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Abstract
This paper reports the results of a retrospective, open-label study in 31 schizophrenic
patients who had been switched from therapy with a typical antipsychotic agent to
risperidone, a novel antipsychotic agent, in the course of their treatment in an outpatient/community
program. The study was based on both a review of all 31 patients' charts and a structured
interview of 26 of the patients. The change to risperidone had been made because of
lack of efficacy or intolerance to typical antipsychotic agents after a mean of 3.5
years of therapy. Patients had been maintained on risperidone for a mean of 1.7 years
at the time of the review. The impact of switching to risperidone was assessed by
comparing clinical variables for the patients with their own historic control data.
The current levels of symptoms, side effects, and social functioning were also assessed
by means of the Interview for Retrospective Assessment of Onset of Schizophrenia and
rating scales. Seventyone percent and 81% of the patients exhibited a positive response,
as measured by a 30% reduction in psychotic and disorganization syndromes, respectively.
After the switch, significant declines were noted in service utilization; the level
of psychotic, disorganization, and negative symptom dimensions; and the use of anticholinergic
drugs (P < 0.01 for all). Assessments conducted at the time of the review revealed a low level
of psychotic (mean, 3.5) and disorganization (mean, 3.0) symptoms, a moderate level
of negative symptoms (mean, 19.5), and a low level of extrapyramidal symptoms (total
mean parkinsonism score, 6.0). No significant changes were seen in the level of employment
or in living conditions. Results of this study suggest that a switch to risperidone
therapy because of the inefficacy of typical antipsychotic agents or patients' inability
to tolerate them may lead to sustained and significant improvement in a substantial
proportion of patients with schizophrenia
Key words
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Article info
Publication history
Accepted:
January 25,
1999
Identification
Copyright
© 1999 Published by Elsevier Inc.
