Neurologic side effects in neuroleptic-naive patients treated with haloperidol or risperidone

Objective: To compare the side effect profile of risperidone with that of o ral haloperidol in patients with no previous exposure to antipsychotic drug s (APDs). Background: Early studies suggested that the APD risperidone may have a side effect profile comparable with that of placebo. These early stu dies involved patients with chronic schizophrenia and a long history of APD use. Very little information is available regarding the neurologic side ef fects of risperidone in patients without previous APD exposure. Methods: Th e authors prospectively studied 350 consecutive neuroleptic-naive patients admitted to their acute-care psychiatry service; 34 of these were treated w ith risperidone (mean dose, 3.2 mg/d) and 212 were treated with low-dose ha loperidol (mean dose 3.7 mg/d). All patients were assessed on admission and twice weekly thereafter using rating scales for dystonia, parkinsonism, ak athisia, and dyskinesia. Results: The incidence and severity of dystonic re actions, akathisia, parkinsonism, and dyskinesia were comparable in the ris peridone- and haloperidol-treated groups. Conclusions: The neurologic side effect profile of low-dose risperidone is comparable with that of haloperid ol in patients receiving APDs for the first time. Risperidone may not be a useful alternative to typical APDs for patients with PD and psychosis.