Patients in the early phases of schizophrenia and schizoaffective disorders effectively treated with risperidone long-acting injectable

Abstract

The efficacy and safety of risperidone long-acting injectable (RLAI) was investigated in patients in the early phases of schizophrenia and schizoaffective disorders (< or = 3 years). Patients who required a treatment change received RLAI (2-weekly gluteal injections of 25, 37.5 or 50 mg, per clinical judgement), without an oral risperidone run-in phase.A total of 382 patients were included in this 6-month open-label study; 73% of patients completed the study. A total of 84% had schizophrenia with a median duration of 1.0 year since diagnosis. Previous medications were mainly atypical antipsychotics (70%) and depot neuroleptics (24%). The main reasons for treatment change were non-compliance (42%) and insufficient efficacy (31%) of previous medication. The total Positive and Negative Syndrome Scale (PANSS) and all its subscale scores improved significantly (p < or = 0.0001), with 40% of patients showing a 20% improvement on total PANSS. Global Assessment of Functioning, quality of life, patient satisfaction and movement disorders also improved significantly. Tolerability of RLAI was generally good and no unexpected adverse events were reported. The ensured delivery of medication with RLAI resulted in significant symptom improvement in this patient population. Direct initiation of RLAI is well accepted by patients. RLAI might represent a novel option for patients in the early phases of psychosis.

Long-acting risperidone injection: efficacy, safety, and cost-effectiveness of the first long-acting atypical antipsychotic

“…Although these patients are the most responsive to treatment, they are also very sensitive to adverse events and often lack “disease insight”, which contribute to poor compliance and high treatment discontinuation rates (Kasper 1999). A recent subanalysis of the 6-month study by Möller et al examined the efficacy and safety of long-acting risperidone in patients in the early phases of schizophrenia and schizoaffective disorders (Parellada et al 2005). Following initiation of long-acting risperidone statistically significant improvements were seen in the control of symptoms and the severity of schizophrenia (both PANSS and CGI-S), as well as Global Assessment of Functioning (GAF), HRQoL, patient satisfaction, and EPS (Parellada et al 2005).…”

Clinical outcomes of long-acting injectable risperidone in patients with schizophrenia: six-month follow-up from the Electronic Schizophrenia Treatment Adherence Registry in Latin America

“…The fact that RLAI tends to be prescribed for severe patients is likely associated with the perception of a higher efficacy, but it supports the hypothesis that there are specific criteria being used for its prescription. Studies have shown that RLAI was effective and well tolerated in patients in their first psychotic episode, reduced hospitalization rates, and improved prognosis by reducing relapse 60–62. However, the preconceived notions about its use still remain.…”

A Comparative Efficacy and Safety Study of Long-Acting Risperidone Injection and Risperidone Oral Tablets Among Hospitalized Patients: 12-Week Randomized, Single-Blind Study

“…The requirement of dosage adjustment was also noted in a 6-month [Switch to Risperidone Microspheres] (StoRMi) study in Europe, that 88 % of 382 patients were switched to RLAI 25 mg initially. However, at the end of the study, 53 % of patients increased RLAI dose to 37.5 or 50 mg [23]. Therefore, more long-term study with larger sample size and pharmacokinetic analysis will be required to test the switching equivalent dose from oral antipsychotics to RLAI.…”