A Comparison of Long-Term Outcome in First-Episode Schizophrenia Following Treatment With Risperidone or a Typical Antipsychotic
J Clin Psychiatry 2001;62(3):179-184
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Most reports assessing the efficacy
and tolerability of risperidone have involved patients previously
treated with typical antipsychotics. Such patients are more
likely to have a greater resistance or intolerance to treatment,
thus restricting our interpretation of the impact a new treatment
might have on the course of schizophrenia and possibly biasing
the results. The present study examines the relative
effectiveness of risperidone and typical antipsychotics in
patients being treated for their first episode of schizophrenia.
Method: From a cohort of 126 patients, 2 groups
of 19 first-episode DSM-III-R/DSM-IV schizophrenia patients
matched for age, gender, length of illness, and length of
treatment and treated with either a typical antipsychotic or
risperidone for a minimum of 1 year were compared on a number of
outcome dimensions during their course of treatment and at
follow-up. Treatment allocation was not random, and patients were
judged to be compliant with medication. Patients treated with
typical antipsychotics were followed up for a statistically
nonsignificantly longer time (mean = 2.7 vs. 1.9 years).
Results: Six patients (31.6%) from the typical
antipsychotic group were admitted to the hospital within the
first year following the index admission compared with 1 patient
(5.3%) in the risperidone group (admitted at month 14). Patients
in the risperidone group showed a statistically significantly
lower length of first hospitalization (p < .01), utilization
of inpatient beds during the course of treatment (p < .001),
and use of anticholinergic medication (p < .05). There were no
statistically significant differences in symptom levels, either
during the course of treatment or at follow-up; in the use of
antidepressant, antianxiety, or mood-stabilizing drugs; or in
changes in living circumstances or employment.
Conclusion: These findings confirm at least
equal long-term efficacy of typical antipsychotics and
risperidone, but a possible advantage for risperidone in
decreased service utilization and decreased use of