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OBJECTIVE: Aripiprazole, risperidone, atomoxetine, and methylphenidate are drugs commonly prescribed for many psychiatric conditions and can be used alone or in combination in children and adolescents. This study aimed to investigate comparatively the possible genotoxic effects or genoprotective potentials of these drugs on human lymphocytes and HepG2 cells. MATERIALS AND METHODS: Cytotoxicity analysis was performed with the cell viability test on human lymphocytes and HepG2 cells, and half-maximal inhibitory concentration (IC50) values of the drugs were determined, and three different doses (1/4 IC50, 1/2 IC50, and IC50) were applied for genetic analysis. For the determined doses, cells with and without DNA damage were examined by comet analysis. RESULTS: In lymphocytes, aripiprazole and risperidone increased DNA damage at moderate and maximum doses, whereas atomoxetine increased DNA damage only at the maximum dose. In HepG2 cells, risperidone reduced DNA damage at all doses, while atomoxetine increased DNA damage at all doses. On the other hand, in the DNA-damaged cells induced by hydrogen peroxide (H2O2), DNA damage decreased at all concentrations of all drugs in both lymphocytes and HepG2 cells. CONCLUSIONS: As a result, the genotoxicity of the drugs was found to be dose-dependent, and all drugs showed a genoprotective effect on DNA-damaged cells. [ABSTRACT FROM AUTHOR]

Medically complex infants experiencing NICU stays can be difficult to manage, exhibiting refractory agitation, disengagement, or both—all signs of delirium, which can present in a hypoactive, hyperactive, or mixed form. Though documented in other settings, delirium is under-recognized in NICUs. Pediatric studies show that a high percentage of patients with delirium are under the age of 12 months. Delirium is associated with increased ventilation days, hospital days, and costs. It negatively affects neurodevelopment and social interaction. Studies show that pediatric nurses are unprepared to recognize delirium. Our nurse-led multidisciplinary group created a best practice recommendation (BPR) focused on detecting delirium and minimizing risk through thoughtful sedation management, promotion of sleep hygiene and mobility, and facilitation of meaningful caregiver presence. Occasionally, medications, including melatonin and risperidone, are helpful. In 2019, we introduced this BPR to reduce delirium risk in our NICU. Practice changes tied to this initiative correlate with a significant reduction in delirium scores and risk including exposure to deliriogenic medications. A multidisciplinary care bundle correlates with decreased delirium screening scores in NICU patients. [ABSTRACT FROM AUTHOR]

Objectives Breath holding spells (BHS) are a type of syncope in children that is commonly seen in the first years of life. Although these attacks do not cause serious damage to the child's brain, in severe or repeated cases, they expose the brain to hypoxia and cause a lot of stress in parents. In these cases, the clinician should consider therapy. The purpose of this study is to investigate the effectiveness of Risperidone in the treatment of BHS in children visiting the neurology clinic of the Children's Medical Center Hospital. Materials & Methods In this randomized clinical trial, the statistical population included patients with the history of Breath Holding spells grades 2 to 3 (after ruling out of seizure disorders) over one year old, visiting the neurology clinic of Tehran Children's Medical Center in 2019. The subjects were randomly selected from patients visiting the clinic using a table of random numbers from the admit ion list. After providing the necessary explanations and obtaining informed consent from their parents, they were treated with low-dose Risperidone (maximum 1 mg) for three months. The patients were observed for three months in terms of frequency and severity of spells monthly. Results In this study, the median (25th and 75th percentile) age of subjects was 2.3 (2.0-2.6) years. Both the number and severity of seizures in the subjects had a statistically significant decrease in the period after treatment with Risperidone (P<0.001). The studied boys and girls experienced statistically significant decrease in terms of both the frequency of spells (P-value of 0.002 and 0.039) and intensity of seizures (P=0.016) and P=0.008), respectively after treatment with Risperidone. Also, in the studied children under 2 years old and over 2 years old, both the frequency (P=0.021 and P=0.004) and intensity of spells (P=0.008) 0.016 for subjects under and over 2 years, respectively) had a statistically significant decrease after treatment with risperidone compared to pretreatment. Conclusion According to the results of this study, it seems that both the frequency and the intensity of spells in children (regardless of gender and age group), experienced a statistically significant decrease after treatment with Risperidone. We suggest conducting a more comprehensive study considering a larger sample size in order to estimate this issue more correctly. [ABSTRACT FROM AUTHOR]

Copyright of Turk Psikiyatri Dergisi is the property of Turk Psikiyatri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkish Journal of Psychiatry is the property of Turk Psikiyatri Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In our case report, a 29-year-old male patient with a known history of schizophrenia presented with altered mental status and catatonia and was found to have an enlarged (21mm) cavum septum pellucidum (CSP) on magnetic resonance imaging (MRI). He was subsequently treated with escitalopram, olanzapine, methylphenidate, lorazepam, and eight electroconvulsive therapy (ECT) treatments during his hospital course, after which his catatonia improved. We compared this to other cases in which a large CSP was identified and discussed the possibility of increased susceptibility to psychosis, specifically catatonia, which might be associated with this developmental anomaly. [ABSTRACT FROM AUTHOR]

Copyright of Revista Colombiana de Psiquiatria is the property of Asociacion Colombiana de Psiquiatria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The purpose of this work was to develop and verify a green stability-indicating "high-performance thin-layer chromatographic (HPTLC)" technique to measure risperidone (RISP). The ternary mixture of ethanol, ethyl acetate, and ammonia (70:20:10 v/v/v) was the green mobile phase that was employed. At 281 nm, the detection of RISP was performed. The suggested method's greener profile was produced using the analytical eco-scale (AES), ChlorTox, and analytical GREENness (AGREE) methodologies. It was then contrasted with RISP analysis published HPTLC methods. The proposed methodology for measuring RISP in the 50–1400 ng/band range showed the linearity. Furthermore, the RISP measurement methodology was green, robust, precise (% RSD = 0.80–1.02), sensitive (LOD = 1.86 ng/band and LOQ = 5.60 ng/band), and accurate (% recoveries = 98.23–101.80). The AES, total ChlorTox, and AGREE scales for the suggested technique were found to be 83, 1.26 g, and 0.75, indicating an excellent greener profile. The current methodology's AES and total ChlorTox were significantly higher than those of previously published HPTLC RISP analysis methods. RISP was found to be highly stable under acid, base, and thermal stress conditions, while it was found to be most unstable under oxidative degradation conditions. Additionally, the stability-indicating aspect of the suggested technique was able to identify RISP in the presence of its degradation products. It was discovered that commercial tablet brands A and B had 98.12 and 99.62 % of RISP, respectively. The results of this investigation suggested that RISP in commercial formulations might be regularly analyzed utilizing the suggested green technology. [ABSTRACT FROM AUTHOR]

