Risperidone in the Treatment of Schizotypal Personality Disorder
J Clin Psychiatry 2003;64(6):628-634
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Objective: Schizotypal personality disorder
(SPD) has many phenomenological, genetic, physiologic, and
neuroanatomical commonalities with schizophrenia. Patients with
the disorder often suffer from marked social and occupational
impairment, yet they have been difficult to treat with
medications because of their unusual sensitivity to side effects.
This study was designed to determine whether low-dose risperidone
treatment is acceptable to SPD patients and can reduce
characteristic schizotypal symptoms. In addition, if SPD patients
respond to an antipsychotic medication, this will provide support
for the notion of a commonality in treatment response between SPD
Method: Twenty-five patients with DSM-IV-defined
SPD were entered into a 9-week randomized, double-blind,
placebo-controlled study of low-dose risperidone (starting dose
of 0.25 mg/day, titrated upward to 2 mg/day) in the treatment of
SPD. Patients were rated with the Positive and Negative Syndrome
Scale (PANSS), the Schizotypal Personality Disorder
Questionnaire, the Hamilton Rating Scale for Depression, and the
Clinical Global Impressions scale. Data were collected from 1995
Results: The subjects had a low incidence of
depression and of comorbid borderline personality disorder.
Patients receiving active medication had significantly (p <
.05) lower scores on the PANSS negative and general symptom
scales by week 3 and on the PANSS positive symptom scale by week
7 compared with patients receiving placebo. Side effects were
generally well tolerated, and there was no group difference in
dropout rate for side effects.
Conclusion: Low-dose risperidone appears to be
effective in reducing symptom severity in SPD and is generally