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Symptomatic remission in elderly schizophrenia patients treated with long-acting risperidone

Published online by Cambridge University Press:  14 July 2008

Shelly Tadger ,
Yehuda Baruch  and
Yoram Barak
Shelly Tadger
Affiliation:
Abarbanel Mental Health Center, Bat-Yam and Sackler School of Medicine, Tel-Aviv University, Israel
Yehuda Baruch
Affiliation:
Abarbanel Mental Health Center, Bat-Yam and Sackler School of Medicine, Tel-Aviv University, Israel
Yoram Barak*
Affiliation:
Abarbanel Mental Health Center, Bat-Yam and Sackler School of Medicine, Tel-Aviv University, Israel
*
Correspondence should be addressed to: Dr Yoram Barak, Director-Psychogeriatric Dept., Abarbanel Mental Health Center, 15 KKL Street, Bat-Yam, Israel. Phone: +972 3 5552738; Fax: +972 3 5552738. Email: [email protected].
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Abstract

Background: In elderly schizophrenia patients remission is difficult to determine due to long disease duration, exposure to differing treatments, long-standing side-effects, non-adherence, cognitive decline and physical comorbidity.

Method: Retrospective chart reviews were undertaken of 48 elderly (60+ years) schizophrenia patients admitted to a university-affiliated tertiary psychiatric center in 2006. These patients were experiencing an exacerbation of symptoms at admission. Remission criteria used were those of the American Psychiatric Association's “Remission in Schizophrenia Working Group”, and clinical status and improvement were quantified using the Clinical Global Impression scale (CGI).

Results: Of 25 patients treated with long-acting risperidone (LAR), 19 (76%) continued uninterrupted treatment for 6 months or longer. In six patients treatment was discontinued due to insufficient response. The clinical severity ratings with the CGI of all patients were in the range 5–7 prior to treatment. Following six months of LAR treatment, mean dose 36.0 mg/2 weeks (range: 25–50), 18 patients were rated as “improved” or “very much improved” on the CGI-global improvement item scale. In 15/25 patients (60%) symptomatic remission was achieved.

Conclusion: LAR may be effective in achieving remission among elderly schizophrenia patients. Tolerability was high and adherence rates improved. However, the results must be treated with caution owing to the inherent bias in this retrospective analysis.

Keywords

antipsychoticold ageefficacyremissionlong-acting risperidone
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 6 , December 2008 , pp. 1245 - 1250
Copyright
Copyright © International Psychogeriatric Association 2008

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn (DSM-IV). Washington, DC: American Psychiatric Association.Google Scholar
Andreasen, N. C., Carpenter, W. T., Kane, J. M., Lasser, R. A., Marder, S. R. and Weinberger, D. R. (2005). Remission in schizophrenia: proposed criteria and rationale for consensus. American Journal of Psychiatry, 162, 441–449.CrossRefGoogle ScholarPubMed
Babiker, I. E. (1987). Comparative efficacy of long-acting depot and oral neuroleptic medications in preventing schizophrenic recidivism. Journal of Clinical Psychiatry, 48, 94–97.Google ScholarPubMed
Byerly, M. J., Weber, M. T., Brooks, D. L., Snow, L. R., Worley, M. A., and Lescouflair, E. (2001). Antipsychotic medications and the elderly: effects on cognition and implications for use. Drugs and Aging, 18, 45–61.CrossRefGoogle ScholarPubMed
Csernansky, J. G., Mahmoud, R. and Brenner, R. (2002). A comparison of risperidone and haloperidol for the prevention of relapse in patients with schizophrenia. New England Journal of Medicine, 346, 16–22.CrossRefGoogle ScholarPubMed
Folsom, D. P., Lebowitz, B. D., Lindamer, L. A., Palmer, B. W., Patterson, T. L. and Jeste, D. V. (2006). Schizophrenia in late life: emerging issues. Dialogues in Clinical Neuroscience, 8, 45–52.CrossRefGoogle ScholarPubMed
Guy, W. (1976). ECDEU Assessment Manual for Psychopharmacology. Revised edn (pp. 218–222). Washington, DC: U.S. Dept. of Health, Education, and Welfare.Google Scholar
Helldin, L., Kane, J. M., Karilampi, U., Norlander, T. and Archer, T. (2007). Remission in prognosis of functional outcome: a new dimension in the treatment of patients with psychotic disorders. Schizophrenia Research, 93, 160–168.CrossRefGoogle ScholarPubMed
Hudson-Jessop, P., Hughes, B. and Brinkley, N. (2007). New for old? Risperidone long acting injection in older patients. Australasian Psychiatry, 15, 461–464.CrossRefGoogle ScholarPubMed
Kane, J. M. et al. (1998). Guidelines for depot antipsychotic treatment in schizophrenia. European Neuropsychopharmacology, 8, 55–66.CrossRefGoogle ScholarPubMed
Lasser, R. A., Bossie, C. A., Zhu, Y., Gharabawi, G., Eerdekens, M. and Davidson, M. (2004). Efficacy and safety of long-acting risperidone in elderly patients with schizophrenia and schizoaffective disorder. International Journal of Geriatric Psychiatry, 19, 898–905.CrossRefGoogle ScholarPubMed
Lasser, R., Bossie, C., Gharabawi, G. and Kane, J. (2005). Remission in schizophrenia: results from a 1-year study of long-acting risperidone injection. Schizophrenia Research, 77, 215–227.CrossRefGoogle ScholarPubMed
Melamed, Y., Finkel, B., Barak, Y., Zipris, P., Oyffe, I., Weizman, A. and Bleich, A. (2005). Pharmacotherapy in schizophrenia – comparison of second generation antipsychotic agents. Harefuah, 144, 285–290, 301 (in Hebrew).Google ScholarPubMed
Moore, A. R. and O'Keeffe, S. T. (1999). Drug-induced cognitive impairment in the elderly. Drugs and Aging, 15, 15–28.CrossRefGoogle ScholarPubMed
Palmer, B. W., Heaton, S. C. and Jeste, D. V. (1999). Older patients with schizophrenia: challenges in the coming decades. Psychiatric Services, 50, 1178–1183.CrossRefGoogle ScholarPubMed
Taylor, D. M., Young, C. and Patel, M. X. (2006). Prospective 6-month follow-up of patients prescribed risperidone long-acting injection: factors predicting favorable outcome. International Journal of Neuropsychopharmacology, 9, 685–694.CrossRefGoogle Scholar
van Os, J., Drukker, M., à Campo, J., Meijer, J., Bak, M. and Delespaul, P. (2006). Validation of remission criteria for schizophrenia. American Journal of Psychiatry, 163, 2000–2002.CrossRefGoogle ScholarPubMed