Objectives: As a severe mental health condition, schizophrenia presents a chronic and complex clinical manifestation and neuropathology. A large body of literature exists on the pharmacological treatment of schizophrenia. However, evidence on some dimensions of such interventions (e.g., eligible candidates, potential predicting factors of the therapeutic outcomes, safe implementation of these interventions, etc.) are notably scarce. Studies revealed superior influences of adjunct statin therapy over placebo among patients with schizophrenia. The study aimed to investigate the effects of aspirin and simvastatin as adjunctive therapy, compared to placebo on positive and negative symptoms and general psychopathology of patients with schizophrenia. Methods: This is a double-blind, randomized clinical trial. The sample size was estimated to be 15 individuals for each one of the three research groups (n=45). The Positive And Negative Syndrome Scale (PANSS) and the Hamilton Rating Scale For Depression (HAM-D) were employed to collect the study data in the present study. The study patients were recruited from patients admitted to the psychiatric wards of Razi Hospital were identified. The study subjects were randomly divided into two test groups and one control group. All groups were initially treated with risperidone 4 mg daily for 3 weeks. Then, group A received aspirin (325 mg twice daily), whereas group B was prescribed 40 mg/d of simvastatin. However, the control group received a placebo. Psychiatric symptoms were recorded according to the PANSS at the beginning of the study and then at weeks 4 and 8. The results were analyzed using inferential statistics (repeated-measures analysis of covariance) and descriptive statistics in SPSS software v. 20. Results: Of 45 patients, 35(77.78%) were men (Mean±SD age: 45.8±10.5 years), and 10(22.23%) were women (Mean±SD age: 42.3±7.8 years). The mean scores of the positive symptoms of PANSS significantly decreased in the groups treated with aspirin and simvastatin (P=0.006 and P=0.005, respectively). However, no such difference was seen in the controls (P=0.447). Furthermore, the mean scores of the negative symptoms of PANSS significantly decreased in the intervention groups (P<0.001); in addition, no significant differences were seen in the controls after the end of the research program (P=0.18). In addition, the mean scores of the general symptoms of PANSS significantly decreased in the aspirin and simvastatin groups (P<0.001). There was an increase in the same value in the controls, but the increase was not significant (P=0.31). Finally, while the total mean scores of the PANSS increased in the control group (P=0.25), the corresponding scores significantly decreased in the test groups receiving aspirin and simvastatin (P<0.001). Discussion: The present study results indicate that either aspirin or simvastatin can reduce the symptoms of schizophrenia, including general psychopathology, negative symptoms, and positive symptoms in the explored patients. Also, the effectiveness of both drugs was similar, and no significant difference was detected between these medications in reducing the symptoms mentioned above. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Ketamine, an N-methyl D-aspartic acid receptor antagonist drug, is reported to produce memory disruptions. The aim of this study was to investigate the protective effects of ethyl pyruvate (EP), a pyruvic acid derivative, and risperidone, an atypical antipsychotic drug, against ketamine-induced cognitive disturbances. MATERIALS AND METHODS: A passive-avoidance test, a novel object recognition test, and a modified elevated plus maze test were used to assess memory functions. Hippocampal malondialdehyde (MDA) levels were measured to determine the oxidation levels. RESULTS: Ketamine applications produced memory deficits in all tests and insignificantly increased MDA levels, which were alleviated by risperidone, EP, and combination treatments. CONCLUSIONS: Increased oxidative stress and neurotransmission imbalance can be responsible for ketamine-induced memory disruptions. With its antioxidant effects, EP may be helpful to reduce cognitive impairments related to schizophrenia either alone or in combination with antipsychotics. [ABSTRACT FROM AUTHOR]

We present the cases of a 60-year-old female patient and 40-year-old male patient who experienced exacerbations of previously well-controlled symptoms of bipolar I disorder (BD1) after receiving COVID-19 vaccines, despite being stable for years on the same medications. The first patient experienced worsened depression, mania, and psychosis that improved with an increase in risperidone. The second patient experienced depression, mania, psychosis, and suicidal ideation that resulted in hospitalization. Prior to hospitalization, he took lamotrigine and bupropion, the latter of which was changed to aripiprazole in hospital. We reviewed current literature on inflammation in mental disorders, vaccination-related inflammatory changes, and the type of inflammation induced by COVID-19 vaccines. Inflammation is a component of psychiatric disorders, and the inflammatory response induced by vaccines might potentiate acute mental health exacerbations, necessitating treatment changes. However, this case series should not be used to justify recommendations against vaccination without larger, well-designed studies. At this time, the known benefits of vaccination outweigh these unknown risks, especially because individuals with serious mental illness are more likely to die from COVID-19 than the general population. [ABSTRACT FROM AUTHOR]

To investigate the efficacy and safety of olanzapine, aripiprazole, and risperidone in the treatment of mental and behavioral symptoms of Alzheimer's Disease. A retrospective analysis was performed on the clinical data of 126 patients with Alzheimer's Disease from February 2018 to February 2020. The patients were divided into group A (aripiprazole, n=44), group B (olanzapine, n=42) and group C (risperidone, n=40) based on the treatment method. Remarkably differences at different time points among the three groups were observed (P<0.05). Significant differences in the Positive and Negative Syndrome Scale scores of different time points and cross-group comparison among the three groups were detected (P<0.05). The time-point comparison of BEHAVE-AD scores among the three groups indicated a remarkable difference (P<0.05). After 4 weeks of treatment, the Positive and Negative Syndrome Scale and BEHAVEAD scores of group A were lower than those of groups B and C (P<0.05). The total incidence of adverse reactions in group A was remarkably lower than in groups B and C (P<0.05). Olanzapine, aripiprazole and risperidone are effective in treating Alzheimer's disease and aripiprazole, with a better safety profile and fewer adverse reactions, is more suitable for elderly patients. [ABSTRACT FROM AUTHOR]

Delirium is a frequent complication of critical illness in adult and pediatric populations and is associated with significant morbidity and mortality. Little is known about the incidence, risk, symptoms, or treatment of delirium in the NICU. Only 4 cases of NICU delirium have been reported, but many pediatric studies include infants. The Cornell Assessment of Pediatric Delirium tool has been validated in neonatal and infant populations for identification of delirium. Initial treatment should focus on identification and reversal of the cause, with pharmacologic management reserved for patients with symptoms that do not resolve or that significantly impact medical care. Routine use of intravenous haloperidol should be avoided because of the high incidence of serious adverse effects, but it may be considered in patients with significant symptoms who are unable to take oral medications. Atypical antipsychotics (olanzapine, quetiapine, and risperidone) appear to be efficacious with a low incidence of adverse effects. Risperidone has weight-based dosing and a liquid dosage form available, making it a good option for use in the NICU. Additional data from large cohorts of NICU patients routinely screened for delirium, and treated as indicated, are needed. [ABSTRACT FROM AUTHOR]

