Efficacy and safety of risperidone in the long-term treatment of patients with schizophrenia

Lindström, Eva; Eriksson, Bo; Hellgren, Anders; Knorring, Lars von; Eberhard, Göran

doi:10.1016/0149-2918(95)80105-7

Cited by 92 publications

(29 citation statements)

References 11 publications

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“…Positron emission tomography (PET) studies have demonstrated that in patients treated with RSP, 6 mg daily for 4 weeks, the D 2 occupancy (7580 %) and 5-HT 2 occupancy (7888 %) was moderate to high (Farde et al 1995;Nyberg et al 1995Nyberg et al , 1996. RSP has been e¤ective in the treatment of positive as well as negative symptoms of schizophrenia and it has a limited risk for causing extrapyramidal side e¤ects (EPS) at therapeutically e¤ective doses (Borison 1995;Chouniard 1995;He and Richardson 1995;Lindstrom et al 1995). RSP is extensively metabolized to 9-hydroxy-risperidone (9-OH-RSP, Fig.…”

Section: Introductionmentioning

confidence: 99%

Distribution after repeated oral administration of different dose levels of risperidone and 9-hydroxy-risperidone in the brain and other tissues of rat

Aravagiri¹,

Yuwiler

Marder³

1998

Psychopharmacology

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Rats were treated with daily oral doses of 1, 4, and 6 mg/kg risperidone (RSP) and its metabolite, 9-hydroxy-risperidone (9-OH-RSP), for 15 consecutive days. Concentrations of RSP and 9-OH-RSP were measured in plasma, brain, liver, kidney, lungs and fat tissue by high-performance liquid chromatography with electrochemical detection. Non-specific distribution of RSP and 9-OH-RSP in various brain regions was also studied after administration of 6 mg/kg per day oral dose for 15 days. After RSP treatment, concentrations of 9-OH-RSP were higher than those of RSP in plasma and tissues except in brain, where both compounds were present in nearly equal concentrations. Similarly, after 9-OH-RSP treatment, levels of 9-OH-RSP were higher than levels of either RSP or 9-OH-RSP or the sum of RSP and 9-OH-RSP levels measured after treatment with RSP. There was a moderate relationship between RSP dose and tissue levels of RSP and 9-OH-RSP (all rs > or = 0.62, P < 0.01), except in fat. There was also a strong relationship between the dose and tissue levels of 9-OH-RSP (all rs > or = 0.68, P < 0.005). A significant relationship was found between plasma levels of RSP and brain levels of RSP and 9-OH-RSP (all rs > or = 0.57, P < 0.03) after treatment with RSP. After 9-OH-RSP treatment, a much stronger relationship was observed between plasma and brain 9-OH-RSP levels (rs > or = 0.90, P < 0.005). The plasma concentrations of RSP and 9-OH-RSP appear to reflect their concentrations in brain. The tissue-to-plasma ratios of RSP and 9-OH-RSP were relatively low compared to other antipsychotics. In liver, kidney and lung the tissue to plasma ratio for RSP and 9-OH-RSP after treating with RSP ranged from 0.85 to 3.4. The brain to plasma ratio for RSP and 9-OH-RSP was several-fold lower than that in peripheral tissues. After RSP administration, the mean brain to plasma level ratio for RSP was 0.22, and for 9-OH-RSP to it was 0.04. The brain to plasma ratio of 9-OH-RSP after giving 9-OH-RSP was similarly low (0.04). The low brain/plasma ratio of high potency RSP and 9-OH-RSP may in part be due to their low lipophilicity, log P = 3.04 and 2.32, respectively, resulting in limited non-specific accumulation in brain tissue.

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Section: Introductionmentioning

confidence: 99%

Distribution after repeated oral administration of different dose levels of risperidone and 9-hydroxy-risperidone in the brain and other tissues of rat

Aravagiri¹,

Yuwiler

Marder³

1998

Psychopharmacology

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“…In comparison, growing empirical evidence suggests that AAs not only improve positive and negative symptoms of schizophrenia, but also patients' vocational, social, and cognitive functions (Christison, Kirch, & Wyatt, 1991;Hamilton, Edgell, Revicki, & Breier, 2000;Lieberman & Safferman, 1992;Lindström, Eriksson, Hellgren, von Knorring, & Eberhard, 1995;Lublin, Eberhard, & Levander, 2005;Smith et al, 2006) without causing the extrapyramidal adverse effects associated with TAs (Gardner et al, 2005).…”

Section: Schizophreniamentioning

confidence: 95%

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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“…In a study conducted in France covering about 16,000 beds in 270 psychiatric wards 34% of occupied beds had patients with schizophrenia [10]. Likewise, a Swedish study found that 40% of patients admitted to hospitals in Sweden on 31 March 1991 had schizophrenia [14,15]. Analysts estimate that while in-patient care of schizophrenia comprises 66.67% [16], 55% [10], and 74%[11 of treatment costs in the United States, France, and the United Kingdom, respectively, pharmacotherapies to treat schizophrenia comprise only 0.6% [16] 5.6% [10], and 3% [11] in these countries (Fig.…”

Section: Economic Considerationsmentioning

confidence: 97%

Is clozapine cost-effective?

Seshamani

2002

The European Journal of Health Economics

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The treatment of schizophrenia accounts for approximately 2.5% of national healthcare expenditures, with the majority of this expense concentrated on costly in-patient services. Health policy leaders have expressed concern that these costs create a strain on limited resources. Newer antipsychotic pharmacotherapies, such as clozapine (Clozaril, Leponex; Novartis), may improve patient symptoms and potentially lower hospital use. However, the high cost of these pharmaceutical treatments must be considered alongside any savings in hospital costs and improvement in patient functioning, when assessing the overall economic impact of using such treatment on schizophrenic patients. This review examines six key cost-effectiveness studies that address the economic considerations and quality-of-life issues associated with the use of clozapine in battling the burdens of schizophrenia to determine whether in fact the use of clozapine is clinically and economically appropriate. As such, the review suggests: (a) treatment with clozapine significantly improves patient symptoms and quality of life; (b) patients who receive clozapine experience a reduction in the number of hospitalizations, which can lead to a decrease in hospital costs; (c) treating patients with clozapine shifts the cost structure from in-patient care to outpatient care and drug therapies; and (d) patients who receive clozapine can experience a reduction in overall treatment costs. However, several cost considerations remain unaccounted in most studies, and a serious effort is needed to conduct studies of the vast numbers of outpatients who might benefit from treatment with clozapine.

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Efficacy and safety of risperidone in the long-term treatment of patients with schizophrenia

Cited by 92 publications

References 11 publications

Distribution after repeated oral administration of different dose levels of risperidone and 9-hydroxy-risperidone in the brain and other tissues of rat

Distribution after repeated oral administration of different dose levels of risperidone and 9-hydroxy-risperidone in the brain and other tissues of rat

Atypical and typical antipsychotics in the schools

Is clozapine cost-effective?

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