olanzapine in the treatment of delirium. Methods This was a 7-day, randomized, comparative clinical trial of risperidone and olanzapine in patients with delirium. The primary outcome measure was the Delirium Rating Scale-Revised-98 (DRS-R-98). Results We enrolled 32 subjects (median age, 70 years). Significant within-group improvements in the DRS-R-98 scores over time were observed at every time point in both treatment groups; however, differences in the change of the DRS-R-98 score from baseline were not significant between the treatment groups. On the first day after drug treatment, there was a trend toward greater improvement in the DRS-R-98 score in the olanzapine group compared with the risperidone group, but it did not reach statistical significance (p,=,0.076). The response rates did not differ significantly between the two groups (risperidone group: 64.7%, olanzapine group: 73.3%). However, the response to risperidone was significantly poorer in patients ,70 years of age compared with those aged <70 years. There was no significant difference in the safety profiles, including extrapyramidal symptoms (EPSs), between the two groups. Conclusion Risperidone and olanzapine were equally effective in reducing delirium symptoms. The response to risperidone was poorer in the older age group. Copyright © 2010 John Wiley & Sons, Ltd. [source] Retrospective database analysis on the effectiveness of typical and atypical antipsychotic drugs in an outpatient clinic settingHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2007Cengiz Akkaya Abstract Objective To report the outcomes of a retrospective database analysis to compare the effectiveness of atypical and typical antipsychotic drugs. Methods Medical records of patients admitted to the psychiatry outpatient clinic between January 1998 and October 2005 were retrospectively reviewed. Data obtained from patient records were noted on a special form assessing four aspects of the treatment history: socio-demographic features, disease characteristics, initial treatment at the time of admission, and course of treatment. Patient groups (typical/atypical and Risperidone/Haloperidol/Olanzapine) were compared for time to all-cause medication discontinuation and rate of discontinuation. Results There was no statistically significant difference in the duration of treatment between patients using atypical (n,=,150) and typical (n,=,124) antipsychotics. The duration of treatment was significantly longer in patients on Haloperidol (n,=,91) compared with those on Risperidone (n,=,63). Rates of discontinuation over 18 months were 59.3% for patients on atypical antipsychotics and 57.3% for those on typical antipsychotics, and 68.3% for patients on Risperidone, 51.6% for patients on Haloperidol and 54.3% for patients on Olanzapine. Conclusion Despite our hypothesis patients with chronic schizophrenia discontinued their atypical and typical antipsychotics, at a high rate with no significant difference indicating substantial limitations in the effectiveness of these drugs. Copyright © 2007 John Wiley & Sons, Ltd. [source] Risperidone and rivastigmine and agitated behaviour in severe Alzheimer's disease: a randomised double blind placebo controlled studyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2007Clive Holmes No abstract is available for this article. [source] Reducing the burden of caring for Alzheimer's disease through the amelioration of ,delusions of theft' by drug therapyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 3 2002Kazue Shigenobu Abstract Background Delusions of theft (delusions involving the theft of possessions) are one of the most frequent neuropsychiatric manifestations of Alzheimer's disease (AD). Objective The current study investigated the presence and extent of such delusions before and after drug treatment in a group of AD patients, and the consequent effects on the burden of care on caregivers. Method The study was an open-label cohort design. The delusions studied consisted only of those involving theft of possessions. Sixteen AD patients served as subjects in order to assess the efficacy of Risperidone administration, in the reduction or elimination of these delusions. The caregiver burden was evaluated using the Zarit Caregiver Burden Interview (ZBI) before the administration of Risperidone and 12 weeks after administration, for cases where delusions of theft were eliminated or reduced. Results The burden of care on caregivers was significantly reduced (p,<,0.001) through the elimination or reduction of delusions of theft. Conclusion Delusions of theft are considered to be a major factor in increasing the burden of care, and the treatment of these, through appropriate drug therapy, is therefore of great importance in the continuation of satisfactory care in the home. Copyright © 2002 John Wiley & Sons, Ltd. [source] Symmetrical