Risperidone versus other atypical antipsychotics for schizophrenia

Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München Klinikum rechts der Isar, Moehlstrasse 26, München, Germany, 81675.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 01/2011; ᅟ(1):CD006626. DOI: 10.1002/14651858.CD006626.pub2
Source: PubMed


This review examines the effects of risperidone compared to other second-generation antipsychotic (SGA) drugs for schizophrenia. We identified 45 relevant studies with 7760 participants comparing risperidone with amisulpride, aripiprazole, clozapine, olanzapine, quetiapine, sertindole and ziprasidone. Comparisons of risperidone with zotepine are currently not available. Risperidone was somewhat more successful than quetiapine and ziprasidone, but somewhat less successful than clozapine and olanzapine. The main disadvantage of risperidone were more frequent movement disorders and more prolactin increase compared to most other SGA drugs.

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    • "Olanzapine treatment has also been associated with significantly higher increases in cholesterol than aripiprazole, risperidone, and ziprasidone and with significantly higher increases in blood glucose than amisulpride, aripiprazole, quetiapine, risperidone, and ziprasidone.102 Risperidone-treated patients have been found to have a significantly higher likelihood for prolactin increases and sexual dysfunction than other atypical antipsychotics.98,103 Studies conducted in the People’s Republic of China have also found significantly reduced extrapyramidal symptoms,86,104 but greater weight gain and greater increases in cholesterol and triglycerides,86,104–106 for olanzapine-treated patients relative to patients treated with risperidone, ziprasidone, or typical antipsychotics. "
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    ABSTRACT: This article describes the personal, societal, and economic burden attributable to schizophrenia in the People's Republic of China and highlights the potential for effective outpatient treatment to reduce this burden given recent changes in the Chinese health care system. The importance of effective antipsychotic therapy in reducing the burden of schizophrenia is also examined. Published research on the burden, disability, management, and economic costs of schizophrenia in the People's Republic of China was examined in the context of the larger body of global research. Research written in English or Chinese and published before June 2012 was identified using PubMed, CNKI, and Wanfang Med database searches. The contribution of effective antipsychotic therapy in reducing the risk for relapse and hospitalization and improving patients' functioning is described. Schizophrenia imposes a substantial burden on Chinese society, with indirect costs accounting for the majority of the total cost. Functional impairment is high, leading to lost wages and work impairment. In the People's Republic of China, schizophrenia is the most common diagnosis among hospitalized psychiatric patients. Ongoing changes in the Chinese health care system may reduce some barriers to effective relapse prevention in schizophrenia and potentially reduce hospitalizations. The use of antipsychotics for acute episodes and maintenance treatment has been shown to decrease symptom severity and reduce the risk for relapse and hospitalization. However, discontinuing antipsychotic medication appears common and is a strong predictor of relapse. Cost-effectiveness research in the People's Republic of China is needed to examine the potential gains from improved outpatient antipsychotic treatment. Schizophrenia is a very costly mental illness in terms of personal, economic, and societal burden, both in the People's Republic of China and globally. When treated effectively, patients tend to persist longer with antipsychotic treatment, have fewer costly relapses, and have improved functioning. Further research examining the long-term effects of reducing barriers to effective treatments on the societal burden of schizophrenia in the People's Republic of China is needed.
    Full-text · Article · Aug 2013 · ClinicoEconomics and Outcomes Research
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    • "Consequently, “treatments for schizophrenia must be individualized” (Lieberman and Stroup, 2011). These findings are endorsed by Cochrane Collaboration reviews and other studies suggesting tentatively that olanzapine may be somewhat more efficacious than some other second generation antipsychotic drugs although concerns with high drop-out rates in the studies, with mixed results with risperidone (Hargreaves and Gibson, 2005; Heres et al., 2006; Komossa et al., 2010, 2011). "
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    ABSTRACT: Introduction: Scrutiny over pharmaceutical expenditure is increasing leading to multiple reforms. This includes Austria with measures to lower generic prices and enhance their utilisation. However the situation for newer antidepressants and atypical antipsychotic drugs (AAPs) is different to PPIs, statins and renin-angiotensin drugs with greater tailoring of therapy and no wish to switch products in stable patients. Authorities welcome generics though given high costs particularly of patented AAPs. Objective: Assess (a) changes in utilisation of venlafaxine versus other newer anti-depressants before and after availability of generics, (b) utilisation of generic versus originator venlafaxine, (c) price reductions of venlafaxine over time and influence on total expenditure, (d) utilisation of risperidone versus other AAPs, (e) suggest potential additional reforms that could be introduced if pertinent. Methodology: A quasi-experimental study design with a segmented time series and an observational study. Utilisation measured in defined daily doses (DDDs) and total expenditure per DDD and over time. Results: No appreciable changes in the utilization patterns of venlafaxine and risperidone after generics. The reduction in expenditure/ DDD for venlafaxine decreased overall expenditure on antidepressants by 5% by the end of the study versus just before generics despite a 37% increase in utilization. Expenditure will further decrease if there was reduced prescribing of duloxetine. Conclusion: Depression, schizophrenia and bipolar diseases are complex diseases. As a result, specific measures are needed to encourage prescribing of generic risperidone and venlafaxine when multiple choices are appropriate, and authorities cannot rely on a ´Hawthorne´ effect between classes to enhance use of generics first line. Measures may include prescribing restrictions for duloxetine. No specific measures planned for AAPs with more generics becoming available.
    Full-text · Article · Jan 2012 · Frontiers in Pharmacology
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    ABSTRACT: Risperidone has been approved by the Food and Drug Administration for the treatment of schizophrenia in the adolescent population. This new indication has been a result of data obtained from two pivotal double-blind trials with supplemental information from open-label and retrospective trials. This brief article provides an overview of risperidone's pharmacological profile followed by information on the double-blind trials that have resulted in the approval of risperidone for the treatment of adolescent schizophrenia.
    Full-text · Article · Feb 2009 · Drugs of today (Barcelona, Spain: 1998)
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