A syndrome of increased affect in response to risperidone among patients with schizophrenia

Six of 13 outpatients with schizophrenia who participated in a ten-week open trial of risperidone had an initial good response to the medication followed by development of intolerable affect, including feelings of agitation and depression and periods of crying and insomnia. Patients who developed this syndrome did not differ from other patients in baseline ratings on the Brief Psychiatric Rating Scale (BPRS) and the Scale for the Assessment of Negative Symptoms, except that patients who developed the syndrome had a significantly higher mean baseline rating on the BPRS anxiety subscale. The authors suggest that risperidone may increase affect in patients with schizophrenia and that some patients, especially those with anxiety, may have difficulty managing the increase.