Drug-Related Intertriginous and Flexural Exanthem due to Oral RisperidonePEDIATRIC DERMATOLOGY, Issue 2 2009BENGU NISA AKAY M.D. The clinical findings were compatible with so-called symmetrical drug related intertriginous and flexural exanthema, also known as Baboon syndrome. Although epicutaneous patch testing with the offending drug was negative, drug rechallenge produced a recurrence of the skin findings. To the best of our knowledge, this is the first case of symmetrical drug related intertriginous and flexural exanthema reported due to risperidone. [source] Latest news and product developmentsPRESCRIBER, Issue 13-14 2008Article first published online: 29 JUL 200 NSAIDs stroke risk NSAIDs have been linked with an increased risk of stroke in an epidemiological study from The Netherlands (Arch Intern Med 2008;168: 1219-24). Nine years' follow-up of 7636 older persons (mean age 70) identified 807 strokes. The risk of stroke was significantly increased for current use of nonselective NSAIDs (hazard ratio 1.72 for all strokes) and COX-2 selective NSAIDs (HR 2.75 for all strokes; HR 4.54 for ischaemic stroke). Increased risk was found for several individual NSAIDs but was statistically significant only for naproxen (HR 2.63) and the withdrawn rofecoxib (HR 3.38). HPV vaccine chosen The DoH has chosen GlaxoSmithKline's Cervarix HPV vaccine for the national immunisation campaign beginning in September. Cervarix is a bivalent vaccine conferring immunity against HPV16 and 18, which account for 70 per cent of cervical cancers worldwide. Its competitor, Gardasil, is a quadrivalent vaccine additionally protecting against HPV6 and 11, which cause 90 per cent of genital warts. The procurement process assessed the vaccines against ,a wide range of criteria such as their scientific qualities and cost effectiveness'. The DoH has not revealed what it will pay for Cervarix. Melatonin for insomnia Lundbeck has introduced melatonin (Circadin) as monotherapy for the short-term treatment of primary insomnia characterised by poor quality of sleep in patients who are aged 55 or over. The dose is 2mg once daily two hours before bed-time and after food for three weeks. A course costs £10.77. Fesoterodine launched Pfizer has introduced feso-terodine (Toviaz), a prodrug for tolterodine (Detrusitol), for the treatment of symptoms of overactive bladder. Treatment is initiated at a dose of 4mg per day and increased to 8mg per day according to response. The full therapeutic effect may not occur until after two to eight weeks; treatment should be re-evaluated after eight weeks. A month's treatment at either dose costs £29.03, the same as sustained-release tolterodine (Detrusitol XL). Intensive glycaemic control for T2D? Two large trials of intensive glycaemic control in patients with type 2 diabetes have conflicting implications for clinical practice. The ACCORD study (N Engl J Med 2008;358:2545-9) found that treating patients at high CVD risk to a target HbA1c of <6.0 per cent was associated with a 22 per cent increased risk of death and no reduction in macrovascular end-points compared with a target of 7.0-7.9 per cent. The ADVANCE study compared treating to a standard (HbA1c 7.3 per cent) or low (HBA1c 6.5 per cent) target. More intensive glycaemic control significantly reduced microvascular end-points, primarily due to a reduction in nephropathy. There was no difference in the risk of retinopathy or macrovascular end-points. Nicorandil as ulcer cause The potassium-channel activator nicorandil (Ikorel) may be associated with gastro-intestinal ulceration but is frequently overlooked as a possible cause, warns the MHRA in its latest Drug Safety Update (2008;1:Issue 11). Ulceration may affect any portion of the gastro-intestinal tract from the mouth to the perianal area, and it is frequently severe and may cause perforation. Ulcers due to nicorandil are refractory to treatment and only resolve on withdrawal of the drug. Withdrawal should be carried out under the supervision of a cardiologist. , This issue of Drug Safety Update also includes an overview of safety issues with natalizumab (Tysabri) for multiple sclerosis. Atypical antipsychotics diabetes risk ,small' The excess risk of diabetes due to treatment with an atypical antipsychotic is small compared with older anti-psychotics, say UK researchers (Br J Psychiatry 2008;192:406-11). Their meta-analysis of 11 studies found that, compared with the use of first-generation antipsychotics in patients with schizophrenia, the over-all increased risk of diabetes with atypicals was 32 per cent. Risperidone was associated with lowest excess risk (16 per cent), followed by quetiapine (Seroquel) and olanzapine (Zyprexa; 28 per cent) then clozapine (39 per cent). Most studies had method-ological limitations. Copyright © 2008 Wiley Interface Ltd [source] Comparison