Objective: Oral atypical antipsychotics are commonly used in elderly patients with psychotic disorders. These agents provide an improved benefit/risk ratio compared to conventional neuroleptics, but have been available only in short-acting formulations, requiring daily dosing. Risperidone microspheres, the first long-acting atypical antipsychotic, were assessed in elderly patients with psychotic disorders.
Design: An open-label study of long-acting risperidone included elderly patients (³65 years of age) with schizophrenia or schizoaffective disorders judged to be symptomatically stable.
Materials and Methods: Patients were assigned by clinician’s judgment to 25, 50, or 75 mg of long-acting risperidone microspheres every 2 weeks for up to 50 weeks.
Results: Fifty-seven elderly patients (mean [SE] age, 70.9 ± 0.68 years) were enrolled. Mean PANSS total score showed significant symptom improvement throughout the 50 weeks and at end point. There were significant improvements on PANSS positive, negative, disorganized thoughts, uncontrolled hostility/excitement, and anxiety/depression scores at endpoint. Although patients were judged to be clinically stable at study entry, 49.0% realized clinical improvement (³20% PANSS total score reduction), and 54.5% improved on CGI ratings at endpoint. The severity of extrapyramidal symptoms were improved or unchanged at endpoint. Adverse events seen in >10% of patients were insomnia (10.5%), constipation (10.5%), and bronchitis (12.3%). The incidence of adverse events was not dose related. Vital sign and electrocardiographic changes were not clinically relevant. Mean weight increased 0.3 kg at end point.
Conclusion: These data suggest that long-acting risperidone microspheres can safely provide continued symptom improvement in stable elderly patients with psychotic disorders.
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