After a dementia diagnosis, goals of care are often reassessed, including the use of preventive medications like statins. To examine changes in statin use after initiating medication for managing dementia. A case-crossover study utilizing medication dispensing data from the Australian Pharmaceutical Benefits Scheme (PBS) 10% random sample was conducted. Use of statins was compared in the 12 months pre- and post-initiation (pre-period and post-period) of anti-dementia medications or risperidone for behavioural symptoms of dementia. Individuals aged ≥65 years who had their first dispensing of anti-dementia medication or risperidone between July 2006 and June 2017 and survived ≥12 months after their first supply were included. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for change in statin use in the discordant pairs. The cohort (n = 19,809) had a median age of 81 years and 61% were female. Statins were less likely to be used after initiating anti-dementia medication or risperidone (OR 0.50; 95%CI 0.45–0.55). The OR for statin use in the post-period versus the pre-period decreased annually over the 11 years from 1.21; 95%CI 0.84–1.75 in 2006–7 to 0.31; 95%CI 0.24–0.41 in 2016–17 (p for interaction <0.05). Statins are more likely to be ceased than started after initiating medication for dementia. This may reflect changes in goals of care, or changes in the interpretation of the available evidence for the safety and efficacy of statins in older people living with dementia. • Statins more likely to be ceased than started after starting medication for dementia. • Decrease in statin use is more evident in recent years. • Odds ratios decrease as age increases. • Prevalence of statins is highest in those with diabetes and cardiovascular disease. [ABSTRACT FROM AUTHOR]

Surface-eroding polymers are of significant interest for various applications in the field of controlled drug delivery. Poly(ethylene carbonate), as an example, offers little control over the rate of degradation and, thus, drug release, which usually conflicts with the requirements for long-acting medications. Here, we challenged an option to decelerate the degradation of poly(ethylene carbonate) in vitro and in vivo. When polymer films loaded with distinct antioxidants (vitamins) along with the model drugs leuprorelin and risperidone were incubated in superoxide radical solution and phagocyte culture, the mass loss and drug release from the delivery vehicle was a function of the type and dose of the utilized antioxidant. Once the polymer surface was "attacked" by reactive oxygen species, the antioxidants were released on demand quenching the polymer-degrading radicals. Accordingly, specific combinations of polymer and radical scavengers resulted in controlled release medications with an extended "life-time" of one month or longer, which is difficult to achieve for poly(ethylene carbonate) in the absence of antioxidants. A comparable degradation and drug release behavior was observed when antioxidant-loaded poly(ethylene carbonate) films were implanted in rats. Furthermore, linear correlations were obtained between the mass loss of the polymer films and the released fraction of drug (with slopes close to 1), a clear indication for the surface erosion of poly(ethylene carbonate) in vitro and in vivo. Overall, an addition of antioxidants to poly(ethylene carbonate)-based controlled drug delivery vehicles represents a reasonable approach to modify the performance of long-acting medications, especially when a "life time" of weeks to months needs to be achieved. Surface-eroding poly(ethylene carbonate) (PEC) is of significant interest for long-acting injectable formulations. However, PEC offers only little control over the rate of degradation and, thus, drug release kinetics. We describe an option to decelerate the degradation rate of PEC in vitro and in vivo. When polymer films loaded with distinct antioxidants along with model drugs were incubated in superoxide radical solution, phagocyte culture and implanted in rats, their mass loss and drug release was a function of the type and dose of the utilized antioxidant. Accordingly, specific combinations of polymer and radical scavengers resulted in controlled release medications with an extended "life-time" of one month or longer, which is difficult to achieve for PEC in the absence of antioxidants. Once a PEC-based drug delivery vehicle is approached by e.g. , phagocytes, which secret radicals to degrade the polymer, an on-demand release of the encapsulated antioxidant took place. Consequently, slower polymer degradation accompanied by a sustained release of co-embedded therapeutic agents was observed. Image, graphical abstract [ABSTRACT FROM AUTHOR]

Copyright of Arquivos de Neuro-Psiquiatria is the property of Thieme Medical Publishing Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Schizophrenia is a chronic disorder that requires long-term treatment to achieve symptom remission and quality of life improvement. Antipsychotic medications are primary treatments for schizophrenia patients. Second-generation antipsychotics (SGAs) have been recognized as first-line drugs in the treatment of schizophrenia. This study aimed at determining the prescription patterns of SGAs in schizophrenia outpatients in the National Mental Hospital in Indonesia. Methods: A retrospective study with descriptive analysis was conducted between October and December 2018, exclusive to data of the patients with schizophrenia only. Data were collected from the prescription records of schizophrenia outpatients. This study performed a descriptive analysis of patient characteristics, percentage of SGAs prescribed, regimen doses of SGAs, average number of SGAs prescribed per patient, and pattern of antipsychotics prescribed. Results: The most commonly used SGAs were risperidone 55%, followed by clozapine 38%, aripiprazole 3%, quetiapine 3%, and olanzapine 1%. Antipsychotics were generally prescribed in their recommended doses. Almost all SGAs were prescribed as polypharmacy, and the most common combination of SGAs were risperidone and clozapine. Conclusions: This study highlighted that risperidone was the major choice for treatment in the outpatient setting. Polypharmacy is the most common pattern prescription of SGAs in the National Mental Hospital in Indonesia. New studies should focus on the analyses of polypharmacy prospectively, and the role of pharmacist in collaboration with other health professionals in the managing of schizophrenia therapy. [ABSTRACT FROM AUTHOR]

Postictal psychosis (PIP) in patients with epilepsy is often mistaken for other primary psychiatric disorders. Depending on its severity, PIP often prompts empiric treatment with atypical antipsychotics, which are balanced against the risk of lowered seizure thresholds. Here we present a case of olanzapine-resistant PIP, where risperidone was used as a safe and effective abortive treatment. [ABSTRACT FROM AUTHOR]

