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Safety and tolerability of a rapidly escalating dose-loading regimen for risperidone
D Feifel1, C Y Moutier, W Perry
1Neuropsychiatry and Behavioral Medicine Unit, University of California, San Diego Medical Center, 92103-8218, USA.
The Journal of Clinical Psychiatry
|February 24, 2001
Summary
Rapid oral loading of risperidone (RIS) is safe and well-tolerated in most psychiatric inpatients. This aggressive dosing strategy achieves therapeutic levels within 24 hours, offering a faster treatment option.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Risperidone is an atypical antipsychotic targeting dopamine-2 and serotonin-2 receptors.
- Standard treatment involves several days of dose titration to reach therapeutic levels (2-6 mg/day).
- This study evaluated a novel rapid oral-loading regimen for risperidone.
Observation:
- The rapid loading protocol initiated with 1 mg risperidone, increasing by 1 mg every 6-8 hours up to 3 mg.
- Dose escalations were dependent on patient tolerance of the preceding dose.
- The study included 11 consecutive inpatients in an acute psychiatric facility.
Findings:
- Seven patients tolerated the fastest titration, reaching 3 mg twice daily (b.i.d.) within 16 hours.
- Three patients required a slower titration, achieving the target dose in 24 hours.
- One patient tolerated 2 mg three times daily (t.i.d.) instead of 3 mg b.i.d. No serious adverse events, including extrapyramidal symptoms or sedation, were reported.
Implications:
- Aggressive dosing of risperidone appears safe and well-tolerated in the majority of psychiatric inpatients.
- This rapid titration method may expedite achieving therapeutic antipsychotic effects.
- Further research could explore broader applications of this dosing strategy.