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P.3.c.015 Dose response side effects of risperidone versus convenient antipsychotics
P.3.c Psychotic disorders and antipsychotics - Antipsychotics (clinical)
Ip.3.c.0151 Dose response side effects of risperidone versus convenient antipsychotics I. Popovic 1 " V. Popovic2 . 1 Spezialized Hospital For Psychiatric Disorders, Admission Ward, Nis, Serbia; 2 Spezialized Hospital For Psychiatric Disorders, Alcoholism ward, Nis, Serbia
Patient sample: The study included 53 hospitaly treated patients in Special psychiatric hospital "Gomja Toponica", near Nis, Serbia: 36 male, 17 female, suffering from different types of Schizophrenia or Schizoaffective disorder. Average age was 40.1 year. Average duration ofthe hospital treatment w~s app~oximate~y nine months, which means the word is about chromc schlZophremc . . . patients. The aim ofthe study was to follow up the Side effects ofRispendone vs. convenient antipsychotics on 53 chronic schizophrenic inpatients. The side effects were measured by KLAWANS scale. Also needed anticholinergic drug (Trihexiphenidil) therapy is followed. Results: During the treatment with convenient antipsychotics (Haloperidol 9.6mg pro die, Fluphenazine 4.2mg pro die) over 66% of patients needed Trihexiphenidil because of the extrapyramidal side effects, in average dose 4.0mg pro die. After the Risperidone was included, there was significant reduction ?f e~ trapyramidal symptoms. During two weeks (average ~ose. Risp~~ done 5.9 mg pro die), only 22% ofpatients needed Tnhexlphemdil (average 2.0mg pro die). After one month: Risperidone average dose 6.3 mg pro die, Trihexiphenidil 2.5 mg pro die, 28% of patients treated. After two months: Risperidone average dose 6.1 mg pro die, 26% of patients needed Trihexiphenidil av~rage d?se 2.3 mg pro die. Decline of the KLAWANS score after mtroducmg the Risperidone, from the score 10 during the treatment with the convenient antipsychotics, to score approximately 4, after the two weeks (average Risperidone dose 5.9mg pro die). Then, in the 4. week of treatment KLAWANS score was approximately 6, on the average dose of Risperidone 6.3 mg pro die. In the 8. week of treatment KLAWANS score approximately 5, on the Risperidone dose 6.1 ~g pro die. It was about 50% less than on the begiIDling of the study (using convenient antipsychotics). Dose responded anticholinergics: After two weeks of treatment, average dose of Trihexiphenidyl was 2 mg pro die (Risperidone average dose 5.9 mg pro die). After 4 wee~ of treatme~t, av~rage dose of Trihexiphenidyl was 2.5 mg pro die (average Rispendone dose 6.3 mg pro die). After the eight weeks of treatment, average dose of Trihexiphenidyl was 2.3 mg pro die (average Risperidone dose 6.1 mg pro die). Conclusion: Side effects of Risperidone meaning at the first place the extrapyramidal symptoms are present in significantly less percent, measured by the KLAWp,.NS s~ale, than in ~e case of using the convenient antipsychotics. Patients treated With Risperidone in the significantly less percentage needed c~rrective therapy with anticholinergic drug vs. in the treatment With convenient antipsychotics. There was a noticeable dose-respond rate Risperidone/Anticholinergic drug in the patients with extrapyramidal symptoms (25% of patients treated with Risperidone). The Risperidone, as the new generation o~ antips~chotic .drug: ~s significantly more safe than the convement antipsychotics; It IS the precedent factor of the positive therapeutically compliance the more important thing in maintaining remission. References [I] Meco G, Bedini L, Bonifati V; Sonsinl U. Risperi~on~ in the treatment of chronic schizophrenia with tardive dyskineSia. Curr Ther 1989;46:876-883.
S519
[2] Ge1ders YG et al. Pilot clinical investigation.of Risperidone in the treatment of psychotic patients. PharmacopsychIatry 1990;23:205-211. [3] Yoshimura R at al. An open study of Risperidone I!quid in t;he acute phase of schizophrenia. Hum Psychopharmacol Clm Exp (m press: www.interscience.wiley.com); 2005.
