PSYCHOSIS IN MEDICAL CONDITIONS - RESPONSE

We report the response to risperidone in seven hospitalized, adult pat ients who presented psychotic symptoms etiologically related to a gene ral medical condition. The conditions included brain surgery in two, a nd anticardiolipin syndrome, renal failure, epilepsy, lupus, and metas tatic carcinoma in one each. Four patients had failed previous treatme nt with at least one typical antipsychotic agent. Response to risperid one was assessed by the Brief Psychiatric Rating Scale (BPRS). Serum w as collected for measurement of steady-stale trough risperidone and 9- hydroxyrisperidone concentrations at effective doses in three patients . Amelioration of psychotic symptoms was noted in all seven patients. Mean (+/-SD) BPRS scores were reduced significantly from baseline (63. 0 +/- 15.1) to endpoint (27.0 +/- 3.5; p < 0.01). The mean effective d aily dose of risperidone was 3.1 +/- 1.7 mg and rime to response was 4 .7 +/- 2.4 clays. Risperidone was not present at detectable concentrat ions in the three patients studied. The mean steady-state trough serum concentration of 9-hydroxyrisperidone in the three patients assessed was 20.3 +/- 9.8 ng/ml. These preliminary findings, which suggest that risperidone is a safe and effective agent in patients with psychotic symptoms due to various medical conditions, need to be confirmed by ra ndomized, antipsychotic comparison trials involving a larger number of patients. (C) 1997 by Elsevier Science Inc.