Risperidone in treatment-refractory schizophrenia.

Examined the clinical safety and efficacy of risperidone compared to haloperidol in patients with treatment-refractory schizophrenia. 67 medication-unresponsive Ss (aged 18–60 yrs) were randomly assigned to treatment with risperidone or haloperidol. After a 3–7 day placebo washout period, there was a 4-wk, double-blind, fixed-dose comparison trial that was followed by a 4-wk, flexible-dose phase. Measures of clinical change were quantified by standard psychopathologic and neuromotor instruments. Risperidone demonstrated clinical efficacy superior to that of haloperidol on the total Brief Psychiatric Rating Scale (BPRS) after the first 4 wks of treatment. Risperidone did not show any advantage over haloperidol after an additional 4 wks. Overall improvement on the BPRS at 4 wks was significantly better for the risperidone group (24%) than for the haloperidol group (11%). Risperidone-treated Ss were significantly less likely than haloperidol-treated Ss to require concomitant anticholinergic medication after 4 wks; they also had significantly less observable akathisia and significantly less severe tardive dyskinesia. Baseline characteristics that correlated significantly with risperidone response were positive symptoms, conceptual disorganization, akathisia, and tardive dyskinesia. (PsycInfo Database Record (c) 2021 APA, all rights reserved)