of Olanzapine to Risperidone in Substance-Abusing Individuals with SchizophreniaTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2007Evaristo Akerele MD A 14-week double blind study compared the efficacy of olanzapine to risperidone in reducing marijuana/cocaine craving and use in individuals with schizophrenia. The study consisted of three phases: a two-week assessment phase, a two-week cross-taper phase onto olanzapine/risperidone, and a ten-week period of maintenance on olanzapine/risperidone. The proportion of cocaine-positive urines decreases over time for both groups with a trend for a greater reduction for the olanzapine group compared to risperidone group. In the last six weeks, marijuana craving was more likely for the risperidone group compared to the olanzapine group, although there was no group difference in the proportion of negative marijuana urines. The data suggest some potential for the utility of olanzapine for the treatment of cocaine dependence in individuals with schizophrenia. [source] Prolactin, Subjective Well-Being and Sexual Dysfunction: An Open Label Observational Study Comparing Quetiapine with RisperidoneTHE JOURNAL OF SEXUAL MEDICINE, Issue 12 2008Jens Westheide PhD ABSTRACT Introduction., Sexual dysfunction is a frequent side effect of antipsychotic treatment. Increased prolactin levels are believed to be responsible for this sexual impairment despite contradictory results. Aim., The primary objective of the present study was to examine the relationship between sexual dysfunction, subjective well-being and prolactin levels in patients with schizophrenia treated either with risperidone or quetiapine. The secondary objective was to explore the relationship between testosterone and the severity of positive and negative symptoms of schizophrenia in male patients. Methods., In a 4-week nonrandomized open label observational study, 102 inpatients with schizophrenia were recruited. Sexual functioning, subjective well-being and endocrinological parameters were assessed as well as psychopathological characteristics. Main Outcome Measures., Two self-rating questionnaires concerned with sexual functioning ("Essener Fragebogen zur Sexualität") and Subjective Well-Being Under Neuroleptic Treatment Scale (SWN) were completed by the patients. Plasma levels of prolactin in male and female patients were measured. Furthermore, in male patients testosterone, luteinizing hormone (LH) and follicle-stimulating hormone (FSH) were determined. Positive and Negative Symptom Scale (PANSS) was applied. Results., After 4 weeks, patients treated with quetiapine reported less severe sexual impairment, as well as lower PANSS negative and general score compared with patients treated with risperidone. Additionally, emotional regulation as measured with the SWN was higher in patients treated with quetiapine. Risperidone was significantly associated with elevated prolactin levels. Prolactin levels were not correlated either with sexual dysfunction or PANSS. However, in the group of patients treated risperidone, sexual impairment was significantly associated with the SWN subscale emotional regulation. Conclusions., Increased prolactin levels do not seem to be decisive for antipsychotic induced sexual dysfunction. Improvement of severity of illness and regaining the ability to regulate one's own emotion have positive influence on sexual functioning. Westheide J, Cvetanovska G, Albrecht C, Bliesener N, Cooper-Mahkorn D, Creutz C, Hornung W-P, Klingmüller D, Lemke MR, Maier W, Schubert M, Sträter B, and Kühn K-U. Prolactin, subjective well-being and sexual dysfunction: An open label observational study comparing Quetiapine with Risperidone. J Sex Med **;**:**,**. [source] Studies on the Acute Toxicity, Pharmacokinetics and Pharmacodynamics of Paliperidone Derivatives , Comparison to Paliperidone and Risperidone in Mice and RatsBASIC AND CLINICAL PHARMACOLOGY & TOXICOLOGY, Issue 2 2010Fengying Sun The i.g. LD50 and i.v. maximum tolerated doses of PD1, PD5 and PD6 were greater than those of paliperidone and risperidone in mice. Pharmacokinetic study showed that PDs were quickly metabolized to paliperidone to take effect in the treatment of schizophrenia in rats after i.g. administration. Only traces of the parent substances were found. Pharmacodynamic study showed that PDs significantly reduced MK-801-induced hyperlocomotion in mice. The electrocardiogram (ECG) was recorded at 0, 5, 10, 15, 20, 25, 30, 45 and 60 min. in anaesthetized rats after i.v. injection of 0.21, 0.59, 1.69 ,mol/kg drugs. Heart rate reduction had a linear relation with dose after i.v. injection of PDs, paliperidone and risperidone. No significant change in the ECG parameters was found in all groups after administration of the low dose. Although the reductions in heart rate and the corrected QT interval (QTc) were