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Risperidone in treatment-refractory schizophrenia.

D A Wirshing1, B D Marshall, M F Green

  • 1Department of Psychiatry, VA Greater Los Angeles Healthcare System, CA 90073, USA.

The American Journal of Psychiatry
|September 15, 1999
PubMed
Summary
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Risperidone showed superior efficacy and better tolerability than haloperidol for treatment-refractory schizophrenia patients, particularly those with positive psychotic symptoms and extrapyramidal side effects.

Area of Science:

  • Psychiatry
  • Pharmacology

Background:

  • Schizophrenia is a complex mental disorder.
  • Treatment-refractory schizophrenia poses significant challenges.
  • Antipsychotic medications are a cornerstone of treatment.

Purpose of the Study:

  • To compare the clinical safety and efficacy of risperidone versus haloperidol.
  • To evaluate outcomes in patients with treatment-refractory schizophrenia.

Main Methods:

  • Randomized assignment of 67 medication-unresponsive patients to risperidone or haloperidol.
  • A 4-week double-blind, fixed-dose trial followed by a 4-week flexible-dose phase.
  • Standardized psychopathologic and neuromotor instruments were used for assessment.

Main Results:

Related Experiment Videos

  • Risperidone demonstrated superior Brief Psychiatric Rating Scale (BPRS) efficacy compared to haloperidol after 4 weeks.
  • Risperidone-treated patients required less anticholinergic medication and experienced less akathisia and tardive dyskinesia.
  • Improvement was significantly greater in the risperidone group (24%) versus haloperidol (11%) at 4 weeks.

Conclusions:

  • Risperidone is better tolerated and more effective in a subset of patients with treatment-refractory schizophrenia.
  • Positive psychotic symptoms and baseline extrapyramidal side effects predict response to risperidone.