A prospective comparative study of risperidone long-acting injectable for treatment-resistant schizophrenia with dopamine supersensitivity psychosis.

Abstract

OBJECTIVE:

Dopamine supersensitivity psychosis (DSP) is considered to be one cause of treatment-resistant schizophrenia (TRS). The authors investigated the efficacy of risperidone long-acting injections (RLAI) in patients with TRS and DSP.

METHOD:

This is a multicenter, prospective, 12-month follow-up, observational study that included unstable and severe TRS patients with and without DSP. 115 patients with TRS were recruited and divided into two groups according to the presence or absence of DSP which was judged on the basis of the clinical courses and neurological examinations. RLAI was administered adjunctively once every 2weeks along with oral antipsychotics. We observed changes in scores for the Brief Psychiatric Rating Scales (BPRS), Clinical Global Impression-Severity of Illness (CGI-S), Global Assessment of Functioning Scale (GAF), and Extrapyramidal Symptom Rating Scale (ESRS) during the study. Of the assessed 94 patients, 61 and 33 were categorized into the DSP and NonDSP groups, respectively.

RESULTS:

While baseline BPRS total scores, CGI-S scores and GAF scores did not differ, the ESRS score was significantly higher in the DSP group compared with the NonDSP group. Treatment significantly reduced BPRS total scores and CGI-S scores, and increased GAF scores in both groups, but the magnitudes of change were significantly greater in the DSP group relative to the NonDSP group. ESRS scores were also reduced in the DSP group. Responder rates (≥20% reduction in BPRS total score) were 62.3% in the DSP group and 21.2% in the NonDSP group.

CONCLUSIONS:

It is suggested that DSP contributes to the etiology of TRS. Atypical antipsychotic drugs in long-acting forms, such as RLAI, can provide beneficial effects for patients with DSP.

CLINICAL TRIALS REGISTRATION:

UMIN (UMIN000008487).

• Authors: Hiroshi Kimura, Nobuhisa Kanahara, Naoya Komatsu, Minoru Ishige, Katsumasa Muneoka, Masayuki Yoshimura, Hiroshi Yamanaka, Tomotaka Suzuki, Hideki Komatsu, Tsuyoshi Sasaki, Tasuku Hashimoto, Tadashi Hasegawa, Akihiro Shiina, Masatomo Ishikawa, Yoshimoto Sekine, Tetsuya Shiraishi, Hiroyuki Watanabe, Eiji Shimizu, Kenji Hashimoto, Masaomi Iyo
• Journal: Schizophrenia research (Schizophr Res) Vol. 155 Issue 1-3 Pg. 52-8 (May 2014) ISSN: 1573-2509 [Electronic] Netherlands
• PMID: 24667073 (Publication Type: Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

Chemical References

• Antipsychotic Agents
• Risperidone
• Dopamine

Topics

• Administration, Oral
• Adolescent
• Adult
• Aged
• Antipsychotic Agents (administration & dosage)
• Dopamine (adverse effects)
• Drug Administration Routes
• Drug Delivery Systems
• Female
• Follow-Up Studies
• Humans
• Male
• Middle Aged
• Prospective Studies
• Psychiatric Status Rating Scales
• Psychotic Disorders (complications, drug therapy)
• Risperidone (administration & dosage)
• Schizophrenia (complications, drug therapy)
• Treatment Outcome
• Young Adult