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Long-acting risperidone in stable patients with schizoaffective disorder
A Mohl1, K Westlye, S Opjordsmoen
1Psychiatrische Dienste Aargau AG, EPD, Baden, Switzerland. andreas.mohl@pdag.ch
Journal of Psychopharmacology (Oxford, England)
|September 8, 2005
Summary
Switching to risperidone long-acting injectable significantly improved symptoms in patients with schizoaffective disorder. This treatment also enhanced quality of life and reduced hospitalization rates.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Medicine
Background:
- Schizoaffective disorder requires effective long-term treatment strategies.
- Risperidone, both oral and long-acting injectable forms, is established for treating schizoaffective disorder.
- Transitioning between antipsychotics can be challenging, necessitating studies on direct switch protocols.
Purpose of the Study:
- To evaluate the efficacy and tolerability of directly switching patients with schizoaffective disorder to risperidone long-acting injectable (RLAI).
- To assess symptom reduction, functional improvement, and quality of life changes following the switch to RLAI.
- To determine the safety and effectiveness of RLAI in a real-world clinical setting for this patient population.
Main Methods:
- A 6-month prospective analysis involving 249 adult patients diagnosed with schizoaffective disorder (DSM-IV) who were switched directly to RLAI (25 mg, with potential dose increases).
- Patients were assessed using the Positive and Negative Syndrome Scale (PANSS), Global Assessment of Function (GAF), SF-36 for quality of life, and the Extrapyramidal Symptom Rating Scale (ESRS).
- Data analysis focused on changes from baseline to endpoint, with specific attention to symptom severity, hospitalization status, and treatment satisfaction.
Main Results:
- Significant reductions in total PANSS scores and subscales were observed by week 4, continuing to endpoint (p < 0.001).
- Mood symptoms (anxiety/depression, hostility/excitement) and GAF scores showed significant improvement (p < 0.001).
- Hospitalization rates decreased by 67% among initially hospitalized patients, and quality of life (SF-36) and treatment satisfaction improved significantly.
Conclusions:
- Direct transition to risperidone long-acting injectable is effective and well-tolerated for patients with schizoaffective disorder.
- RLAI treatment leads to substantial improvements in psychiatric symptoms, particularly mood disturbances, and enhances overall functioning and quality of life.
- The study supports RLAI as a viable option for managing schizoaffective disorder, potentially reducing hospitalizations and improving patient outcomes.