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Extrapyramidal side effects and tolerability of risperidone: a review
1Department of Psychiatry, University of Edinburgh, U.K.
The Journal of Clinical Psychiatry
|May 1, 1994
Summary
Risperidone, a novel antipsychotic, demonstrated significantly fewer extrapyramidal side effects (EPS) compared to haloperidol in clinical trials. This suggests improved tolerability for schizophrenia treatment with risperidone.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Neuroscience
Background:
- Conventional neuroleptics for schizophrenia often cause extrapyramidal side effects (EPS), leading to poor patient compliance and treatment relapse.
- Drugs with combined 5-HT2 and D2 receptor blockade show potential for improved EPS profiles.
Purpose of the Study:
- To evaluate the efficacy and tolerability of risperidone, a 5-HT2/D2 antagonist, in treating schizophrenia.
- To compare the extrapyramidal side effect (EPS) profile of risperidone with haloperidol and placebo.
Main Methods:
- Two large clinical trials compared risperidone (various doses) against placebo and haloperidol (20 mg/day or 10 mg/day).
- Extrapyramidal side effects were assessed using the Extrapyramidal Symptom Rating Scale and anticholinergic medication use.
- The UKU Side Effects Scale evaluated other adverse events.
Main Results:
- Risperidone groups exhibited significantly lower EPS severity compared to the haloperidol group in both studies.
- Low-dose risperidone (2 and 6 mg/day) showed EPS comparable to placebo.
- Minor side effects included transient hypotension and weight gain; risperidone was better tolerated overall than haloperidol.
Conclusions:
- Risperidone offers a favorable EPS profile compared to conventional neuroleptics like haloperidol.
- Risperidone represents a well-tolerated antipsychotic option for managing schizophrenia.
- The dual 5-HT2/D2 receptor antagonism of risperidone contributes to its improved tolerability.