observed in all drugs at the high dose, PD5 and PD6 were associated with smaller effects on the ECG parameters than other compounds, including paliperidone and risperidone. Therefore, PD5 and PD6 could be potential candidates for the treatment of schizophrenia. [source] Risperidone for the treatment of acute mania in children and adolescents with bipolar disorder: a randomized, double-blind, placebo-controlled studyBIPOLAR DISORDERS, Issue 7 2009Magali Haas Objectives:, To evaluate the efficacy, safety, and tolerability of risperidone monotherapy for the treatment of an acute mixed or manic episode in children and adolescents with bipolar I disorder. Methods:, This randomized, placebo-controlled, double-blind, 3-arm study (N = 169) included children and adolescents (ages 10,17 years) with a DSM-IV diagnosis of bipolar I disorder, experiencing a manic or mixed episode. Study participants were randomized to placebo (n = 58), risperidone 0.5,2.5 mg/day (n = 50), or risperidone 3,6 mg/day (n = 61) for 3 weeks. The primary efficacy measure was change in Young Mania Rating Scale (YMRS) total score from baseline to end point. Safety assessments included adverse event (AE) monitoring and scores on extrapyramidal symptom rating scales. Results:, Improvement in mean YMRS total score was significantly greater in risperidone-treated subjects than in placebo-treated subjects [mean change (SD) ,9.1 (11.0) for placebo; ,18.5 (9.7) for risperidone 0.5,2.5 mg (p < 0.001); ,16.5 (10.3) for risperidone 3,6 mg (p < 0.001)]. The most common risperidone-associated AEs were somnolence, headache, and fatigue. Mean (SD) weight gain was 0.7 (1.9) kg, 1.9 (1.7) kg, and 1.4 (2.4) kg in the placebo, risperidone 0.5,2.5 mg, and risperidone 3,6 mg groups, respectively, during this 3-week study. Conclusions:, At daily doses of 0.5,2.5 mg and 3,6 mg, risperidone was effective and well tolerated in children and adolescents experiencing acute manic or mixed episodes of bipolar I disorder. Results indicate that risperidone 0.5,2.5 mg has a better benefit,risk profile than risperidone 3,6 mg. [source] Risperidone in the treatment of disruptive behavioural symptoms in children with autistic and other pervasive developmental disordersCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2005Richard ReadingArticle first published online: 16 FEB 200 Risperidone in the treatment of disruptive behavioural symptoms in children with autistic and other pervasive developmental disorders . SheaS, TurgayA, CarrollA, SchulzM, OrlikH, SmithI & DunbarF. ( 2004 ) Pediatrics , 114 , e634 , e641 . Objective To investigate the efficacy and safety of risperidone for the treatment of disruptive behavioural symptoms in children with autism and other pervasive developmental disorders (PDD). Methods In this 8-week, randomized, double-blinded, placebo-controlled trial, risperidone/placebo solution (0.01,0.06 mg/kg/day) was administered to 79 children who were aged 5,12 years and had PDD. Behavioural symptoms were assessed using the Aberrant Behaviour Checklist (ABC), Nisonger Child Behaviour Rating Form and Clinical Global Impression-Change. Safety assessments included vital signs, electrocardiogram, extrapyramidal symptoms, adverse events and laboratory tests. Results Subjects who were taking risperidone (mean dosage: 0.04 mg/kg/day; 1.17 mg/day) experienced a significantly greater mean decrease on the irritability subscale of the ABC (primary endpoint) compared with those who were taking placebo. By study endpoint, risperidone-treated subjects exhibited a 64% improvement over baseline in the irritability score almost double that of placebo-treated subjects (31%). Risperidone-treated subjects also exhibited significantly greater decreases on the other four subscales of the ABC; on the conduct problem, insecure/anxious, hyperactive and overly sensitive subscales of the Nisonger Child Behaviour Rating Form (parent version); and on the Visual Analog Scale of the most troublesome symptom. More risperidone-treated subjects (87%) showed global improvement in their condition compared with the placebo group (40%). Somnolence, the most frequently reported adverse event, was noted in 72.5% vs. 7.7% of subjects (risperidone vs. placebo) and seemed manageable with dose/dose-schedule modification. Risperidone-treated subjects experienced statistically significantly greater increases in weight (2.7 vs. 1.0 kg), pulse rate and systolic blood pressure. Extrapyramidal symptoms scores were comparable between groups. Conclusions Risperidone was well-tolerated and efficacious in treating behavioural symptoms associated with PDD in children. [source] Retrospective database analysis on the effectiveness of typical and atypical antipsychotic drugs in an outpatient clinic settingHUMAN PSYCHOPHARMACOLOGY: CLINICAL AND EXPERIMENTAL, Issue 8 2007Cengiz Akkaya Abstract