Risperidone: Review and Assessment of Its Role in the Treatment of Schizophrenia

Cardoni, Alex A.

doi:10.1177/106002809502900611

Cited by 24 publications

(8 citation statements)

References 23 publications

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“…At the start of the study, risperidone had just been introduced on the market. Results from clinical trials indicated a superior effect and a more beneficial side effect profile in comparison with the first‐generation antipsychotics (48–56). However, inclusion criteria for participating in a clinical trial are narrow: a defined age interval, no cardiac or neurological disorders, no abuse, not pregnant or nursing, on safe contraceptives and so on.…”

Section: Discussionmentioning

confidence: 99%

Five‐year follow‐up during antipsychotic treatment: efficacy, safety, functional and social outcome

Lindström¹,

Eberhard²,

Levander³

2007

Acta Psychiatr Scand

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Section: Discussionmentioning

confidence: 99%

Five‐year follow‐up during antipsychotic treatment: efficacy, safety, functional and social outcome

Lindström¹,

Eberhard²,

Levander³

2007

Acta Psychiatr Scand

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“…Risperidone levels are not routinely measured, because therapeutic blood concentrations have not been established (Cardoni 1995). Plasma levels of these drugs, obtained at the time of symptom onset and again with return of the mental status to baseline, could have helped elucidate the mechanism(s) underlying the clinical deterioration.…”

Section: Discussionmentioning

confidence: 98%

Erythromycin Interaction with Risperidone or Clomipramine in an Adolescent

Fisman

Reniers²,

Diaz³

1996

Journal of Child and Adolescent Psychopharmacology

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An adverse event is described which appeared when the macrolide antibiotic erythromycin was added to a regimen of risperidone 0.5 mg bid and clomipramine 50 mg tid in a 15-year-old male being treated for Tourette's, obsessive-compulsive, and attention-deficit hyperactivity disorders. An acute onset of behavioral symptoms, including agitation, labile mood, incessant talking, and argumentativeness, began within 24 h of starting the erythromycin and persisted for 9 days after its discontinuation. It was followed by a return to stable functioning on the prior risperidone-clomipramine regimen. Erythromycin, risperidone, and clomipramine are all metabolized by the hepatic cytochrome P450 system. It is postulated that the addition of erythromycin, a known inhibitor of CYP3A and CYP1A2, resulted in alterations in the metabolism of clomipramine and risperidone. Clomipramine metabolism is dependent upon the isoenzymes CYP2D6 and CYP1A2, and risperidone is a substrate for CYP2D6. Erythromycin would inhibit demethylation of clomipramine at the 1A2 isoenzyme and lead to a dual interaction between risperidone and clomipramine at the CYP2D6 isoenzyme. The subsequent increases in plasma levels of clomipramine, risperidone, their metabolites, or a combination of these agents could explain the adverse effects noted in this patient. In the absence of risperidone, clomipramine could have been metabolically cleared by CYP2D6. In the absence of clomipramine, risperidone clearance would not be affected by erythromycin. So the proposed mechanism requires an interaction involving all three agents: erythromycin, clomipramine, and risperidone. Alterations in plasma protein binding may also have played a role, because all three agents are extensively protein bound. Caution is urged when prescribing erythromycin with psychotropic drugs that are highly protein bound and/or are metabolized by the same P450 isoenzymes.

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“…In comparison to haloperidol, which many consider one of the most effective TAs, risperidone and olanzapine (Ivanov & Charney, 2008;Sikich, Hamer, Bashford, Sheitman, & Lieberman, 2004) as well as clozapine (Kumra et al, 1996) have all demonstrated significantly greater improvements in samples of children and adolescents with schizophrenia. Risperidone, representing probably the most extensively investigated AA, has demonstrated through clinical trials superior efficacy and a more beneficial side-effect profile in comparison with the most prominently used TAs (Ayd, 1995;Cardoni, 1995;Carman, Peuskens, & Vangeneugden, 1995;Fleischacker, 1994;Kane, 1994;Kee, Kern, Marshall, & Green, 1998;Leysen, Janssen, Schotte, Luyten, & Megens, 1993;Marder & Meibach, 1994;Tomasi, de Girolamo, Santone, 2006). Not only do AAs appear to outperform TAs in symptom reduction overall, but symptom improvement tends to also be seen sooner.…”

Section: Schizophreniamentioning

confidence: 93%

Atypical and typical antipsychotics in the schools

Noggle

Dean

2009

Psychology in the Schools

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The use of antipsychotic medications within the school‐age population is rapidly increasing. Although typical antipsychotics may be used in rare cases, this influx is largely secondary to the availability of the atypical antipsychotics. Reduction of possible adverse effects and increased efficacy represent the primary basis for the atypical antipsychotics' popularity over traditional agents. Although these agents, as their name suggests, are most commonly used to alleviate positive, as well as some negative, symptoms of psychotic manifestations, empirical evidence has suggested their efficacy in the treatment of other presentations. These include bipolar disorder, Attention‐Deficit/Hyperactivity Disorder and other disruptive behavior disorders, pervasive developmental disorders, anorexia nervosa, and tic disorders. Discussion of antipsychotic agents and their use in these presentations is offered. Information on positive and negative outcomes, including school impact, is provided. © 2009 Wiley Periodicals, Inc.

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Risperidone: Review and Assessment of Its Role in the Treatment of Schizophrenia

Cited by 24 publications

References 23 publications

Five‐year follow‐up during antipsychotic treatment: efficacy, safety, functional and social outcome

Five‐year follow‐up during antipsychotic treatment: efficacy, safety, functional and social outcome

Erythromycin Interaction with Risperidone or Clomipramine in an Adolescent

Atypical and typical antipsychotics in the schools

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