Risperidone for severe tardive dyskinesia: a 12-week randomized, double-blind, placebo-controlled study

Area of Science:

• Psychiatry
• Pharmacology

Background:

• Tardive dyskinesia (TD) is a potential side effect of antipsychotic medications.
• Previous studies suggested risperidone may alleviate TD, but lacked placebo control to rule out spontaneous remission.
• This study aimed to rigorously evaluate risperidone's efficacy in treating severe TD.

Purpose of the Study:

• To investigate the efficacy of risperidone in treating severe tardive dyskinesia.
• To compare the effects of risperidone versus placebo in patients with schizophrenia and severe TD.

Main Methods:

• A 12-week, randomized, double-blind, placebo-controlled trial involving 49 schizophrenia patients with severe TD.
• Participants underwent a 4-week washout period before receiving either risperidone (titrated to 6 mg/day) or placebo.
• Efficacy was assessed using the Abnormal Involuntary Movement Scale (AIMS) and Extrapyramidal Symptom Rating Scale.

Main Results:

• Risperidone treatment resulted in a significantly greater mean decrease in AIMS total scores compared to placebo (5.5 vs. 1.1, p < .05).
• A higher proportion of patients in the risperidone group were classified as responders (68%) versus the placebo group (30%, p < .05).
• Improvements were more pronounced in the buccolinguomasticatory region than in extremity movements, with significant effects noted from week 8.

Conclusions:

• Risperidone, at a dose of 6 mg/day, offers significant improvement in severe tardive dyskinesia compared to antipsychotic discontinuation.
• The efficacy of risperidone is particularly evident in the orofacial areas.
• This study provides robust evidence for risperidone as a treatment option for severe TD in schizophrenia patients.