Risperidone in chronic schizophrenia: a detailed audit, open switch study and two-year follow-up of patients on depot medication

Abstract

Little information exists on the medium- to long-term outcome of switching patients with schizophrenia from traditional depot to atypical oral antipsychotic agents. By detailed clinical audit, we identified a representative group of 102 patients of an Irish psychiatric service with DSM-IV chronic schizophrenia and on depot neuroleptics for a mean of 15 years. Of 69 eligible to participate, 33 entered a 6-month switch study of risperidone, with limited follow-up of consenters and non-consenters at 1 and 2 years. At 6 months, 23 of 33 were still on risperidone and had small significant improvements in clinical and extrapyramidal side effects, QOL and adjunct medication measures over baseline. At 12 months, 19 of 33 were still on risperidone, reducing to 13 of 33 at 2 years. At 2 years, of 32 surviving consenters to switch, 19 had suffered clinically detrimental events and were no longer on risperidone, compared to none of the 33 surviving non-consenters, who were all still on depot. These findings suggest that switching from depot to risperidone may encounter high rates of refusal and attrition subsequent to switch. While a majority of switched patients may improve to least 6 months, audit plus switch may have clinically unfavourable effects on others over a 2-year follow-up period [corrected].

Pharmacokinetics and efficacy of a direct switch from conventional depot to risperidone long‐acting injection in Chinese patients with schizophrenic and schizoaffective disorders

“…Significant reduction of ESRS scores and usage of anticholinergics has been demonstrated to be beneficial for movement disorders in patients with schizophrenia. Previous studies conducted over 6‐month treatment periods also showed similar results 33,39 . A previous report also indicated that long‐acting injectable risperidone was tolerable in elderly patients due to lower EPS 33 .…”

“…Previous studies conducted over 6-month treatment periods also showed similar results. 33,39 A previous report also indicated that long-acting injectable risperidone was tolerable in elderly patients due to lower EPS. 33 In addition, the use of long-acting risperidone was also reported to be efficacious in recent-onset psychosis 40 and schizophrenic patients with comorbid substance abuse.…”

Switching atypical antipsychotics: a review

“…Significant declines were noted in service utilization and in the use of anticholinergics, and no significant changes were seen in the level of employment or in living conditions. In contrast, while an open study of patients receiving conventional depot found initial benefits in patients switched to risperidone ( n = 33) compared with those that remained on depot ( n = 33), after 2 years, only 13 switched patients remained on risperidone while all of the nonswitched patients remained on depot (97). However, a recent 1-year study of patients receiving either conventional antipsychotics (oral/depot) or atypical antipsychotics switched to risperidone long-acting injection demonstrated progressive improvement and high retention rates over the duration of study (98).…”