EFFICACY OF RISPERIDONE IN REDUCING POSITIVE AND NEGATIVE SYMPTOMS INMEDICATION-REFRACTORY SCHIZOPHRENIA - AN OPEN PROSPECTIVE-STUDY

Background: Although risperidone has been shown to be an effective ant ipsychotic medication in schizophrenia, the clinical studies performed for the Food and Drug Administration's approval process focused on on ly a mixed group of schizophrenic patients. Most of these studies did not directly address the efficacy of risperidone in chronic nonrespond ing schizophrenics. To better evaluate whether risperidone has a subst antial degree of efficacy in schizophrenic non-responders, we conducte d an open prospective study of risperidone in a sample of chronically hospitalized schizophrenic patients. Method: Twenty-five patients who met DSM-III-R criteria for schizophrenia or schizoaffective psychosis, who were chronically hospitalized at a tertiary care state facility, and who had no responded to conventional neuroleptics were evaluated b efore and during treatment with risperidone by using several standard rating scales and adjunctive assessments. Results: Endpoint analysis s howed that 36% (N = 9) of the patients were classified as responders o n the basis of at least a 20% decrease in total Brief Psychiatric Rati ng Scale score at final evaluation. A higher percentage of patients we re classified as responders when other rating scale criteria were used . Reductions in psychopathology scores were seen in scales reflecting positive symptoms but not in scores of negative symptoms. High baselin e negative symptom scores were correlated with poorer response to risp eridone as indicated by the decrease in positive symptom scores. Concl usion: This study offers evidence that risperidone may reduce positive symptoms of schizophrenia for a subgroup of chronically hospitalized schizophrenic patients who have not responded to conventional neurolep tics. The comparative evaluation of the efficacy of risperidone versus that of clozapine in these types of patients requires further study.