Copyright of Cukurova Medical Journal / Çukurova Üniversitesi Tip Fakültesi Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Contributions / Prilozi (1857-9345) is the property of Sciendo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives We aimed to answer the question whether or not previous antiepileptic drugs with combination of omega-3 and risperidone are more efficient than previous antiepileptic drugs with risperidone alone in decreasing of seizures monthly frequency of children with refractory epilepsy and attention-deficit/hyperactivity disorder (ADHD). Material & Methods In a randomized clinical trial (IRCT201604212639N18), participants referred to Pediatric Neurology Clinic of Shahid Sadoughi Hospital, Yazd, Iran from Jun 2015 were distributed randomly into two groups. In group I, one capsule of omega-3 daily and 0.5 mg of risperidone was divided into two doses with previous antiepileptic drugs and in group II, 0.5 mg of risperidone was divided into two doses with previous antiepileptic drugs were given. The drugs use was continued for three months and the children were followed up monthly for three consecutive months. Primary outcomes included seizure monthly frequency and good response (more than 50% of reduction in seizures monthly frequency). Secondary outcome was clinical side effects. Results Overall, 23 girls and 33 boys with mean age of 9.24±0.15 yr (29 children in omega-3 group and 27 children in control group) were evaluated. Omega-3 therapy was effective in decreasing of seizures monthly frequency (10.41±3.92 times vs. 17.01±4.98, P=0.03). Good response was seen in three children (11.1%) in control (95% confidence interval: 8%-22.8%) and in 9 children (31%) in omega-3 (95% CI: 47.83%-14.17%) group, which showed that omega-3 was more effective in seizure control. (P=0.001). Frequency of side effects was not different in the two groups (14.8 % in control vs. 20.7% in omega-3 groups, P=0.5). Conclusion Omega-3 might be used as an effective and safe drug in seizures control of children with refractory epilepsy and ADHD. [ABSTRACT FROM AUTHOR]

The purpose of this study was to develop and evaluate a transdermal delivery system for RIS using hydrogels. First, the effects of different concentrations of hydroxypropyl methylcellulose and Carbomer 934 (CBR) on RIS permeation were investigated in porcine skin. The optimized formulation was chosen as the base gel to screen for penetration enhancers. The pharmacokinetics of the optimized RIS formulation was then studied in vitro in rabbits. A formulation with 0.5% CBR showed the highest RIS permeation and was selected as the base gel. RIS permeation was further increased by incorporation of Azone, lauryl alcohol, or menthol, and the enhancing effects of the three were dose- dependent. When each enhancer combined with propylene glycol (PG) a synergistic effect was found. A combination of 6% menthol and 6% PG exhibited highest RIS in vitro penetration rate and showed a high efficiency in vivo, with a relative bioavailability of 131.53% compared with intragastric administration. These findings showed that 1% RIS in 0.5% CBR, containing a combination of 6% menthol and 6% PG, can deliver doses of RIS that are therapeutically relevant for treating patients with schizophrenia. [ABSTRACT FROM AUTHOR]

In the present investigation, proniosomes of risperidone were formulated, optimized and evaluated for effective transdermal delivery in order to overcome the bioavailability issues of orally administered risperidone. The proniosomes were prepared using various sorbitan esters with cholesterol and soya lecithin and were evaluated for in-vitro parameters, ex-vivo permeation and in-vivo performance. Results indicated that the vesicles were spherical in shape, their size ranged from 284.00 nm to 941.40 nm and they had high zeta potential. The entrapment efficiency for spans was higher compared to tweens. DSC and IR studies confirmed the absence of chemical interactions between the risperidone and proniosome components. In-vitro release study showed that formulations with spans exhibit controlled release profile and followed the Higuchi model. No significant change in vesicle size and entrapment efficiency was observed when the proniosomes were stored at 4 ± 1 °C and 25 ± 2 °C for three months. Proniosomes with span 60 showed no signs of erythema or edema and has highest flux across the rat skin (169.851 ± 2.13 μg cm −2 h −1 ). The relative bioavailability was 92% after transdermal administration of proniosomes and the t max was increased to 8 h. So we conclude that the developed proniosome formulation would be a promising alternative to improve the bioavailability problems of risperidone. [ABSTRACT FROM AUTHOR]

Risperidone is most commonly used as an antipsychotic in India for treatment of schizophrenia. However, the response to treatment with risperidone is affected by many factors, genetic factors being one of them. So, we attempted to evaluate the association between dopamine D2 (DRD2) receptor, serotonergic (5HT2A) receptor and CYP2D6 gene polymorphisms and response to treatment with risperidone in persons with schizophrenia from North India. It was a multicentric 12-weeks prospective study, undertaken in patients diagnosed with schizophrenia according to International Classification of Diseases 10th revision, Diagnostic Criteria for Research module (ICD-10 DCR). Patients were treated with incremental dosages of risperidone. Nine gene polymorphisms from three genes viz. DRD2, 5-HT2A and CYP2D6 along with socio-demographical and clinical variables were analyzed to ascertain the association in response to risperidone treatment. The change in the Positive and Negative Syndrome Scale (PANSS) was used to measure the outcome. Significant differences in the frequencies of single nucleotide proteins (SNPs) rs180498 (Taq1D) and rs 6305 (C516T) polymorphisms were found amongst the groups defined according to percent decline in PANSS. The CYP2D6*4 polymorphism differed significantly when drop outs were excluded from analysis. Presence of DRD2 Taq 1 D2D2 and 5-HT2A C516T CT genotypes in patients were more likely to be associated with non-response to risperidone. Ser311Cys (rs1801028) mutation was absent in the North Indian patients suffering from schizophrenia. [ABSTRACT FROM AUTHOR]

To evaluate post-discharge use of antipsychotics in patients with incident hospital-acquired delirium and the associated risk of mortality. We conducted a nested case-control study for patients newly diagnosed with hospital-acquired delirium and subsequently discharged from hospital using Taiwan's National Health Insurance Database (NHID) from 2011 to 2018. The use of antipsychotics after discharge did not increase the risk of mortality (adjusted OR: 1·03; 95% CI: 0·98–1·09). The findings suggested that using antipsychotics after discharge in patients with hospital-acquired delirium may not increase the risk of mortality. • Previous studies indicated more than a quarter of patients continuously used antipsychotics after discharge from hospital-acquired delirium. • The use of antipsychotics in patients with hospital-acquired delirium after discharge may not increase the mortality risk. • We did not find an association between post-discharge use of antipsychotics in patients with hospital-acquired delirium and risk of mortality (adjusted OR: 1.03; 95% CI: 0.98–1.09) from this population-based case-control study. • The results showed that the use of antipsychotics in patients with hospital-acquired delirium after discharge may not increase the mortality risk. [ABSTRACT FROM AUTHOR]

