New for Old? Risperidone Long-Acting Injection in Older Patients

Hudson-Jessop, Pamela; Hughes, Brendan; Brinkley, Neridah

doi:10.1080/10398560701616262

Cited by 3 publications

(5 citation statements)

References 9 publications

(15 reference statements)

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“…Data are available on the positive effect of IM long-acting risperidone (LAR) and other long-acting medications on remission among a population of adult schizophrenia patients (Lasser et al, 2005) and their contribution to the reduction of the risk of relapse and rehospitalization (Babiker, 1987;Kane et al 1998;Csernansky et al, 2002). However, data regarding the long-term use of this medication in elderly schizophrenia populations remains controversial (Hudson-Jessop et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

Symptomatic remission in elderly schizophrenia patients treated with long-acting risperidone

Tadger

Baruch

Barak

2008

IPG

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Background: In elderly schizophrenia patients remission is difficult to determine due to long disease duration, exposure to differing treatments, long-standing side-effects, non-adherence, cognitive decline and physical comorbidity. Method: Retrospective chart reviews were undertaken of 48 elderly (60+ years) schizophrenia patients admitted to a university-affiliated tertiary psychiatric center in 2006. These patients were experiencing an exacerbation of symptoms at admission. Remission criteria used were those of the American Psychiatric Association's "Remission in Schizophrenia Working Group", and clinical status and improvement were quantified using the Clinical Global Impression scale (CGI). Results: Of 25 patients treated with long-acting risperidone (LAR), 19 (76%) continued uninterrupted treatment for 6 months or longer. In six patients treatment was discontinued due to insufficient response. The clinical severity ratings with the CGI of all patients were in the range 5-7 prior to treatment. Following six months of LAR treatment, mean dose 36.0 mg/2 weeks (range: 25-50), 18 patients were rated as "improved" or "very much improved" on the CGI-global improvement item scale. In 15/25 patients (60%) symptomatic remission was achieved. Conclusion: LAR may be effective in achieving remission among elderly schizophrenia patients. Tolerability was high and adherence rates improved. However, the results must be treated with caution owing to the inherent bias in this retrospective analysis.

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Section: Introductionmentioning

confidence: 99%

Symptomatic remission in elderly schizophrenia patients treated with long-acting risperidone

Tadger

Baruch

Barak

2008

IPG

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“…Based on published case series, the manufacturers’ recommended dose of 25 mg fortnightly can be safely doubled in some cases. The commonest dose in two series was 37.5 mg 21,22. It seems reasonable to start depot treatment at a dose of 25 mg fortnightly after a period of treatment with oral risperidone (0.5 to 3 mg daily) to confirm tolerability.…”

Section: Discussionmentioning

confidence: 98%

“…Extrapyramidal side effects (tremor, tardive dyskinesia with bradykinesia, and bradykinesia with rigidity) were the reasons given for discontinuation in three patients in a case series of six treated with long-acting risperidone injection 21. In another case series of 18 patients, adverse effects were uncommon with only two patients stopping treatment because of extrapyramidal symptoms 22.…”

Section: Safety and Tolerabilitymentioning

confidence: 98%

“…In a review of six patients (mean age 72 years) treated with fortnightly doses of either 25 mg or 37.5 mg long-acting risperidone, two demonstrated long-term clinical improvement 21. Of the 18 patients (mean age 71 years) in another series, 12 required 37.5 mg per fortnight, three were given 50 mg, and one was given 75 mg. All experienced some symptomatic improvement and four became free of all positive and negative symptoms 22.…”

Section: Efficacymentioning

confidence: 99%

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Efficacy and safety of risperidone long-acting injection in elderly people with schizophrenia

Singh

O'Connor

2009

CIA

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Antipsychotic medication is the mainstay of treatment in elderly patients with psychosis. In recent years, second generation antipsychotics have come to be preferred. Long-acting risperidone is the first such antipsychotic available for use in this vulnerable group of patients and offers an attractive alternative to traditional medications. The available literature revealed that long-acting risperidone is generally well tolerated and is effective in treating both the positive and negative symptoms of schizophrenia. Despite a lack of randomized trials and head-to-head studies, it appears to be a useful addition to the treatment armory for patients with chronic psychosis who require a depot preparation. Further research into its endocrine and metabolic side effects is needed.

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“…Les hospitalisations seraient aussi moins fréquentes sous rispéridone dépôt. Dans une petite série de six patients âgés avec des diagnostics hétérogènes incluant schizophrénie paranoïde de longue date, schizophrénie à début très tardif, trouble schizo-affectif, trouble délirant tardif, la rispé-ridone dépôt s'est avérée un échec de traitement avec trois patients développant des symptômes extrapyramidaux né-cessitant un changement de traitement, étude qui appelle à la prudence en cas d'utilisation de produits dépôts chez la personne âgée [21]. Si l'olanzapine dépôt a été admise par la «Food and Drug Administration» en 2009 aux Etats-Unis, cette forme galénique n'est pas encore disponible en Suisse.…”

Section: Alexopoulos Et Al (2004)unclassified

Prise en soins de la schizophrénie chez la personne âgée

2011

Swiss Arch Neurol Psychiatr

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SummaryCare of the elderly schizophrenic patient Despite the development of new aetiopathological models the treatment of late-life schizophrenia is still based essentially on antipsychotic medication. The absence of research specifically targeting late-life schizophrenics limits the value of recommendations on indication, dosage and treatment alternatives, particularly as the latter have scant regard for the age of schizophrenia onset (early, late, very late onset), for the various comorbidities and the polymedication so common in the elderly. The use of atypical neuroleptics at adapted doses should be combined with biopsychosocial care and treatment of psychiatric and somatic comorbidities. The choice of an adapted treatment is often conditioned, especially if early schizophrenia is con sidered, by many years of treatment and side effects which may limit compliance when the evolution itself has been unfavourable with persistent, sometimes handi capping residual symptoms. Moreover, schizophrenia is complicated by c ognitive disorders for which the best therapeutic approach in the elderly remains uncertain.

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New for Old? Risperidone Long-Acting Injection in Older Patients

Abstract: Risperidone long-acting injection may have a role to play in the management of older patients with psychotic disorders but further research is required.

Cited by 3 publications

References 9 publications

Symptomatic remission in elderly schizophrenia patients treated with long-acting risperidone

Symptomatic remission in elderly schizophrenia patients treated with long-acting risperidone

Efficacy and safety of risperidone long-acting injection in elderly people with schizophrenia

Prise en soins de la schizophrénie chez la personne âgée

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