Risperidone Safety and Efficacy in the Treatment of Bipolar and Schizoaffective Disorders

Vieta, Eduard; Goikolea, José Manuel; Corbella, Bàrbara; Benabarre, Antonio; Reinares, María; Martinez, G.; Fernández, A.; Colom, Francesc; Martínez‐Arán, Anabel; Torrent, Carla

doi:10.4088/jcp.v62n1011

Cited by 114 publications

(67 citation statements)

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“…As yet there are no RCTs of risperidone maintenance treatment in bipolar disorder; however, three-and six-month open-label data suggest that risperidone adjunctive to valproate or lithium improves depressive symptomatology (118,119). Further, a small two-year open trial of 10 patients provides tentative support for adjunctive depot risperidone in treatment-resistant bipolar disorder (120).…”

Section: Antipsychoticsmentioning

confidence: 99%

Medicating mood with maintenance in mind: bipolar depression pharmacotherapy

2009

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Objectives: Bipolar depression is a core feature of bipolar disorder, a phase in which many patients spend the majority of time and one that confers a significant degree of burden and risk. The purpose of this paper is to briefly review the evidence base for the pharmacotherapy of bipolar depression and to discuss the recommendations for its optimal management.Methods: A detailed literature review was undertaken with a particular emphasis on pharmacological treatment strategies for bipolar depression across the acute and maintenance phases of the illness. Electronic library and Web‐based searches were performed using recognised tools (MEDLINE, PubMED, EMBASE and PsychINFO) to identify the pertinent literature. A summary of the evidence base is outlined and then distilled into broad clinical recommendations to guide the pharmacological management of bipolar depression.Results: Partitioning treatment into acute and maintenance therapy is difficult based on the paucity of current evidence. The evidence from treatment trials favours the use of lithium and lamotrigine as first‐line treatment in preference to valproate, and indicates that, for acute episodes, quetiapine and olanzapine have perhaps achieved equivalence at least in terms of efficacy. However, the effectiveness of the atypical antipsychotics in maintenance therapy is constrained by the potential for significant side effects of individual agents and the lack of both long‐term research data and clinical experience in treating bipolar disorder as compared to other agents. Conversely, lithium and the anticonvulsants are generally slower to effect symptomatic change, and this limits their usefulness.Conclusions: There has been a tendency for research trials of bipolar depression to differentiate the illness cross‐sectionally into the acute and maintenance phases of bipolar depression; however, in clinical terms, bipolar depression invariably follows a longitudinal course in which the phases of illness are inextricably linked, and useful acute treatments are typically continued in maintenance. Therefore, when medicating mood in acute bipolar depression it is imperative to keep maintenance in mind as it is this aspect of treatment that determines long‐term success.

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Section: Antipsychoticsmentioning

confidence: 99%

Medicating mood with maintenance in mind: bipolar depression pharmacotherapy

2009

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“…Few recent studies exist examining the efficacy of risperidone in the treatment of bipolar depression and the findings from these studies remain mixed. While some data has shown that risperidone is associated with improvements in patient-reported symptoms of bipolar depression [34], other findings have suggested that these improvements do not significantly differ from placebo [35]. Indeed, more data is necessary to examine the use of risperidone in treating bipolar depression.…”

Section: Fda Approval Of Second-generation Antipsychoticsmentioning

confidence: 99%

The Role of Atypical Antipsychotic Therapy for Patients with Treatment- Resistant Bipolar Depression

Shah¹

2014

J Psychiatry

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Physicians treating patients with bipolar depression have a unique challenge when considering drug therapy. Historically, patients with bipolar depression have been treated with SSRIs or other medications commonly utilized with patients presenting with non-bipolar depression. Indeed, many of these medications are not ideal for patients suffering from bipolar depression. Recently, a class of second-generation atypical antipsychotics has emerged as an exciting new avenue for the treatment of bipolar depressive episodes. While these medications have received a wealth of empirical support for treating treatment-resistant unipolar depression, less is known about the efficacy of these medications in treating bipolar depression. Early evidence is promising, though additional trials may be warranted to more clearly delineate the role of second-generation atypical antipsychotics in treating bipolar depressive episodes. This article discusses the second-generation atypical antipsychotics that have received empirical support for use in treating depressive symptoms in patients with bipolar depression. Current FDA approvals for usage are reviewed and avenues for future work are proposed.

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“…Risperidone was better tolerated than haloperidol, with significantly more haloperidol-treated patients experiencing EPS (P = .03). In an open study 14 of schizoaffective disorder or bipolar disorder (N = 541), the addition of risperidone (mean dose = 3.9 mg/d) to mood stabilizers showed significant improvement on the YMRS, the HDRS, the PANSS, and the CGI (P < .0001 for all). The adjunctive risperidone was well tolerated, with only 2.4% of subjects experiencing weight gain, which was the most commonly reported adverse event.…”

Section: Implement Pharmacotherapymentioning

confidence: 99%