A 44-year-old woman with a history of chronic schizoaffective disorder, epilepsy, social phobia, anxiety, and panic attacks presented with concern for "feeling anxious." After a history, physical examination, and laboratory tests, the woman received a diagnosis of treatment-resistant schizophrenia. While clozapine is the standard therapy for schizophrenia, certain patients such as the woman in this case do not respond well to clozapine monotherapy, requiring clozapine to be augmented with other antipsychotics or antidepressants. This case outlines the unique challenges of managing patients with treatment-resistant schizophrenia, especially when they present with comorbid conditions such as epilepsy that can limit treatment options. A multipronged approach, including pharmacologic therapy as well as cognitive behavioral therapy, should also be considered. [ABSTRACT FROM AUTHOR]

Antipsychotic treatment has been conceived to alter brain connectivity, but it is unclear how the changes of network phenotypes relate to the underlying transcriptomics. Given DNA methylation (DNAm) may alter transcriptional levels, we further integrated an imaging-transcriptomic-epigenetic analysis to explore multi-omics treatment response biomarkers. Forty-two treatment-naive first-episode schizophrenia patients were scanned by TI weighted (T1W) imaging and DTI before and after 8-week risperidone monotherapy, and their peripheral blood genomic DNAm values were examined in parallel with MRI scanning. Morphometric similarity network (MSN) quantified with DTI and T1W data were used as a marker of treatment-related alterations in interareal cortical connectivity. We utilized partial least squares (PLS) to examine spatial associations between treatment-related MSN variations and cortical transcriptomic data obtained from the Allen Human Brain Atlas. Longitudinal MSN alterations were related to treatment response on cognitive function and general psychopathology symptoms, while DNAm values of 59 PLS1 genes were on negative and positive symptoms. Virtual-histology transcriptomic analysis linked the MSN alterations with the neurobiological, cellular and metabolic pathways or processes, and assigned MSN-related genes to multiple cell types, specifying neurons and glial cells as contributing most to the transcriptomic associations of longitudinal changes in MSN. We firstly reveal how brain-wide transcriptional levels and cell classes capture molecularly validated cortical connectivity alterations after antipsychotic treatment. Our findings represent a vital step towards the exploration of treatment response biomarkers on the basis of multiple omics rather than a single omics type as a strategy for advancing precise care. • The neural network MSN and DNAm modalities may be complementary in predicting treatment response. • Virtual histology study identified specific cell classes enriched for the treatment-related MSN variations. • This study represents a vital step to advance precise and personalized care. [ABSTRACT FROM AUTHOR]

Objective: The relationship between the plasma concentration of risperidone or paliperidone and efficacy, the extrapyramidal symptoms (EPS), and quality of life (QOL) was investigated in the same patients with schizophrenia. Methods: 30 patients with schizophrenia currently receiving risperidone were switched to PAL. During treatment with risperidone and paliperidone, their efficacy was assessed using Clinical Global Impression-Severity/Change (CGI-S/CGI-C), and their EPS were assessed using the Abnormal Involuntary Movement Scale (AIMS) and the Barnes Akathisia Scale (BAS), and their QOL was assessed using the Euro-QOL (EQ-5D) scale. Plasma concentrations were measured by the liquid chromatography-mass spectrometry/mass spectrometry method. Results: There were significant correlations between the plasma concentration of active moiety (risperidone plus 9-hydroxy risperidone) and the AIMS and BARS scores (p < 0.05). Although there was a significant correlation between the plasma concentration of paliperidone and the CGI-C, there was no correlation between the plasma concentration of paliperidone and the AIMS or BARS scores. Furthermore, although there was a significant correlation between the plasma concentration of paliperidone and the EQ-5D utility score (p < 0.05), there was no correlation between the plasma concentration of the active moiety and the EQ-5D utility score. Conclusion: The results of this study reveal that in contrast to risperidone, when there is a switching from risperidone to paliperidone, increases in the paliperidone concentration were less likely to result in an increase of EPS, but correlated to the CGI-C and EQ-5 utility score, suggesting that paliperidone may contribute to improvement in efficacy and QOL with dose increase. [ABSTRACT FROM AUTHOR]

Hypothermia is a rare adverse effect of risperidone and is associated with ventricular arrhythmias, which may lead to intensive care unit admission and sometimes death. We describe a patient with schizophrenia who was taking risperidone and who, after falling into a hypothermic state, suffered cardiac arrest. Observations of the case and a brief literature review are provided. [ABSTRACT FROM AUTHOR]

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The relationship between tobacco smoke and schizophrenia (SZ) is well established. Smoking is hypothesized to alleviate symptoms and reduce the adverse effects of antipsychotic medications in patients with SZ. However, the underlying biological mechanisms by which smoke improves symptoms in SZ remain unclear. The aim of this study was to investigate the effect of smoking on clinical symptoms and antioxidant enzyme activity after risperidone treatment in a 12-week prospective cohort study of drug-naïve first-episode (DNFE) SZ patients. Two hundred and fifteen DNFE patients were recruited and received 12 weeks of risperidone monotherapy. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of patient's symptoms at baseline and post-treatment. Plasma GPx activity was also measured at baseline and at the end of 12 weeks. Smokers showed greater improvement in negative symptoms relative to nonsmokers with DNFE SZ. In addition, repeated ANCOVA analysis showed no significant interaction of time and group on GPx activity. Improvement in negative symptoms was not associated with changes in GPx activity. However, in nonsmokers, increased GPx activity was correlated with improvement in positive symptoms. • Two hundred and fifteen DNFE patients were recruited and received 12 weeks of risperidone monotherapy. • Smokers showed greater improvement in negative symptoms relative to nonsmokers. • Increased GPx activity was correlated with improvement in positive symptoms. [ABSTRACT FROM AUTHOR]

OBJECTIVE: We wanted to compare the effects of tiapride and risperidone in treating behavioral and psychological symptoms of senile dementia. PATIENTS AND METHODS: 108 patients with senile dementia received respective treatments (54 patients per treatment, either with 100 mg/day risperidone or 2.0 mg tiapride/day) for 2 months. Outcomes included the positive and negative syndrome scale (PANSS) scores, the curative rate of senile dementia, and prevalence of adverse effects (somnolence, headache, loss of weight, extrapyramidal system response, irritation and insomnia). RESULTS: PANSS scores before treatment were comparable between treatment groups. On days 7, 15, 30, and 60 of the treatment, the differences between two treatment groups became evident. Thus, curative rates in patients treated with risperidone were 74.1% and in those treated with tiapride 88.9% (p < 0.05). Prevalence of adverse reactions was significantly lower in the latter group (9.3% vs. 25.9% in patients treated with risperidone; p < 0.05). CONCLUSIONS: Tiapride is more effective in improving clinical symptoms of senile dementia and causes fewer adverse effects. [ABSTRACT FROM AUTHOR]