Objective To report the outcomes of a retrospective database analysis to compare the effectiveness of atypical and typical antipsychotic drugs. Methods Medical records of patients admitted to the psychiatry outpatient clinic between January 1998 and October 2005 were retrospectively reviewed. Data obtained from patient records were noted on a special form assessing four aspects of the treatment history: socio-demographic features, disease characteristics, initial treatment at the time of admission, and course of treatment. Patient groups (typical/atypical and Risperidone/Haloperidol/Olanzapine) were compared for time to all-cause medication discontinuation and rate of discontinuation. Results There was no statistically significant difference in the duration of treatment between patients using atypical (n,=,150) and typical (n,=,124) antipsychotics. The duration of treatment was significantly longer in patients on Haloperidol (n,=,91) compared with those on Risperidone (n,=,63). Rates of discontinuation over 18 months were 59.3% for patients on atypical antipsychotics and 57.3% for those on typical antipsychotics, and 68.3% for patients on Risperidone, 51.6% for patients on Haloperidol and 54.3% for patients on Olanzapine. Conclusion Despite our hypothesis patients with chronic schizophrenia discontinued their atypical and typical antipsychotics, at a high rate with no significant difference indicating substantial limitations in the effectiveness of these drugs. Copyright © 2007 John Wiley & Sons, Ltd. [source] Comparison of Olanzapine to Risperidone in Substance-Abusing Individuals with SchizophreniaTHE AMERICAN JOURNAL ON ADDICTIONS, Issue 4 2007Evaristo Akerele MD A 14-week double blind study compared the efficacy of olanzapine to risperidone in reducing marijuana/cocaine craving and use in individuals with schizophrenia. The study consisted of three phases: a two-week assessment phase, a two-week cross-taper phase onto olanzapine/risperidone, and a ten-week period of maintenance on olanzapine/risperidone. The proportion of cocaine-positive urines decreases over time for both groups with a trend for a greater reduction for the olanzapine group compared to risperidone group. In the last six weeks, marijuana craving was more likely for the risperidone group compared to the olanzapine group, although there was no group difference in the proportion of negative marijuana urines. The data suggest some potential for the utility of olanzapine for the treatment of cocaine dependence in individuals with schizophrenia. [source] Safety of sertindole versus risperidone in schizophrenia: principal results of the sertindole cohort prospective study (SCoP)ACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010S. H. L. Thomas Thomas SHL, Drici MD, Hall GC, Crocq MA, Everitt B, Lader MH, Le Jeunne C, Naber D, Priori S, Sturkenboom M, Thibaut F, Peuskens J, Mittoux A, Tanghøj P, Toumi M, Moore ND, Mann RD. Safety of sertindole versus risperidone in schizophrenia: principal results of the sertindole cohort prospective study (SCoP) Objective:, To explore whether sertindole increases all-cause mortality or cardiac events requiring hospitalization, compared with risperidone. Method:, Multinational randomized, open-label, parallel-group study, with blinded classification of outcomes, in 9858 patients with schizophrenia. Results:, After 14147 person-years, there was no effect of treatment on overall mortality (sertindole 64, risperidone 61 deaths, Hazard Ratio (HR) = 1.12 (90% CI: 0.83, 1.50)) or cardiac events requiring hospitalization [sertindole 10, risperidone 6, HR = 1.73 (95% CI: 0.63, 4.78)]: Of these, four were considered arrhythmia-related (three sertindole, one risperidone). Cardiac mortality was higher with sertindole (Independent Safety Committee (ISC): 31 vs. 12, HR=2.84 (95% CI: 1.45, 5.55), P = 0.0022; Investigators 17 vs. 8, HR=2.13 (95% CI: 0.91, 4.98), P = 0.081). There was no significant difference in completed suicide, but fewer sertindole recipients attempted suicide (ISC: 68 vs. 78, HR=0.93 (95% CI: 0.66, 1.29), P = 0.65; Investigators: 43 vs. 65, HR=0.67 (95% CI: 0.45, 0.99), P = 0.044). Conclusion:, Sertindole did not increase all-cause mortality, but cardiac mortality was higher and suicide attempts may be lower with sertindole. [source] Successful medication withdrawal after cognitive-behavioral therapy in a treatment-resistant preadolescent male with obsessive-compulsive disorderDEPRESSION AND ANXIETY, Issue 1 2009Robert B. Goldstein M.D. Abstract There are no reports of a child taking a selective serotonin reuptake inhibitor and an atypical anti-psychotic being successfully tapered from these medications after completion of cognitive-behavioral therapy (CBT) for obsessive-compulsive disorder. With this in mind, we report the case of an 8.5-year,old male who was taking risperidone 