With medication compliance a significant issue in some people who grapple with schizophrenia, drug companies often look toward injectable forms of their psychiatric medications to help with this issue. A new study suggests that an atypical antipsychotic in injectable form looks to be just as effective as its non-injectable counterpart.
Patients with psychosis treated early on in the course of their illness with risperidone long-acting injection demonstrated high response and remission rates with low relapse rates according to the study.
A reduction of the Positive and Negative Syndrome Scale (PANSS) total score of at least 50% was experienced by 84% of the 51 patients included in the study, with only four of these patients relapsing by the study endpoint. During the two-year trial period, the study also showed 64% of patients achieved remission.
Non-compliance or partial compliance remain key barriers in the management of schizophrenia and are often significant contributing factors in relapse. Relapse is associated with increased risk of hospitalization and a dramatically poorer quality of life. Patients experiencing numerous relapses are at high risk of never regaining previous levels of functioning.
Prevention of relapse, therefore, becomes an important factor to help support patients toward remission and recovery. It may be of particular importance in the early stages of the disorder to prevent irreversible decrease of functioning.
“The trial suggests that an atypical long-acting formulation introduced as first-line treatment may play an important role in the management of schizophrenia,” commented lead investigator of the study Professor Robin Emsley from the Department of Psychiatry at the University of Stellenbosch. “Whilst this is a small study, any data suggesting low relapse and high remission rates during this critical stage in a patient’s treatment pathway are welcome.”
In the study, risperidone long-acting injection (also known by its brand name, Risperdal Consta) was administered every two weeks to patients with an age range of 15 – 43 years with recent onset schizophrenia or schizophreniform disorder. A total of 27 patients had not been previously prescribed any medication.
The study period ran over two years in order to assess the effects of risperidone long-acting injection on symptom reduction and assess whether it can be used as a first-line treatment in early psychosis. Results showed that 84% of patients experienced a clinical response of at least 50% reduction of symptom severity on the PANSS. Of these patients, only four relapsed during the study. 92% of patients experienced a clinical response of at least 20% reduction of symptom severity.
Young patients who have never received previous medication treatment for their disorder may manifest high sensitivity to antipsychotics, both in terms of responsiveness and to side effects such as extrapyramidal symptoms and weight gain.
Therefore, the lowest dose of antipsychotic medication was used and patients were closely monitored throughout the study. Overall, the results suggest the treatment was well tolerated and the majority of patients responded well to treatment. As previously reported in studies of patients with early onset psychosis, weight gain was reported, particularly in the first 12 months. At endpoint, mean BMI gain was 4.8 (SD 3.8 [n=50]) from 20.6 (SD 4.6) at baseline (p< .001).The study was published in the April edition of the Journal of Clinical Psychopharmacology.
Although cautious interpretation of this small, preliminary, open-label and non-comparative study is necessary, it suggests that risperidone long-acting injection is well tolerated and effective in recent onset psychosis. The patients showed improvements in terms of symptom reduction and health related quality of life and functional outcome. Study remission rates were high and relapse rates low.
Risperidone long-acting injection has a favorable efficacy and tolerability profile; it is the first long-acting injectable atypical antipsychotic medication indicated for schizophrenic psychoses and other psychotic conditions. Risperidone long-acting injection only needs to be administered every two weeks, eliminating the daily pill burden associated with oral medications.
Source: Journal of Clinical Psychopharmacology