Importance: In treatment-resistant schizophrenia, clozapine is considered the standard treatment. However, clozapine use has restrictions owing to its many adverse effects. Moreover, an increasing number of randomized clinical trials (RCTs) of other antipsychotics have been published.Objective: To integrate all the randomized evidence from the available antipsychotics used for treatment-resistant schizophrenia by performing a network meta-analysis.Data Sources: MEDLINE, EMBASE, Biosis, PsycINFO, PubMed, Cochrane Central Register of Controlled Trials, World Health Organization International Trial Registry, and clinicaltrials.gov were searched up to June 30, 2014.Study Selection: At least 2 independent reviewers selected published and unpublished single- and double-blind RCTs in treatment-resistant schizophrenia (any study-defined criterion) that compared any antipsychotic (at any dose and in any form of administration) with another antipsychotic or placebo.Data Extraction and Synthesis: At least 2 independent reviewers extracted all data into standard forms and assessed the quality of all included trials with the Cochrane Collaboration's risk-of-bias tool. Data were pooled using a random-effects model in a Bayesian setting.Main Outcomes and Measures: The primary outcome was efficacy as measured by overall change in symptoms of schizophrenia. Secondary outcomes included change in positive and negative symptoms of schizophrenia, categorical response to treatment, dropouts for any reason and for inefficacy of treatment, and important adverse events.Results: Forty blinded RCTs with 5172 unique participants (71.5% men; mean [SD] age, 38.8 [3.7] years) were included in the analysis. Few significant differences were found in all outcomes. In the primary outcome (reported as standardized mean difference; 95% credible interval), olanzapine was more effective than quetiapine (-0.29; -0.56 to -0.02), haloperidol (-0. 29; -0.44 to -0.13), and sertindole (-0.46; -0.80 to -0.06); clozapine was more effective than haloperidol (-0.22; -0.38 to -0.07) and sertindole (-0.40; -0.74 to -0.04); and risperidone was more effective than sertindole (-0.32; -0.63 to -0.01). A pattern of superiority for olanzapine, clozapine, and risperidone was seen in other efficacy outcomes, but results were not consistent and effect sizes were usually small. In addition, relatively few RCTs were available for antipsychotics other than clozapine, haloperidol, olanzapine, and risperidone. The most surprising finding was that clozapine was not significantly better than most other drugs.Conclusions and Relevance: Insufficient evidence exists on which antipsychotic is more efficacious for patients with treatment-resistant schizophrenia, and blinded RCTs-in contrast to unblinded, randomized effectiveness studies-provide little evidence of the superiority of clozapine compared with other second-generation antipsychotics. Future clozapine studies with high doses and patients with extremely treatment-refractory schizophrenia might be most promising to change the current evidence. [ABSTRACT FROM AUTHOR]

Inflammation-mediated changes in drug metabolism may lead to alterations in the absorption, distribution, and clearance of psychotropic drugs and thus elevate drug levels in blood and lead to intoxications. We report about two patients who developed an up to threefold increase of dose-related serum concentrations of risperidone’s active moiety (risperidone plus 9-hydroxyrisperidone) during acute inflammation indicated by elevated C-reactive protein. The two female patients (aged 56 and 38 years, respectively) had the diagnoses of paranoid schizophrenia and schizoaffective disorder. For both patients, there was a close time-dependent parallel fluctuation of drug levels and C-reactive protein. Since elevated drug levels could not be attributed to prescribed comedications, it seemed likely that high-serum concentrations of risperidone were due to inflammation. It is concluded that elevated C-reactive protein should be considered as an indication to control blood levels of risperidone and possibly dose adaption. [ABSTRACT FROM AUTHOR]

A patient with comorbid intellectual disability, catatonic schizophrenia, and recurrent oneiroid state of consciousness improved on long-acting risperidone and remains well at the three-year follow-up. We report a case treated with 50 mg long-acting risperidone administered every 14 days, who has been followed-up for three years. We studied his regional cerebral blood flow through technetium-99 m hexamethylpropyleneamine oxime single-photon emission computed tomography after two years of treatment. Symptoms of catatonic schizophrenia improved after two months of treatment, followed suit by oneiroid syndrome remission. Two years later, his brain perfusion was normal. No side effect has occurred since the patient was started on long-acting risperidone. Long-acting risperidone proved to be safe and effective in treating symptoms of catatonia and oneiroid syndrome. [ABSTRACT FROM AUTHOR]

Risperidone causes hyperprolactinemia by blocking D2 receptors on lactotrophs anterior pituitary, which prevents prolactin secretion inhibition. Risperidone is converted to 9-hydroxyrisperidone by the CYP2D6 enzyme. Polymorphisms in CYP2D6 may affect serum prolactin and could be a predictor of hyperprolactinemia. The goal of this study was to see if there was an association between CYP2D6 variants, risperidone dose, clinical data and serum prolactin levels in Thai children and adolescents with autism spectrum disorder (ASD). In 107 Thai ASD patients on risperidone, allele-specific primer extension and multiplex PCR platforms were used to genotype the CYP2D6 gene. The chemiluminescence immunoassay (CLIA) technique was used to measure fasting serum prolactin levels. The median serum prolactin level was 16. 25 ng/mL (IQR; 10. 43-22. 18), and patients with CYP2D6*1/*5 (6. 54%) had substantially lower prolactin levels than those with CYP2D6*1/*1 [median; 11. 2 ng/mL (IQR; 3. 95-21. 10) vs. 21.3 (IQR; 14. 43-32. 18), p =0. 032]. CYP2D6*1/*10 , *10/*10 , and *10/*41 produced less prolactin than *1/*1 (wild type). Furthermore, gender and risperidone dose were associated with significantly different prolactin levels with p -value 0. 02 and 0. 006, respectively. Multivariate analysis showed a significant association of serum prolactin level with body mass index and risperidone dose (p <0.05). Our study showed that CYP2D6 carriers of absent and decreased functional alleles had lower serum prolactin levels in Thai ASD patients treated with risperidone treatment; this is important to clinicians, indicating that they should consider about CYP2D6 genotyping before beginning risperidone in ASD patients. CYP2D6 genotypes might be a predictor for levels of prolactin in clinical treatment. • The CYP2D6 polymorphisms influence serum prolactin concentrations in Thai ASD patients treated with risperidone. • Result suggests that high doses of risperidone result in elevated serum prolactin levels. • Clinicians expected fewer side effects in Thai ASD male patients treated with risperidone harboring reduced CYP2D6 activity. [ABSTRACT FROM AUTHOR]