0.5,mg bid, sertraline 100,mg, and atomoxetine 25,mg at presentation. After a successful course of CBT, we describe how medications were systematically withdrawn. Implications of this case on practice parameters (e.g., CBT may be an effective augmenting agent for those non-responsive to initial pharmacological treatments) are highlighted. Depression and Anxiety, 2009. © 2008 Wiley-Liss, Inc. [source] The subjective experience of taking antipsychotic medication: a content analysis of Internet dataACTA PSYCHIATRICA SCANDINAVICA, Issue 2 2009J. Moncrieff Objective:, We explored the subjective effects associated with olanzapine, risperidone and older antipsychotics. Method:, We conducted a content analysis of an Internet database of comments about prescribed medications. Results:, We analysed 223 comments on risperidone, 170 on olanzapine and 46 relating to three older antipsychotics. The predominant subjective effects produced by all drugs consisted of sedation, cognitive impairment and emotional flattening or indifference. Connections appeared between these effects and Parkinsonian-like symptoms with the older drugs, sexual impairment with risperidone and metabolic effects with olanzapine. The experience of akathisia was frequently linked to suicidal thoughts. Some respondents described how the drugs' subjective effects helped to reduce symptoms of mania, psychosis and anxiety. Conclusion:, The generalisability of Internet data is uncertain. However, the data suggest that adverse subjective effects play a central role in the experience of taking antipsychotic drugs and may be related to the drugs' desired benefits. [source] Weight gain in bipolar disorder: pharmacological treatment as a contributing factorACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2008C. Torrent Objective:, The aim of this paper was to review the association of most commonly used psychopharmacological drugs with weight gain in bipolar disorder. Method:, Information was retrieved from a PubMed/Medline literature search reviewing weight gain in pharmacological studies in bipolar disorder. Results:, Obesity and overweight in bipolar disorder are partly related to prescribed drugs with a strong effect of clozapine and olanzapine. Lesser but still relevant weight gain is caused by quetiapine, risperidone, lithium, valproate, gabapentin and by some antidepressants. Ziprasidone, aripiprazole, carbamazepine and lamotrigine do not seem to cause significant overweight. Conclusion:, Careful monitoring of weight changes in patients before and after drug prescription should be implemented in the clinical routine and drugs which potentially cause weight gain should be avoided in overweight patients with bipolar disorder. Furthermore, eating habits and daily activities should be targeted as they may also have a significant impact on overall health and weight-related issues. [source] Encephalopathy with combined lithium-risperidone administrationACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2008K. Boora Objective:, Lithium-neuroleptics induced encephalopathy is a rare drug interaction. Here I am reporting a patient who developed reversible encepatholopathy with lithium-risperidone combination. Method:, A single case report. Result:, A patient of bipolar disorder, who presented with manic symptoms with psychotic feature, started with a combination of lithium and risperidone. Within few days, the patient developed encepatholopathy, which reversed upon discontinuation of lithium and risperidone. Conclusion:, Combining lithium and neuroleptic is useful in treatment of bipolar disorder. However, encepatholapthy can be anticipated to result when lithium is used with high potency anti-psychotic such as haloperidol and risperidone and there are baseline EEG abnormalities. [source] Five-year follow-up during antipsychotic treatment: efficacy, safety, functional and social outcomeACTA PSYCHIATRICA SCANDINAVICA, Issue 2007E. Lindström Objective:, Explore the long-term course of schizophrenia and related disorders. Method:, Naturalistic study of 225 patients initially treated with risperidone (monotherapy or in combination with other psychotropic drugs) over 5 years. Results:, Stable symptomatology and side effects were observed. Clinician GAF scores were 55,61, but patients' self-ratings were higher. Clinician and patient CGI scores were at the same level. Annual in-patient days decreased but days in sheltered accommodations increased still more. Only 12% of the patients studied or worked full-time. One in four had no social contacts except with staff. Eight patients died during the 5 years. Conclusion:, The findings underline the chronicity and seriousness of psychotic disorders in terms of social outcome and, indirectly, the low quality of life of this group of persons. Patients were generally well aware of their illness and