Rapid Onset of Therapeutic Effect of Risperidone Versus Haloperidol in a Double-Blind Randomized Trial
Jonathan Rabinowitz, Tzipi Hornik, and Michael Davidson
J Clin Psychiatry 2001;62(5):343-346
© Copyright 2015 Physicians Postgraduate Press, Inc.
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Background: Speed of onset of therapeutic effect
is an important dimension of drugs employed to treat psychosis
and schizophrenia. Faster onset is desirable to reduce the
anguish caused by delusions and hallucinations and to protect
patients and others from the consequences of poor judgment
associated with psychotic exacerbation. Although sufficient
studies have demonstrated that novel antipsychotics have
advantages over clinically employed doses of classic drugs in
terms of tolerability and aspects of efficacy, less is known
about differences in speed of onset of therapeutic effect. This
report consists of a post hoc subanalysis of data from a large
double-blind, randomized pivotal trial in which we compared onset
of therapeutic effect between risperidone and haloperidol.
Method: During an 8-week period, 227 patients
with DSM-III chronic schizophrenia received 4 mg/day of
risperidone and 226 patients received 10 mg/day of haloperidol.
Symptoms were assessed 6 times (days 0, 7, 14, 28, 42, and 56)
using the Positive and Negative Syndrome Scale (PANSS) for
schizophrenia and the Clinical Global Impressions-Severity of
Illness scale (CGI-S). Data were analyzed using analysis of
variance for multiple dependent variables and repeated-measures
multivariate analysis of variance.
Results: The analyses revealed that patients
receiving risperidone improved more rapidly than those receiving
haloperidol as measured by PANSS total and CGI-S scores.
Differences were most pronounced during the first week of
treatment.
Conclusion: Results suggest that risperidone
offers a more rapid response than haloperidol, particularly
during the active phase of illness when time to response can be
crucial.