1P.3.c.0161 Assessment of efficacy and metabolic effects in schizophrenic patients switched from risperidone to ziprasidone
IH. Lee 1 " 10. Song2, S.l Lee 3 , K.H. Lee4 . 1 Catholic University of Daegu, Department of Psychiatry, Daegu, SouthKnrea; 2 Daegu Mental Hospital, Department of Psychiatry, Daegu, South-Knrea; 3Kyungpook National Univ~rsity, Department of Psychiatry, Dae-gu, South-Korea; Dongguk University, Department ofPsychiatry, Gyeongju, South-Korea The introduction of the second-generation antipsychotics has represented a major advance in the treatment of schizophrenia [I]. But treatment with psychotropic medications, including secondgeneration, or atypical, antipsychotic medications, can ~e associated with adverse metabolic effects [2]. Recent studies on switching from either conventional or newer antipsyc~ot~cs to ziprasidone in patients with schizophrenia have. shown slgmfi~~t improvement in both efficacy (positive, negative, and cogmtive symptoms) and tolerability (EPS, prolactinemia, weight gain, and metabolic parameters) [3]. The purpose of the study was to assess clinical effectiveness and metabolic parameters changes by switching from risperidone to ziprasidone in chronic schizophrenic patients. A total of 19 patients were switched to a 12-week, open label, flexible dose (8Q-160mg/day) of ziprasidone. Current psychiatric status was evaluated by Positive and Negative Syndrome Scale, Clinical Global Impression Severity & improvement scale, and Global Assessment of Functioning. Other Measures included drug induced abnonnal movements (Simpson Angus Scale, Barnes Akathisia Scale, Abnonnal Involuntary Movement Scale). Laboratory tests (total cholesterol, low-density lipoprotein cholesterol, high- density lipoprotein cholesterol, triglyceride, HbAlc, fasting plasma glucose, etc) and electrocardiography with QTc interval were carried out. Of the 19 enrolled patients, 14 patients (73.7%) completed the study. Mean dose of risperidone was 6.13±2.042mg/day at the baseline and that of ziprasidone at the end point of study was 123.08±8.117 mg/day. Clinically, PANSS total score and other subscale scores showed improvement, especially significant improvements were reported for mean Negative Syndro~e. Scale Scores (p < 0.05). With regard to other laboratory tests, slgmficant improvement were also found for mean total cholesterol (p < 0.05), triglyceride (p < 0.05), free fatty acid (p < 0:05~. Frequen~y and severity of abnonnal movements were not slgmficantly different between two drugs. In addition, mean body weight and hip size significantly decreased from baseline (p < 0.05). The analysis of the ECG results showed a QTc interval was not significantly changed between before and after trial. In conclusion, the data from this study, support the use of ziprasidone as treatment option for stable outpatients w~th schizophrenia who continue to have symptoms from .thelr curr~nt antipsychotic regimen, with gain in efficacy(espeCially negative symptom), reduction ofbody weight & hip size, and improvements in metabolic syndrome risk factors.
Ip.3.c.0151 Dose response side effects of risperidone versus convenient antipsychotics I. Popovic 1 " V. Popovic2 . 1 Spezialized Hospital For Psychiatric Disorders, Admission Ward, Nis, Serbia; 2 Spezialized Hospital For Psychiatric Disorders, Alcoholism ward, Nis, Serbia
Patient sample: The study included 53 hospitaly treated patients in Special psychiatric hospital "Gomja Toponica", near Nis, Serbia: 36 male, 17 female, suffering from different types of Schizophrenia or Schizoaffective disorder. Average age was 40.1 year. Average duration ofthe hospital treatment w~s app~oximate~y nine months, which means the word is about chromc schlZophremc . . . patients. The aim ofthe study was to follow up the Side effects ofRispendone vs. convenient antipsychotics on 53 chronic schizophrenic inpatients. The side effects were measured by KLAWANS scale. Also needed anticholinergic drug (Trihexiphenidil) therapy is followed. Results: During the treatment with convenient antipsychotics (Haloperidol 9.6mg pro die, Fluphenazine 4.2mg pro die) over 66% of patients needed Trihexiphenidil because of the extrapyramidal side effects, in average dose 4.0mg pro die. After the Risperidone was included, there was significant reduction ?f e~ trapyramidal symptoms. During two weeks (average ~ose. Risp~~ done 5.9 mg pro die), only 22% ofpatients needed Tnhexlphemdil (average 2.0mg pro die). After one month: Risperidone average dose 6.3 mg pro die, Trihexiphenidil 2.5 mg pro die, 28% of patients treated. After two months: Risperidone average dose 6.1 mg pro die, 26% of patients needed Trihexiphenidil av~rage d?se 2.3 mg pro die. Decline of the KLAWANS score after mtroducmg the Risperidone, from the score 10 during the treatment with the convenient antipsychotics, to score approximately 4, after the two weeks (average Risperidone dose 5.9mg pro die). Then, in the 4. week of treatment KLAWANS score was approximately 6, on the average dose of Risperidone 6.3 mg pro die. In the 8. week of treatment KLAWANS score approximately 5, on the Risperidone dose 6.1 ~g pro die. It was about 50% less than on the begiIDling of the study (using convenient antipsychotics). Dose responded anticholinergics: After two weeks of treatment, average dose of Trihexiphenidyl was 2 mg pro die (Risperidone average dose 5.9 mg pro die). After 4 wee~ of treatme~t, av~rage dose of Trihexiphenidyl was 2.5 mg pro die (average Rispendone dose 6.3 mg pro die). After the eight weeks of treatment, average dose of Trihexiphenidyl was 2.3 mg pro die (average Risperidone dose 6.1 mg pro die). Conclusion: Side effects of Risperidone meaning at the first place the extrapyramidal symptoms are present in significantly less percent, measured by the KLAWp,.NS s~ale, than in ~e case of using the convenient antipsychotics. Patients treated With Risperidone in the significantly less percentage needed c~rrective therapy with anticholinergic drug vs. in the treatment With convenient antipsychotics. There was a noticeable dose-respond rate Risperidone/Anticholinergic drug in the patients with extrapyramidal symptoms (25% of patients treated with Risperidone). The Risperidone, as the new generation o~ antips~chotic .drug: ~s significantly more safe than the convement antipsychotics; It IS the precedent factor of the positive therapeutically compliance the more important thing in maintaining remission. References [I] Meco G, Bedini L, Bonifati V; Sonsinl U. Risperi~on~ in the treatment of chronic schizophrenia with tardive dyskineSia. Curr Ther 1989;46:876-883.