able to sort out symptoms from drug side effects. This opens for more active involvement of patients in monitoring their own treatment. [source] Medication decisions and clinical outcomes in the Canadian National Outcomes Measurement Study in SchizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 2006R. Williams Objective:, To evaluate over a 2-year period, patients from academic/non-academic centres, from each region of Canada, to determine whether location or other variables such as medication type, gender or income was associated with outcome as defined by non-hospitalization and persistence on original treatment. Method:, A total of 448 patients were recruited from academic and non-academic centres across all provinces of Canada and followed up for 2 years. Results:, Patients from British Columbia had significantly lower rates of hospitalization than patients from other provinces. Male patients showed greater symptomatic improvement at 2 years from initial assessment compared to females. Patients on clozapine, risperidone and olanzapine were least likely to be hospitalized. Conclusion:, There were some regional differences noted in both utilization of types of antipsychotic medications and hospitalization rates. In this sample of stable out-patients over 70% who started on monotherapy with clozapine, risperidone, olanzapine and quetiapine remained on the same medication over the 2-year study period. [source] Novel antipsychotics in bipolar and schizoaffective maniaACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2004G. J. R. Mensink Objective:, Novel antipsychotics are increasingly used in the treatment of bipolar and schizoaffective mania. This paper presents an overview of the controlled studies in this field. Method:, Using cross-references, a computerized search was performed on MEDLINE and EMBASE psychiatry covering the period 1990,2002. Results:, Olanzapine and risperidone, added to mood stabilizers, and olanzapine as monotherapy enjoy the most evidential support in terms of efficacy and side-effect profile for their use in acute bipolar mania. The use of modern antipsychotics in bipolar prophylaxis and in both the short- and long-term treatment of schizomania has not been widely studied yet. Conclusion:, More controlled trials are still needed comparing modern antipsychotics as monotherapy and adjunctive to mood stabilizers with conventional antipsychotics, lithium, anticonvulsants and with each other in short-term and, especially, maintenance treatment of (schizo)mania. Partly based on controlled studies, olanzapine, risperidone and other modern antipsychotics could become preferable for these indications. [source] Effectiveness and tolerability of risperidone in Asian patients with first-episode psychosisACTA PSYCHIATRICA SCANDINAVICA, Issue 2002S. Verma Objectives, To evaluate the effectiveness and tolerability of risperidone in Asian patients with first-episode psychosis and to examine correlates of response in a naturalistic study. Method, Patients with first-episode psychosis were evaluated at baseline and weekly for 6 weeks with the Positive and Negative Scale for Schizophrenia (PANSS), Simpson,Angus Rating Scale (SARS), Barnes Akathisia Rating Scale (BARS), Rating Scale for Side-effects (RSSE), and the Abnormal Involuntary Movement Scale (AIMS). Results, 42 patients with a mean age of 24.85 ± 9.68 years and mean duration of untreated illness of 11.91 ± 22.04 months were recruited. The mean dose of risperidone was 1.82 ± 0.77 mg. The mean reduction in PANSS score was from 67.97 ± 20.02 at baseline to 42.53 ± 14.08 at week 6 (P < 0.005). The incidence of extrapyramidal symptoms was 9.5% and akathisia was 7.1%. 45.2% of patients showed more than or equal 40% reduction in the PANSS score (responders). When responders were compared to nonresponders, the responders had a significantly higher total and positive PANSS score at baseline. Conclusion, Risperidone is an effective and safe antipsychotic in first-episode psychosis. [source] Delusion and desire: erotomania revisitedACTA PSYCHIATRICA SCANDINAVICA, Issue 1 2000B. D. Kelly Objective: This paper examines the phenomonology in a case of erotomania and reviews classical and contemporary treatment options. Method: A case of primary erotomania is described. Results: Treatment with hospitalization and risperidone produced rapid clinical improvement. Conclusion: Atypical antipsychotic drugs may be useful in the treatment of this interesting syndrome. [source] Atypical antipsychotics and weightgain , a systematic reviewACTA PSYCHIATRICA SCANDINAVICA, Issue 6 2000D. M. Taylor Objective: To review systematically data relating to weight changes with atypical antipsychotics. Method: We conducted a Medline search on October 29 1999 and covered the period 1980,99. All recovered papers were examined for further relevant