Long‐term safety and efficacy of long‐acting risperidone in elderly psychotic patients

Abstract

This subgroup analysis of the 6-month, open-label Switch to Risperidone Microspheres (StoRMi) trial evaluated long-term safety and efficacy of a direct conversion to risperidone long-acting injectable (RLAI) in 52 elderly patients (> or =65 years) with psychosis stabilized on oral or depot antipsychotic. Study outcomes included adverse events, movement disorder severity, psychiatric symptoms, functional ability, quality of life and patient satisfaction. Change in the Positive and Negative Syndrome Scale at endpoint was the primary efficacy measure. The most common dosage of RLAI used at endpoint was 25 mg every 14 days (60%). The trial was completed by 81% of patients, with six patients discontinuing treatment due to an adverse event. Tolerability was good and most side effects were mild to moderate. Serious adverse events occurred in 11 patients. Two of these (suicidal attempt, n = 1; exacerbation of disease, n = 1) were considered possibly related to RLAI. Conversion to RLAI resulted in significant improvements in movement disorder severity, psychiatric symptoms, functional status and patient satisfaction. Mean PANSS total decreased by 15.8 at endpoint, with 23 patients (46.9%) experiencing a > or =20% improvement. This post-hoc analysis supports that RLAI is well tolerated and safe in elderly patients with psychotic illnesses switched from stable antipsychotic regimens, and suggests possible efficacy, although inferences are limited.

Efficacy and safety of risperidone long-acting injection in elderly people with schizophrenia

“…Similar findings emerged from another secondary analysis of data from the six-month, open-label Switch to Risperidone Microspheres (StoRMi) study concerning 52 older patients (mean age 71 years) with clinically stable schizophrenia or schizoaffective disorder 20. Doses at study end were 25 mg (60%), 37.5 mg (26%), and 50 mg (14%) every two weeks.…”

“…In the other secondary analysis outlined previously concerning 52 elderly patients, the adverse effects of long-acting risperidone were monitored at baseline and then one, three, and six months later 20. Adverse events occurring in more than 5% of cases were as follows: parkinsonism (15%), other extrapyramidal disorders (15%), tremor (8%), depression (6%), diarrhoea (6%), dizziness (6%), and insomnia (6%) 20.…”

The Elderly Safety Imperative and Antipsychotic Usage

“…4,63,64 The limited data from RCTs for the treatment of schizophrenia in older adults have shown that clozapine and chlorpromazine are equally effective, 36 that risperidone and olanzapine are equally effective, 38 and that olanzapine is superior to haloperidol. 37 Data from open-label 65 and retrospective 66 studies suggest that long-acting depot risperidone is also effective for treating schizophrenia in older adults. Data comparing the risk of adverse events from antipsychotics in dementia patients compared to schizophrenic older adults are limited; atypical antipsychotics likely have similar sideeffect profiles in these two populations, though dementia patients may carry a greater risk of some adverse events such as stroke and death.…”

Diagnostik und medikamentöse Therapie bei schizophrenen Patienten im Alter

“…Es kamen auch Antipsychotika in Depotform zum Einsatz, welche in der Literatur auch als effektiv und sicher bei älteren und alten Patienten mit psychotischen Störungen untersucht wurden [16,17].…”