Risperdal scientific update |
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Int Clin Psychopharmacol. 2005 Mar;20(2):79-85.
Bai YM, Yu SC, Chen JY, Lin CY, Chou P, Lin CC.
aInstitute of Public Health, National Yang-Ming University, Taipei bDepartment of Psychiatry, Yu-Li Veterans Hospital, Yu-Li cDepartment of Psychiatry, Yu-Li Hospital, Yu-Li dGraduate Institute of Medical Informatics, Taipei Medical University, Taipe
Risperidone for pre-existing severe tardive dyskinesia: a 48-week prospective follow-up study.
A 48-week prospective follow-up study on risperidone for pre-existing severe tardive dyskinesia. There was a noteworthy improvement in tardive dyskinesia in 8 weeks. The results shows that risperidone is effective on pre-existing tardive dyskinesia.
Atypical antipsychotics can alleviate the severity of tardive dyskinesia, but few studies have monitored their long-term effects. The present study investigated the effect of risperidone on pre-existing severe tardive dyskinesia among 40 patients with chronic schizophrenia over 48 weeks. The total Abnormal Involuntary Movement Scale (AIMS) score decreased in 35 patients (87.5%) and increased in three patients (7.5%). At the end of the 48-week trial, the mean total AIMS score decreased significantly, from 15.7+/-4.7 (baseline) to 10.6+/-4.4 (P<0.001), with a mean risperidone dosage of 3.6+/-1.5 mg/day. Twenty-three patients (57.5%) were responders with an average total AIMS score decrease of 8.0+/-2.7. Multiple logistic regression analysis controlling for age, gender, duration of illness, index hospitalization duration, risperidone dose, anticholinergic concomitant use and dystonia score change revealed that a change in the parkinsonism score was the most significant factor related to responders (odds ratio 3.476, 95% confidence interval 1.173-10.298). A significant improvement observed in tardive dyskinesia was noted at week 8, and this improvement persisted until week 48. The results show that the effect of risperidone on pre-existing tardive dyskinesia may be beneficial.
Pharmacopsychiatry. 2005 Mar;38(2):105-6.
Mithat B, Alpaslan T, Bulent C, Cengiz T.
Associated Professor, Departments of Endocrinology, University of Dicle, School of Medicine, Diyarbakir, Turkey.
Risperidone-associated Transient Diabetic Ketoacidosis and Diabetes Mellitus Type 1 in a Patient Treated with Valproate and Lithium - A Case Report -.
A case study on risperidone-associated transient diabetic ketoacidosis and diabetes mellitus type 1 in a patient treated with valproate and lithium. The use of risperidone may lead to transient DM type 1 and DKA. Tremendous improvement was seen in transient diabetic ketoacidosis and diabetes mellitus type 1 patients after stopping risperidone.
A 37-year-old man treated with valproate and lithium for bipolar affective disorder since 1999 and with risperidone since March 2003 was admitted to our clinic due to metabolic acidosis. Serum glucose was 647 mg/dL and urine ketones were positive. The patient was accepted as diabetic ketoacidosis (DKA). Risperidone, valproate, and lithium were immediately stopped, and the patient was treated with insulin and IV fluid replacement. Serum insulin and C-peptide levels were too low, and islet cell antibody and anti-GAD antibody were positive. We accepted him as type 1 diabetes mellitus (DM type 1). After the intensive treatment of diabetes, insulin requirements decreased gradually and diabetes mellitus disappeared completely within three months. Conclusion: Risperidone may lead to transient DM type 1 and DKA.
Int J Neuropsychopharmacol. 2005 Mar 01;:1-12.
Smith RC, Lindenmayer JP, Bark N, Warner-Cohen J, Vaidhyanathaswamy S, Khandat A.
Department of Psychiatry, New York University Medical School, NY, USA.
Clozapine, risperidone, olanzapine, and conventional antipsychotic drug effects on glucose, lipids, and leptin in schizophrenic patients.
A study to evaluate the effect of clozapine, risperidone, olanzapine, and conventional antipsychotic drug effects on glucose, lipids, and leptin in schizophrenic patients. The researchers tested the fasting levels of glucose, lipids, and leptin in the patients during this sectional study. The patients who were treated with rrisperidone had higher glucose levels.