reports. In addition, we wrote to pharmaceutical manufacturers and 10 practising clinicians to ask them to provide other relevant reports known to them. Results: Eighty reports mentioning change in body weight were retrieved. Data relating to weight changes were of variable quality. Weight changes were indicated by a variety of measures. The majority of reports related to short-term changes. Conclusion: All atypical drugs, with the exception of ziprasidone, have been associated with weight increases. Clozapine seems to have the highest risk of weight gain, followed by olanzapine and quetiapine. There is probably a lower risk with risperidone, sertindole and zotepine and a still lower risk with amisulpride. Ziprasidone appears not to be associated with weight gain. In the absence of more compelling data, these rankings must be considered approximate and preliminary. Longer, more robust trials are needed. [source] Amisulpride: a review of its efficacyin schizophreniaACTA PSYCHIATRICA SCANDINAVICA, Issue 400 2000H. J. Möller Objective: To assess the efficacy of the new atypical antipsychotic drug, amisulpride. Method: Studies comparing the efficacy of amisulpride with that of haloperidol and risperidone, respectively, are reviewed. Outcome measures were Clinical Global Impression, Brief Psychiatric Rating Scale (BPRS), and Positive And Negative Symptom Scale (PANSS) scores. Results: Amisulpride was at least as effective as haloperidol and risperidone in the improvement of positive symptoms, and significantly more efficacious than haloperidol in reducing PANSS negative subscores (P=0.038) in patients with acute exacerbations. Amisulpride demonstrated a greater improvement in BPRS total scores (P<0.05) and PANSS negative subscores (P=0.0001) than haloperidol after 12 months of treatment in chronic schizophrenic patients with acute exacerbations. Conclusion: Amisulpride can thus be considered for use as first-line treatment of acute and chronic schizophrenia. [source] Early intervention with second-generation antipsychotics in first-episode psychosis: results of an 8-week naturalistic studyEARLY INTERVENTION IN PSYCHIATRY, Issue 1 2010Richard C. Josiassen Abstract Objective: The objective was to compare short-term effectiveness of aripiprazole with three other second-generation antipsychotics (SGAs) in the treatment of first-episode psychosis. Method: In a naturalistic, ,single-blind' design, 60 subjects experiencing their first psychotic episode were treated for 8 weeks with aripiprazole (n = 19), risperidone (n = 16), olanzapine (n = 14) or quetiapine (n = 11). Medication and dosing decisions were made by treating psychiatrists, constrained to once-a-day dosing, low initial doses and no clozapine. Weekly ratings were obtained using the Positive and Negative Syndrome Scale (PANSS), Simpson-Angus Rating Scale and Barnes Akathasia Rating Scale. Weight and vital signs were also collected weekly. Results: The group presented with severe psychotic symptoms (mean baseline PANSS total score of 105.2), which were reduced rapidly (P < 0.0005). The between-group and group by time interaction terms were non-significant. Similar reductions were seen across all PANSS sub-scales. At Week 1 the mean PANSS Activation Scale score was reduced more with olanzapine than in the other groups (P < 0.002). Few instances of extrapyramidal symptoms occurred; all were sporadic and did not require treatment. Group body weight increased by 7.3% over the study. Vital signs remained unchanged. Conclusions: Early intervention with low doses of four SGAs led to rapid symptom reduction in first-episode psychotic patients with severe psychopathology. Although no clear medication advantages were observed in the short term, longer duration studies with larger samples will be required for determining efficacy, rates of compliance, relapse prevention and diminished incidence of extrapyramidal signs and symptoms. [source] Development of a Controlled Release System for Risperidone Using Polypyrrole: Mechanistic StudiesELECTROANALYSIS, Issue 4 2010Darren Svirskis Abstract Polypyrrole (PPY) film has been selected as a platform material for drug delivery due to its inherent conductivity, ease of preparation and apparent biocompatibility. PPY films were prepared containing the antipsychotic drug risperidone as a model compound. Drug release profiles could be altered by applying different electrical stimulation to these films. Atomic force microscopy was used to investigate changes in PPY film thickness when different stimuli were applied. The highest levels of drug release were observed when PPY was reduced; this was accompanied by expansion of the film. Technology such as this could be utilized for implantable drug delivery devices, where the dose could be adjusted by external signaling. [source] | ||||||||||||||||||||||||||||||||||||||||