New choices and alternatives
Dr. John M. Kane
Hillside Hospital, Long Island Jewish Medical Center,
Glen Oaks, NY, USA, Presenter

Dr Kane reported on the potential usefulness of a long-acting formulation of risperidone, which may combine the benefits of decanoate formulations of conventional antipsychotic drugs with the better benefit/adverse effect balance of atypical antipsychotics. The clinical introduction depot risperidone should deliver effective and well-tolerated control of symptoms in schizophrenics, resulting in better compliance.

In the long-term management of schizophrenics, the rate of relapse and time to relapse are valid outcome measures for treatment success. A long-term randomized controlled trial has reported advantages of risperidone over haloperidol with respect to these outcome measures. Because risperidone has been reported to be better tolerated than haloperidol, better medication compliance in risperidone-treated schizophrenic patients may account for the difference. A depot formulation of risperidone is likely to further enhance outcome.

Dr Kane indicated that long-acting depot formulations of conventional antipsychotics may reduce the rate of re-hospitalization in schizophrenic patients, compared with the orally administered medication. A long-acting depot formulation of risperidone has recently been developed.

Dr Kane discussed characteristics of depot risperidone. Instead of the esterification method previously used in depot formulations of typical antipsychotics, a polymer matrix method is used to produce a controlled rate of absorption of depot risperidone. The pharmacokinetic characteristics of single doses of long-acting risperidone showed a post-injection lag time, followed by a rapid rise in plasma drug concentrations and then decay (see Figure).

Dr. Kane also reported efficacy findings in placebo-controlled trials of approximately 1500 patients with schizophrenia. The results showed excellent short-term improvement in symptoms and continued improvement over a longer term without unexpected adverse events.

Dr. Kane believes that the new depot formulation of risperidone should deliver effective and well-tolerated control of symptoms in schizophrenic patients.


Reporter: Heii Arai, M.D.

 

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