S519
[2] Ge1ders YG et al. Pilot clinical investigation.of Risperidone in the treatment of psychotic patients. PharmacopsychIatry 1990;23:205-211. [3] Yoshimura R at al. An open study of Risperidone I!quid in t;he acute phase of schizophrenia. Hum Psychopharmacol Clm Exp (m press: www.interscience.wiley.com); 2005.
1P.3.c.0161 Assessment of efficacy and metabolic effects in schizophrenic patients switched from risperidone to ziprasidone
IH. Lee 1 " 10. Song2, S.l Lee 3 , K.H. Lee4 . 1 Catholic University of Daegu, Department of Psychiatry, Daegu, SouthKnrea; 2 Daegu Mental Hospital, Department of Psychiatry, Daegu, South-Knrea; 3Kyungpook National Univ~rsity, Department of Psychiatry, Dae-gu, South-Korea; Dongguk University, Department ofPsychiatry, Gyeongju, South-Korea The introduction of the second-generation antipsychotics has represented a major advance in the treatment of schizophrenia [I]. But treatment with psychotropic medications, including secondgeneration, or atypical, antipsychotic medications, can ~e associated with adverse metabolic effects [2]. Recent studies on switching from either conventional or newer antipsyc~ot~cs to ziprasidone in patients with schizophrenia have. shown slgmfi~~t improvement in both efficacy (positive, negative, and cogmtive symptoms) and tolerability (EPS, prolactinemia, weight gain, and metabolic parameters) [3]. The purpose of the study was to assess clinical effectiveness and metabolic parameters changes by switching from risperidone to ziprasidone in chronic schizophrenic patients. A total of 19 patients were switched to a 12-week, open label, flexible dose (8Q-160mg/day) of ziprasidone. Current psychiatric status was evaluated by Positive and Negative Syndrome Scale, Clinical Global Impression Severity & improvement scale, and Global Assessment of Functioning. Other Measures included drug induced abnonnal movements (Simpson Angus Scale, Barnes Akathisia Scale, Abnonnal Involuntary Movement Scale). Laboratory tests (total cholesterol, low-density lipoprotein cholesterol, high- density lipoprotein cholesterol, triglyceride, HbAlc, fasting plasma glucose, etc) and electrocardiography with QTc interval were carried out. Of the 19 enrolled patients, 14 patients (73.7%) completed the study. Mean dose of risperidone was 6.13±2.042mg/day at the baseline and that of ziprasidone at the end point of study was 123.08±8.117 mg/day. Clinically, PANSS total score and other subscale scores showed improvement, especially significant improvements were reported for mean Negative Syndro~e. Scale Scores (p < 0.05). With regard to other laboratory tests, slgmficant improvement were also found for mean total cholesterol (p < 0.05), triglyceride (p < 0.05), free fatty acid (p < 0:05~. Frequen~y and severity of abnonnal movements were not slgmficantly different between two drugs. In addition, mean body weight and hip size significantly decreased from baseline (p < 0.05). The analysis of the ECG results showed a QTc interval was not significantly changed between before and after trial. In conclusion, the data from this study, support the use of ziprasidone as treatment option for stable outpatients w~th schizophrenia who continue to have symptoms from .thelr curr~nt antipsychotic regimen, with gain in efficacy(espeCially negative symptom), reduction ofbody weight & hip size, and improvements in metabolic syndrome risk factors.