CLINICAL PREDICTORS OF ACUTE RISPERIDONE RESPONSE IN SCHIZOPHRENIA, SCHIZOAFFECTIVE DISORDER, AND PSYCHOTIC MOOD DISORDERS

Background: In studies of patients with schizophrenia, the atypical an tipsychotic risperidone has been shown to be comparable in efficacy to haloperidol and, at dosages of 4 to 8 mg/day, to have a lower rate of extrapyramidal side effects. However, little is known about the effic acy of risperidone in patients with schizophrenia refractory to treatm ent with typical antipsychotics, schizoaffective disorder, and psychot ic mood disorders. The purpose of this study was to assess the efficac y of risperidone in the treatment of these disorders and to identify c linical factors associated with risperidone response. Method: By surve ying treating clinicians and chart data, we assessed response to rispe ridone and factors associated with response to risperidone in 144 cons ecutive patients treated with the drug for at least 2 weeks at a regio nal state psychiatric hospital. Results: Patients displaying a moderat e-to-marked response to risperidone were more likely to be younger: re ceive diagnoses of bipolar disorder or schizoaffective disorder, depre ssive type; and have a shorter duration of illness and shorter length of stay prior to risperidone treatment. Response to risperidone was su fficient to allow discharge in 26% of patients with treatment-refracto ry schizophrenia hospitalized for at least 10 weeks prior to risperido ne and in 11% of patients with treatment-refractory schizophrenia hosp italized for greater than 1 year. Conclusion: Risperidone may be a use ful alternative or adjunctive treatment for patients with schizophreni a refractory to treatment with standard antipsychotic agents, schizoaf fective disorder (especially the depressive type), and bipolar disorde r when used in conjunction with mood stabilizers.