IMPORTANCE Long-acting, injectable, second-generation antipsychotic medication has tremendous potential to bring clinical stability to persons with schizophrenia. However, long-acting medications are rarely used following a first episode of schizophrenia, OBJECTIVE To compare the clinical efficacy of the long-acting injectable formulation of risperidone with the oral formulation in the early course of schizophrenia. DESIGN, SETTING, AND PARTICIPANTS A randomized clinical trial performed at a university-based research clinic, between 2005 and 2012. Eighty-six patients with recent onset of schizophrenia were randomized to receive long-acting injectable risperidone or oral risperidone. Half of each group was simultaneously randomized to receive cognitive remediation to improve cognitive functioning or heaithy-behaviors training to improve lifestyle habits and well-being. An intent-to-treat analysis was performed between October 4, 2012, and Novembers, 2014. INTERVENTIONS A 12-month trial comparing the long-acting injectable vs oral risperidone and cognitive remediation vs heaithy-behaviors training. MAIN OUTCOMES AND MEASURES Psychotic relapse and control of breakthrough psychotic symptoms. RESULTS Of the 86 patients randomized, 3 refused treatment in the long-acting injectable risperidone group. The psychotic exacerbation and/or relapse rate was lower for the long-acting risperidone group compared with the oral group (5% vs 33%; X²1, = 11.1 ; P < .001; relative risk reduction, 84.7%). Long-acting injectable risperidone better controlled mean levels of hallucinations and delusions throughout follow-up (β = -0.30; t68 = -2.6, P = .01). The cognitive remediation and heaithy-behaviors training groups did not differ significantly regarding psychotic relapse, psychotic symptom control, or hospitalization rates, and there were no significant interactions between the 2 medications and the 2 psychosocial treatments. Discontinuations owing to inadequate clinical response were more common in the oral group than in the long-acting risperidone group (X²1= 6.1; P = .01). Adherence to oral risperidone did not appear to differ before randomization but was better for the long-acting risperidone group compared with the oral group (t80 = 5.3; P < .001). Medication adherence was associated with prevention of exacerbation and/or relapse (X²1= 11.1 ; P = .003) and control of breakthrough psychotic symptoms (β = 0.2; t79 = 2.1; P = .04). CONCLUSIONS and RELEVANCE The use of long-acting injectable risperidone after a first episode of schizophrenia has notable advantages for clinical outcomes. The key clinical advantages are apparently owing to the more consistent administration of the long-acting injectable. Such formulations should be offered earlier in the course of illness. TRIAL REGISTRATION clinicaltrials.gov Identifier; NCT00333177 [ABSTRACT FROM AUTHOR]

Speech subsystems are susceptible to the effects of several factors including medications. The atypical antipsychotics can also adversely affect the speech because of its action on serotonin and dopamine neurotransmitters. The present study aims to analyze the speech characteristics associated with atypical antipsychotic risperidone. Speech of 92 patients on risperidone with or without trihexyphenidyl and/or clonazepam were compared with that of 31 persons who were not on any psychotropic medicines. Compared to control group, maximum phonation duration, sequential motion rate of diadochokinesia was reduced by about 3 s and 1 syllable/s respectively and s/z ratio was increased by 0.16 in patients with risperidone. Performance of larynx, lips and tongue sub-system and intelligibility of speech were also significantly reduced in risperidone group. Risperidone did impact the phonation and articulation sub-systems of speech mildly, which was independent of tardive dyskinesia and extrapyramidal symptoms. Randomized controlled prospective study looking into impact on speech and related effect on drug adherence, functioning and quality of life needs to be conducted with risperidone and other atypical antipsychotics. [ABSTRACT FROM AUTHOR]

Background Contradictory information exists regarding the influence of CYP2D6 polymorphisms on adverse drug reactions (ADRs) (extrapyramidal symptoms (EPS) and weight gain) related to risperidone treatment. This prompted us to evaluate the influence of CYP2D6 genetic variation in a cohort of South African patients who presented with marked movement disorders and/or weight gain while on risperidone treatment. Methods Patients who were experiencing marked risperidone ADRs were recruited from Weskoppies Public Psychiatric Hospital. As poor or intermediate metabolism was expected, comprehensive CYP2D6 sequence variations were evaluated using XL-PCR + Sequencing. Results No statistically significant association was found between CYP2D6 poor metabolism and risperidone ADRs. An inverse relationship between EPS and weight gain was however identified. A novel CYP2D6 allele was identified which is unlikely to affect metabolism based on in silico evaluation. Conclusion CYP2D6 variation appeared not to be a good pharmacogenetic marker for predicting risperidone-related ADRs in this naturalistic South African cohort. Evaluation of a larger cohort would be needed to confirm these observations, including an examination of the role of potential intermediaries between the hypothesised genetic and clinical phenotypes. [ABSTRACT FROM AUTHOR]

Long-acting injectable antipsychotics constitute a valuable alternative for the treatment of psychotic disorders, mainly schizophrenia. They assure a more stable drug level, improve treatment compliance, and increase the chances for favorable and long-lasting improvement. Additionally, the long-acting second-generation antipsychotics combine the values of long-acting injectable drugs with the values of atypical antipsychotics. Four second generation long-acting antipsychotics have been described: risperidone, olanzapine, aripiprazole and paliperidone. The indications for their use, treatment strategy, tolerance, and potential interactions are discussed. [ABSTRACT FROM AUTHOR]

Background/Purpose The USA Food and Drug Administration (FDA) issued warnings regarding the use of antipsychotics in patients with dementia in 2003 and 2005. We aimed to study the dose and duration of antipsychotic treatment in dementia, and to examine whether physicians' prescription behaviors changed after the FDA warnings. Methods Medical charts of outpatients who had Alzheimer's disease, vascular dementia, or mixed dementia were reviewed. Patients must have achieved a clinically stable state for at least 4 weeks after receiving antipsychotic treatment for agitation or psychosis. Demographics, clinical correlates, and duration of antipsychotic treatment were compared among different antipsychotic groups. Because the quetiapine group had the largest sample size, the optimal dose and duration of quetiapine treatment were compared among three time periods (before 2003, 2003–2005, after 2005). Results Stable state was achieved in 215 patients (80 had Alzheimer's disease, 117 vascular dementia, and 18 mixed dementia). Most patients (177) took quetiapine, 25 took risperidone, and 13 took sulpiride. The whole sample had a long total duration of antipsychotic treatment (median 525 days, mean 707 days). The median dose and total duration of antipsychotic treatment were 1.0 mg/day and 238 days for risperidone, 100 mg/day and 390 days for sulpiride, and 25 mg/day and 611 days for quetiapine, respectively. The optimal dose and total duration of quetiapine treatment decreased significantly after FDA warning in 2005, although the duration remained long. Conclusion The optimal doses of antipsychotics were not higher than those of western reports, but the total duration of antipsychotic treatment was quite long. Although our study suggests the prescription dosage and duration of antipsychotic treatment decreased significantly after FDA warning in 2005, the duration of treatment was still long. Given the serious safety concerns, more effort should be made to avoid unnecessary and prolonged prescription. [ABSTRACT FROM AUTHOR]

