J. Rabinowitz et al., Rapid onset of therapeutic effect of risperidone versus haloperidol in a double-blind randomized trial, J CLIN PSY, 62(5), 2001, pp. 343-346
Background: Speed of onset of therapeutic effect is an important dimension
of drugs employed to treat psychosis and schizophrenia. Faster onset is des
irable to reduce the anguish caused by delusions and hallucinations and to
protect patients and others from the consequences of poor judgment associat
ed with psychotic exacerbation. Although sufficient studies have demonstrat
ed that novel antipsychotics have advantages over clinically employed doses
of classic drugs in terms of tolerability and aspects of efficacy, less is
known about differences in speed of onset of therapeutic effect. This repo
rt consists of a post hoc subanalysis of data from a large double-blind, ra
ndomized pivotal trial in which we compared onset of therapeutic effect bet
ween risperidone and haloperidol.
Method: During an 8-week period, 227 patients with DSM-III chronic schizoph
renia received 4 mg/day of risperidone and 226 patients received 10 mg/day
of haloperidol. Symptoms were assessed 6 times (days 0, 7, 14, 28, 42, and
56) using the Positive and Negative Syndrome Scale (PANSS) for schizophreni
a and the Clinical Global Impressions-Severity of Illness scale (CGI-S). Da
ta were analyzed using analysis of variance for multiple dependent variable
s and repeated-measures multivariate analysis of variance.
Results: The analyses revealed that patients receiving risperidone improved
more rapidly than those receiving haloperidol as measured by PANSS total a
nd CGI-S scores. Differences were most pronounced during the first week of
treatment.
Conclusion: Results suggest that risperidone offers a more rapid response t
han haloperidol, particularly during the active phase of illness when time
to response can be crucial.