Some reports have indicated increased rates of diabetes and increased prevalence of glucose and lipid abnormalities during treatment with second-generation antipsychotics, with most concern raised about clozapine and olanzapine. Most of the findings have come from case reports, retrospective examination of laboratory values, and analysis of health-care claims databases. This study investigated fasting levels of glucose, lipids, and leptin in a non-randomized, cross- sectional study of 210 patients, with schizophrenic or schizoaffective disorder, treated with a single antipsychotic medication - clozapine, risperidone, olanzapine, or a conventional antipsychotic. Glucose tolerance tests (GTT), with a 75-g glucose load, were preformed in a subset of patients. In this sample most mean fasting glucose and lipid levels were within the normal range and were not significantly different across the four drug treatment groups. Patients treated with clozapine and olanzapine had higher triglyceride levels than risperidone patients. In patients receiving a GTT, risperidone-treated patients had higher glucose levels at 1 h than patients treated with olanzapine, and there were more patients on risperidone who met American Diabetes Association glucose metabolic criteria for diagnosis of diabetes. Although there were no significant differences in age or body mass index among the four drug groups, we cannot rule out some potential biasing factors we did not assess which could potentially influence our results. These include unknown physician preference in drug selection based on their beliefs about the weight-inducing or diabetes potential of different antipsychotics, differences in visceral fat, and differences in patients' antipsychotic drug history.
Schizophr Res. 2005 May 12;
Ren XS, Kazis LE, Lee AF, Huang YH, Hamed A, Cunningham F, Herz L, Miller DR.
Health Services Department, Boston University School of Public Health, Boston, MA, USA; Center for Health Quality, Outcomes, and Economic Research, Veterans Affairs Medical Center, Bedford, MA, USA.
Patient characteristics and the likelihood of initiation on olanzapine or risperidone among patients with schizophrenia.
A study to find out the patient characteristics and the likelihood of initiation on olanzapine or risperidone among patients with schizophrenia. The patients were treated with either olanzapine or risperidone during the test. The patients treated with risperidone had more medical comorbidities and more non-psychiatric hospitalizations.
Although pharmacologic treatments are available for patients with schizophrenia, little is known about how prescription patterns of atypical antipsychotic agents are related to patient characteristics. In this study, we examined the association between patient characteristics and the likelihood of being initiated on olanzapine or risperidone, two of the most frequently prescribed atypical agents for schizophrenia. We selected patients who were diagnosed with schizophrenia or schizoaffective disorder based on >/=1 inpatient or >/=2 outpatient ICD-9-CM codes (>/=7 days apart) between 7/1/98 and 6/30/99 from the Veterans Health Administration (VA). We classified patients into one of three types of initiation: (a) not on olanzapine or risperidone, (b) not on any atypical agents, or (c) not on any antipsychotic agents for 6 months, and then subsequently being prescribed the target drugs. Using logistic regression, we examined whether the odds ratio of being initiated on olanzapine versus risperidone are related to patient sociodemographic and clinical characteristics. Compared to risperidone initiators, olanzapine initiators used more drugs for psychiatric conditions (including antiparkinsonian agents, typical antipsychotics, and mood stabilizers) than risperidone initiators. On the other hand, risperidone initiators had more medical comorbidities and more non-psychiatric hospitalizations. Olanzapine and risperidone appear to be prescribed to patients with different characteristics. Initiation of risperidone was more common among patients who presented with more medical comorbid conditions, whereas initiation of olanzapine was more common among patient who presented with more mental comorbid conditions. Future research needs to determine the reasons for those differences.
Pharmacogenomics. 2005 Mar;6(2):139-49.
Lane HY, Lee CC, Liu YC, Chang WH.
China Medical University and Hospital, Department of Psychiatry, No. 2, Yuh-Der Road, Taichung, 404 Taiwan.
Pharmacogenetic studies of response to risperidone and other newer atypical antipsychotics.
Report of a Pharmacogenetic study on risperidone and other newer atypical antipsychotics. Risperidone and other newer atypical antipsychotics are used commonly used for the treatment of schizophrenia. Researchers already started to explore genetic effects on cognitions in schizophrenia patients.
Risperidone and other newer atypical antipsychotics are becoming the mainstay for schizophrenia treatment. Recent studies suggest that the 5-hydroxytryptamine receptor 2A (5-HT2A) gene (HTR2A) T102C and G-1438A polymorphisms may influence treatment response of risperidone or olanzapine for schizophrenia's negative symptoms (e.g., blunted affect and social withdrawal). In addition, the HTR6 T267C polymorphism has been linked to risperidone response for positive symptoms (delusions and hallucinations). The dopamine D2 receptor (DRD2) Ser311Cys polymorphism may also play a role in determining risperidone efficacy for positive, negative and cognitive symptoms, the DRD2 Ins-A2/Del-A1 diplotype may predict better risperidone response, and the DRD3 Ser311Cys variant may affect general treatment response of several atypical agents. Although investigators have started to explore genetic effects on cognitions of schizophrenia patients receiving antipsychotics, future larger sized pharmacogenetic studies on both psychotic symptoms and cognitive functions are warranted.
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Drug category:Schizophrenia, Psychosis
 Risperdal scientific update
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