Importance: Antipsychotic drugs constitute the mainstay in the treatment of schizophrenia, and their efficacy is well established in hundreds of randomized clinical trials. However, it is not known whether they are effective or how effective they are across the wide range of baseline symptom severity.Objective: To examine the influence of baseline severity of schizophrenia on the efficacy of antipsychotic drugs.Design, Setting, and Participants: Meta-analysis of participant-level data from 3 pivotal randomized trials of acute schizophrenia (n = 611) and 3 pivotal trials in patients with predominantly negative symptoms of schizophrenia (n = 475).Interventions: Olanzapine or risperidone vs placebo, and amisulpride vs placebo.Main Outcomes and Measures: Change scores on the Positive and Negative Syndrome Scale (PANSS; score range, 30-210) and the Scale for the Assessment of Negative Symptoms (SANS; score range, 0-125) up to 6 weeks after baseline. The relationship between baseline and change scores for the drug and placebo groups was examined with 8 competing mixed-effects models for repeated measures.Results: The best-fitting models showed that, for both types of patients, the interactions between baseline symptom severity and treatment were statistically significant (P < .01). The greater the baseline severity was, the greater the magnitude of the differences was between active treatment and placebo. In acute treatment, the mean differences in PANSS change scores were 9.5 points for patients who were mildly ill at baseline (baseline PANSS score of 58), 13.7 for moderately ill patients (baseline PANSS score of 75), 18.8 for markedly ill patients (baseline PANSS score of 95), and 24.0 for severely ill patients (baseline PANSS score of 116). In treatment of predominantly negative symptoms, the mean differences in SANS change scores were 1.7 for those who were moderately ill (baseline SANS score of 55), 5.7 for markedly ill patients (baseline SANS score of 70), and 9.7 for severely ill patients (baseline SANS score of 85).Conclusions and Relevance: We can expect benefits of antipsychotic drugs for the full spectrum of patients likely to be treated for acute schizophrenia and for highly symptomatic patients with predominantly negative symptoms. Toward the mildest end of the spectrum, clinicians need to be aware that patients benefit less in terms of symptom improvement but may experience full adverse effects of antipsychotics. Clinicians also need to be aware that in addition to the treatment of active symptoms, which was the focus of this study, antipsychotics have another important action, namely to prevent relapses among patients in remission. [ABSTRACT FROM AUTHOR]

Pharmaceutically active compounds risperidone has difficulty to be packaged into nanocarrier due to its positive charge. In this study, we encapsulated risperidone into chitosan-based nanocarrier via ionic interaction. The nanocarrier was consisted of chitosan:sodium TPP = 5.72:1 and prepared by ionic gelation method. Encapsulation efficiency was enhanced by modification of pH of chitosan, sodium tripolyphosphate (TPP), and the concentration as well as the surface charge of risperidone. The later was done by addition of SDS (Sodium Dodecyl Sulphate) minimum 0.005% (w/v). The particle size was in the range of 300-400 nm. Encapsulation efficiency of risperidone was reached up to 25.62% with addition of 0.050% SDS. Encapsulation of risperidone into chitosan-TPP nanocarrier was increased by modification of risperidone's charge with low concentration of SDS. Further amount of SDS higher than 0.1% increased the particle size to microparticles. Chitosan-based type nanocarrier was preferable for encapsulating anionic drugs via ionic interaction. [ABSTRACT FROM AUTHOR]

The article discusses research which was conducted to investigate the therapeutic window for striatal dopamine D2/3 receptor occupancy in older patients with schizophrenia. Researchers evaluated nine subjects that had been treated previously with risperidone.They found that there was a lower therapeutic window for older patients with schizophrenia than in younger patients.

Objective Many patients with late-diagnosed phenylketonuria (PKU) suffer from severe behavior problems. This study compares the effects of buspirone and risperidone on reducing behavior disorders in these patients. Materials & Methods In this crossover clinical trial study, patients with severe behavior disorders after medical examination were randomly divided into two groups of two 8-week crossover treatments with risperidone or buspirone. Patient behavioral disorders before and after treatment by each drug was rated by parents on the Nisonger Child Behavior Rating Form (NCBRF), and after treatment by each drug, were assessed by a physician through clinical global impression (CGI). Results Thirteen patients were able to complete the therapy period with these two medications. The most common psychiatric diagnoses were intellectual disability accompanied by pervasive developmental disorder NOS, and intellectual disability accompanied by autistic disorder. Risperidone was significantly effective in reducing the NCBRF subscales of hyperactivity disruptive/ stereotypic, and conduct problems. Treatment by buspirone only significantly decreased the severity of hyperactivity, but other behavior aspects showed no significant differences. Assessment of the severity of behavior disorder after treatment by risperidone and buspirone showed significant differences in reducing hyperactivity and masochistic/stereotype. Conclusion Although buspirone is effective in controlling hyperactivity in patients with PKU, it has no preference over risperidone. Therefore, it is recommended as an alternative to risperidone. [ABSTRACT FROM AUTHOR]

In this review, we analyzed the status and changes in the research on second-generation (atypical) antipsychotic drugs in the Asia-Pacific region (i.e., Japan, South Korea, Taiwan, Hong Kong, Singapore, and Australia). We also performed a bibliometric study of the literature in this region on atypical antipsychotic drugs (e.g., clozapine, risperidone, olanzapine, ziprasidone, quetiapine, sertindole, aripiprazole, paliperidone, amisulpride, zotepine, asenapine, iloperidone, lurasidone, perospirone, and blonanserin). We applied bibliometric indicators of production and dispersion (i.e., Price's law on the increase of scientific literature and Bradford's law, respectively). We also calculated the participation index of different countries. The data were also correlated with relevant social and health data from the Asia-Pacific region (e.g., the per capita gross domestic product and total per capita expenditure on health and gross domestic expenditure on research and development). All data are discussed together. We also analyzed the different aspects among the six countries in the region. [ABSTRACT FROM AUTHOR]

The article discusses research which was conducted to compare the effects galantamine and risperidone had on global function and neuropsychiatric symptoms in patients with probable dementia (NPSD). Researchers evaluated the drugs with 100 patients. They found that galantamine was effective as a first line treatment of NPSD unless symptoms of irritation and agitation were present and then risperidone was more efficient.