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Risperidone versus clozapine in treatment-resistant chronic schizophrenia: a randomized double-blind study. The
G Bondolfi1, H Dufour, M Patris
1Département Universitaire de Psychiatrie Adulte, Prilly-Lausanne, Switzerland.
The American Journal of Psychiatry
|April 18, 1998
Summary
Risperidone and clozapine showed similar short-term effectiveness for chronic schizophrenia patients resistant to other treatments. Both antipsychotics were well-tolerated with mild side effects, suggesting risperidone as a viable alternative.
Area of Science:
- Psychiatry
- Pharmacology
- Clinical Neuroscience
Background:
- Schizophrenia is a chronic mental disorder often requiring long-term treatment.
- Treatment resistance is common, necessitating alternative therapeutic strategies.
- Conventional neuroleptics are not always effective or tolerated by patients.
Purpose of the Study:
- To compare the short-term efficacy and safety of risperidone and clozapine.
- To evaluate these antipsychotics in patients with chronic schizophrenia resistant to conventional treatments.
Main Methods:
- A double-blind, multicenter study involving 86 inpatients with chronic schizophrenia.
- Random assignment to 8 weeks of treatment with risperidone or clozapine after a washout period.
- Dose titration followed by fixed doses (mean 6.4 mg/day risperidone, 291.2 mg/day clozapine) and efficacy/safety evaluations.
Main Results:
- Both risperidone and clozapine significantly reduced psychotic symptoms.
- No significant differences in efficacy were observed between the two groups.
- Clinical improvement was seen in 67% of the risperidone group and 65% of the clozapine group.
- Risperidone demonstrated a faster onset of action.
- Adverse events were generally mild and infrequent in both groups.
Conclusions:
- Risperidone is well-tolerated and as effective as clozapine for treatment-resistant chronic schizophrenia.
- Risperidone presents a viable alternative to clozapine in this patient population.