Risperidone controlled studies

Chouinard G, Jones B, Remington G, et al (1993). A Canadian multicentre placebo controlled study of fixed doses of risperidone and haloperidol in the treatment of chronic schizophrenic inpatients./Clin Psychopharmacol25—40. 

In contrast to the typical antipsychotics, early evidence suggests that the newer atypical antipsychotics might be helpful for the core symptoms of PTSD. Although there have been some negative studies, several small controlled studies of olanzapine (5-20mg/day), quetiapine (25-300 mg/day), and risperidone (0.5-3 mg/day) have demonstrated improvement in PTSD reexperiencing symptoms. 

Koro CE, Fedder DO, L ltaUen GJ, et al. Assessment of independent effect olanzapine and risperidone on risk of diabetes among patients with schizophrenia population based nested case-control study. BMJ 2003 326 283. 

McDougle CJ, Epperson CN, Pelton GH, Wasylink S, Price LH (2000) A double-blind, placebo-controlled study of risperidone addition in serotonin reuptake inhibitor-refractory obsessive-compulsive disorder. Arch Gen Psychiatry 57 794-801... 

B., Volkmar, F.R., Votolato, N.A., and Walson, P. (2000). Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. Background and rationale for an initial controlled study of risperidone. Child Adolesc Psychiatr Clin North Am 9 201-224. 

McDougle, C.J., Holmes, J.P., Carlson, D.C., Pelton, G.H., Cohen, D.J., and Price, L.H., (1998b) A double-blind placebo-controlled study of risperidone in adults with autistic disorder and other pervasive developmental disorders. Arch Gen Psychiatry 55 633-641. 

McDougle, C.J., Scahill, L., McCracken, J.T., Aman, M.G., Tierney, E., Arnold, L.E., Freeman, B.J., Martin, A., McGough, J.J., Cronin, P., Posey, D.J., Riddle, M.A., Ritz, L., Swiezy, N.B., Vitiello, B., Volkmar, F.R., Votolato, N.A., and Walson, P. (2000b) Research Units on Pediatric Psychopharmacology (RUPP) Autism Network background and rationale for an initial controlled study of risperidone. Child Adolesc Psychiatry Clin North Am 9 201—224. 

In the Expert Consensus survey, the respondents endorsed risperidone, olanzapine, and quetiapine, in that order, followed by high-potency traditional antipsychotics, for managing self-injury. A placebo-controlled study comparing risperidone with a classical antipsychotic, such as haloperidol, could provide valuable data for this field. 

Aman, M.G., De Smedt, G., Derivan, A., Lyons, B., Findling, R.L., and the Risperidone Disruptive Behavior Study Group (In press). Risperidone treatment of children with disruptive behavior symptoms and subaverage IQ a double-blind, placebo-controlled study. Am J Psychiatry... 

In an open trial in boys suffering from outbursts, risperidone decreased aggression, explosivity, and self-injury (Horrigan and Barnhill, 1997). Sleep and hygiene improved as well. In a 10-week double-blind, placebo-controlled study, Findling et al. (2000) found that risperidone improved conduct symptoms and aggression. 

Lavretsky H, Sultzer D A structured trial of risperidone for the treatment of agitation in dementia. Am J Geriatr Psychiatry 6 127-135, 1998 Lawlor BA, Sunderland T, Mellow AM, et al Hyper responsivity to the serotonin agonist m-chlorophenylpiperazine in Alzheimer s disease a controlled study. Arch Gen Psychiatry 46 542-549, 1989a... 

In a double-blind, placebo-controlled study of the addition of low-dose risperidone (mean dosage 2.2 mg/day) to a 5-HT re-uptake inhibitor in refractory obsessive-compulsive disorder in 70 adults, 18 of 20 risperidone-treated patients had at least one adverse effect (37). The adverse effects in both groups included sedation (n = 17 for risperidone, n = 8 for placebo), increased appetite (6 and 3), restlessness (6 and 6), and dry mouth (5 and 5). 

In a 12-week, double-blind, randomized, placebo-controlled study in 40 patients with treatment-resistant schizophrenia (funded by Johnson Johnson Pharmaceutical Research Development), the addition of risperidone to clozapine improved overall symptoms and positive and negative symptoms (49). The adverse events profile of clozapine + risperidone was similar to that of clozapine + placebo. Clozapine + risperidone did not cause additional weight gain, agranulocytosis, or seizures compared with clozapine + placebo. All the patients completed 12 weeks of treatment however, the small sample size precluded definitive conclusions. 

In a two-phase placebo-controlled study with an initial sample of 45 patients, 39 of whom completed the study, the addition of low doses of risperidone (0.5 mg/day) appeared to improve symptoms in patients with obsessive-compulsive disorder taking fluvoxamine monotherapy (51). The main adverse events included transient sedation and mildly increased appetite. 

Aman MG, De Smedt G, Derivan A, Lyons B, Findling RLRisperidone Disruptive Behavior Study Group. Double-blind, placebo-controlled study of risperidone for the treatment of disruptive behaviors in children with subaverage intelligence. Am J Psychiatry 2002 159(8) 1337-46. 

Erzegovesi S, Guglielmo E, Siliprandi F, Bellodi L. Low-dose risperidone augmentation of fluvoxamine treatment in obsessive-compulsive disorder a double-blind, placebo-controlled study. Eur Neuropsychopharmacol 2005 15 69-74. 

Reports have suggested that atypical antipsychotic drugs, such as risperidone (71-73) and olanzapine (74), can be effective in the treatment of acute and residual metamfetamine-induced psychosis. Moreover, adherence to olanzapine for about 8 weeks also effectively controlled cravings for metamfetamine. Rigorous controlled studies are needed to establish the therapeutic efficacy of atypical antipsychotic drugs in the treatment of the psychosis and cravings of metamfetamine addiction. 

Until the advent of the atypical antipsychotics, conventional agents were widely used, although available placebo-controlled studies suggested that they were moderately effective at best. More recently, risperidone has been shown to have modest effects in patients with psychotic symptoms or behavioral disturbances associated with dementia. " It is recommended to begin with 0.25 mg daily and to titrate in 0.25- to 0.5-mg increments to 1 mg daily, which is usually considered the optimal dose. If response is inadequate, further titrating to a maximum of 2 mg daily may be necessary if the patient is tolerating the medication however, side effects, particularly extrapyramidal effects, somnolence, and orthostasis, increase with increased dose. 

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