Amisulpride vs. risperidone in the treatment of acute exacerbations of schizophrenia

Amisulpride, a substituted benzamide with high selectivity for dopamine D-3 and D-2 receptors, was compared with the antipsychotic risperidone in pati ents with acute exacerbations of schizophrenia. The study was double-blind and involved 228 patients allocated, after a 3-6-day wash-out period, to am isulpride 800 mg (n = 115) or risperidone 8 mg (n = 113) for 8 weeks. Both treatments produced a marked improvement in schizophrenic symptomatology. D ecreases in mean BPRS total score were 17.7 +/- 14.9 for amisulpride and 15 .2 +/- 13.9 for risperidone, and all of the individual factors on the BPRS showed a numerically greater improvement in the amisulpride than in the ris peridone patients. Both treatments were equally effective against positive symptoms on the PANSS positive syndrome subscale; however, there was a tren d in favor of greater improvement in negative symptoms assessed on the PANS S negative subscale in patients receiving amisulpride with a decrease of 6. 9 +/- 7.5 vs. 5.3 +/- 6.6 for risperidone (P = 0.09). Both drugs demonstrat ed good safety profiles, and scores on neurological scales (SAS, AIMS, and BAS) did not increase during treatment. A comparable proportion of patients received antiparkinsonian medication, 30 and 23% in the amisulpride and ri speridone groups, respectively (P = 0.21). Patients receiving risperidone e xperienced an increase in body weight, which was significantly greater than for amisulpride (P = 0.026). (C) 1999 Elsevier Science Ireland Ltd. All ri ghts reserved.