Risperidone, 2 mg/day vs. 4 mg/day, in First-Episode, Acutely Psychotic Patients: Treatment Efficacy and Effects on Fine Motor Functioning
J Clin Psychiatry 2002;63:885-891
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: The aim of this study was to examine
differences in the improvement of clinical psychopathology and in
fine motor functions at 2 doses of risperidone in first-episode,
acutely psychotic patients.
Method: In a double-blind, fixed-dose study, 49
acutely psychotic, neuroleptic-naive patients who were admitted
for the first time and who met DSM-IV criteria for schizophrenia,
schizophreniform disorder, or schizoaffective disorder were
randomly assigned to 2 or 4 mg/day of risperidone. Treatment
efficacy was measured using the Brief Psychiatric Rating Scale,
the Scale for the Assessment of Negative Symptoms, The Clinical
Global Impressions scale, and the Social and Occupational
Functioning Assessment Scale. Fine motor functions were assessed
using a computerized device (the Vienna Test System) and were
compared with those of a control group of 20 healthy subjects who
were matched for age, gender, and educational level.
Results: Treatment with doses of 2 and 4 mg of
risperidone daily significantly reduced positive (p < .0001)
and negative (p < .01) symptoms at 8 weeks. Although there
were no significant differences in motor movements as measured
using the Barnes Akathisia Scale and the Simpson-Angus Scale,
computerized fine motor assessment showed significantly less
motor dysfunction in the 2-mg/day group at 8 weeks. No
significant correlations to plasma concentration of active moiety
were found for data on psychopathology and fine motor functions.
Conclusion: The 2 doses of risperidone
did not differ in terms of clinical improvement, but the 2-mg/day
dose produced fewer fine motor dysfunctions. These results
suggest that a dose as low as 2 mg/day of risperidone may be
effective for patients with first-episode psychosis.