Switching from depot antipsychotics to risperidone: Results of a study of chronic schizophrenia

Designed to provide information about patients with schizophrenia who switc h from depot neuroleptics to the oral, atypical antipsychotic risperidone, this multicenter observational study enrolled patients who wished to stop t he depot, had an unsatisfactory response, or experienced unacceptable side effects. Individuals remained on depot medication for 4 weeks and then rece ived risperidone monotherapy for 3 months. Of the 143 patients who entered the study, 130 received risperidone, 109 completed the initial 16-week stud y, and 88 entered an optional 12-week follow-up. Symptoms and side effects did not change significantly during the depot phase (mean Positive and Nega tive Syndrome Scale [PANSS] score 72.2 at baseline, 71.6 at visit 2), but P ANSS scores, global assessment of functioning, parkinsonism, and dyskinesia improved significantly during the risperidone phase (mean PANSS score decr eased from 71.6 to 55.5 after 3 months). The number of contacts with health care professionals fell significantly during the risperidone phase; in addi tion, symptomatic improvements were maintained during follow-up, and moveme nt disorders continued to decrease significantly. The investigators conside red that 81% of patients had switched successfully. Patient acceptance of r isperidone was significantly higher than for depot medication (83% vs 23%; P<.001), and 65% considered risperidone better than their previous treatmen t. Indications for depot medication should be reviewed, and patients may be nefit from a switch to risperidone.