Original scientific paper

FIRST GENERATION ANTIPSYCHOTICS SWITCH WITH RISPERIDONE IN THE TREATMENT OF CHRONIC SCHIZOPHRENIC PATIENTS

Irena Popović ; Specialized Hospital for Psychiatric Disorders “Gornja Toponica” Niš, Serbia
Dragan Ravanić ; Department for psychiatry, Medical faculty, University of Kragujevac, Serbia
Vojin Popović ; Specialized Hospital for Psychiatric Disorders “Gornja Toponica” Niš, Serbia
Snežana Vladejić ; Specialized Hospital for Psychiatric Disorders “Gornja Toponica” Niš, Serbia
Albina Stanojević ; Specialized Hospital for Psychiatric Disorders “Gornja Toponica” Niš, Serbia
Miodrag Stojanović ; Department for Social medicine and statistics, Medical faculty, University of Niš, Serbia

Abstract

Background: Schizophrenia is a severe chronic psychiatric disorder for which treatment compliance is important in the
prevention of relapse. Second generation antipsychotics (SGA), such as Risperidone, have been found to be more effective in the
treatment of such patients than the high potency first generation antipsychotics (FGA). This is an open study where the same group
of patients was first treated with FGA and then were switched to Risperidone, in controlled hospital conditions, after a wash- out
period. The aim of the study was to examine whether patients with schizophrenia who were judged to be stable on long-term
treatment with FGA would further benefit from a switch to an atypical antipsychotic drug.
Subjects and methods: Eighty hospitalized patients suffering from Schizophrenia or Schizoaffective disorder (male 54, female
26) were first treated with Haloperidol (N=60) or Fluphenazine (N=20), and then were switched to Risperidone. Their clinical state
was monitored using the PANSS scale for Schizophrenia, measuring the Total PANSS score. The KLAWANS scale for assessment of
extrapyramidal syndrome (EPS) was also used. Administration and dosage of Trihexiphenidil (THF) was recorded. The study lasted
for 8 weeks, with 4 screenings (Visit 0-baseline- FGA, Visits 1-3 Risperidone on Day 14, 28 and 56, respectively).
Results: The average age was 38. Patients usually suffered the paranoid form of Schizophrenia (55%). The duration of illness
was more than 5 years (38.8%). During the eight- week trial on Risperidone, using the PANSS total scores, we observed clinical
improvement where the therapy switch had caused an initial worsening (p<0.05). Also, the compared baseline (FGA) and last visit
showed a low, but statistically significant benefit in favor of Risperidone (t=5.45, df=79, p<0.005). Intensity of EPS measured by
KLAWANS scores significantly decreased during time (F=4.115; p=0.016; Partial Eta Square=0.058). Average Trihexiphenidil
doses followed Risperidone in a dose dependent manner (r=0.748, r=0.661, respectively, p<0.01) with the consequent decrease of
patients needing THF corrective therapy (68.8% at the baseline toward 22.5% on last visit).
Conclusion: Switch to Risperidone medication provided significant additional improvement in symptom severity, extrapyramidal
side effects and need for anticholinergic medication. This suggests that one might expect better compliance in future treatment in this
population of chronic schizophrenic patients.

Keywords

psychiatric status rating scales; psychotic disorders; risperidone; treatment outcome; dose response relationship

Hrčak ID:

76848

URI

https://hrcak.srce.hr/76848

Publication date:

31.12.2011.

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