Risperdone in the Treatment of Chronic Schizophrenia

Thirty subjects (aged 18 years and above) who satisfied DSM IV criteria for the diagnosis of chronic Schizophrenia were recruited in Lagos and Kaduna (15 subjects each) as part of an international Multicenter open label single arm trial of Risperidone in the treatment of Schizophrenic disorder. The subjects who were both inpatients and outpatients were initially continued with their conventional antipsychotics for four weeks before they were treated with Risperidone for 16 weeks. Compared with their week 4 assessments, the subjects experienced significant improvement in their Positive, Negative, Psychopathology and Total PANSS scores at the end of the trial (week 16). Forty eight percent of the subjects had a decline of 20% or more in their mean total PANSS scores. Eighty eight percent of the subjects had some form of improvement in their Clinical Global Impression Change scores at week 16 compared with 20% at week 4. The subjects also showed significant decline in the extrapyramidal side effects they experienced with Risperidone at week 16 compared with week 4 as shown in the findings of their Extrapyramidal rating scales scores (ESRS) - Questionnaire and Behaviour (P=0.001), Physical Examination for Parkinsons (P=0.000), Dystonia (P=0.009), Dyskinesia (P=0.000) and Total for Parkinsons, Dystonia and Dyskinesia (P=0.000). The mean social activity level of the subjects at week 16 was significantly better than that of week 4 (P=0.01) and 72% of the subjects claimed that risperidone was acceptable to them. The only adverse effects reported by the subjects was extrapyramidal side effects which was reported by 40% of the subjects at week 16 compared with 100% at week 4. The findings were generally similar to those previously reported in trials in other parts of the world. Overall, Risperidone was found to be safe and more effective than the conventional antipsychotics in the management of positive and negative symptoms of schizophrenia. It may turn out to be cost effective and may improve the quality of life of schizophrenic patients. The drug is recommended for use in Nigeria. Nigerian Medical Practitioner Vol.44(1) 2003: 11-1