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A long‐term, multicenter, open‐label study of risperidone in elderly patients with psychosis
Author(s) -
Davidson M.,
Harvey P. D.,
Vervarcke J.,
Gagiano C. A.,
De Hooge J. D.,
Bray G.,
Dose M.,
Barak Y.,
Haushofer M.
Publication year - 2000
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/1099-1166(200006)15:6<506::aid-gps146>3.0.co;2-v
Subject(s) - risperidone , extrapyramidal symptoms , tardive dyskinesia , antipsychotic , positive and negative syndrome scale , medicine , schizophrenia (object oriented programming) , psychosis , psychopathology , clinical endpoint , psychiatry , dyskinesia , olanzapine , psychology , clinical trial , parkinson's disease , disease
Rationale Studies have shown that risperidone is safe and efficacious in young and middle‐aged adults with chronic schizophrenia, but considerably fewer data are availabale on the treatment of elderly patients with schizophrenia or other psychotic disorders, particularly long‐term outcomes. Objective A 12‐month, open‐label study was conducted to assess the effects of risperidone in elderly, chronically ill, psychotic patients. Methods This study enrolled 180 elderly, chronically ill, psychotic patients (median age, 72 years [range 54–89]), 97 of whom completed the 12‐month study. At endpoint, the mean dose of risperidone was 3.7 mg/day. Results Clinical improvement (≥20% reduction in Positive and Negative Syndrome Score [PANSS] total score) was achieved by 54% of patients at endpoint. There were significant reductions in PANSS total, subscale (positive, negative, and general psychopathology), and cognition cluster scores at endpoint ( p <0.001). Clinical Global Impressions severity of illness scores showed continued improvement through month 12 ( p <0.001). In contrast, PANSS data from a historical comparable control group of patients receiving conventional antipsychotic agents showed no symptom improvement over a 12‐month treatment period. The severity of preexisting extrapyramidal symptoms (EPS) in patients treated with risperidone decreased significantly from baseline to endpoint ( p <0.001), and the use of antiparkinsonian medication decreased from 41.1% of patients before the trial to 25.6% during the trial. There were no spontaneous reports of tardive dyskinesia (TD) and the incidence of assessed TD was 4.3% in contrast to the expected 26% reported in middle‐aged and elderly patients receiving conventional antipsychotic agents for 1 year. Conclusions Long‐term treatment with risperidone was associated with continued symptom improvement, a decrease in the severity of preexising EPS, and a low incidence of TD in elderly psychotic patients. Copyright © 2000 John Wiley & Sons, Ltd.