The long-term efficacy and safety of risperidone were evaluated in patients with chronic schizophrenia in an open-label study. Thirty-two patients received risperidone for 1 year and 19 of the 32 received risperidone for 2 years. The mean dose of risperidone was 9.4 mg/d in the 1-year follow-up. At the end of 1 and 2 years, improvements were found in total scores on the Positive and Negative Syndrome Scale (PANSS), on four PANSS factors (positive, negative, excited, and cognitive), and the Clinical Global Impression scale. Severity of extrapyramidal symptoms (based on scores on the Extrapyramidal Symptom Rating Scale) was also reduced. Clinical improvement (defined as a 20% or more reduction in total PANSS scores) was shown by 54% of the patients at end point. Social functioning (as assessed by using the modified Strauss/Carpenter scale) was significantly improved after 2 years. Number of days spent in hospitals was significantly reduced during the 2 years of treatment, and the number of days in treatment (group) homes significantly increased. It is concluded that treatment with risperidone for 1 and 2 years is associated with significant reductions in symptoms of schizophrenia, improved social functioning, and reduction in days spent in the hospital.

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Psychoses in twins. A 10 year clinical and biochemical follow-up study.

An unbiased sample of monozygotic and dizygotic twins with psychotic or pre-psychotic symptoms has been followed during a 10 year period. The sample was based on 9000 patients, both born in 1930-1946, and hospitalized in Scania, Sweden, during the 1960s. 23 complete pairs were examined in 1972 with regard to a variety of clinical, genetic, and biochemical parameters. A fairly young sample was chosen in order to include a sufficient number of discordant pairs to be followed prospectively, thus making it possible to study a group of individuals with a very high risk of developing psychosis. 18 of the 23 pairs were re-examined by the same clinician 10 years later. The biochemical methods were both partly the same as those used 10 years earlier and partly extended. Very few changes in the clinical diagnoses of the twins were noted during the follow-up period. A highly significant correlation was found between 1972 and 1982 activity both for catechol O-methyltransferase (COMT) and for monoamine oxidase (MAO). The basal levels of MAO, COMT, dopamine beta-hydroxylase (DBH) and serotonin (5-HT) did not show correlations to the presence of pre-psychotic or psychotic symptoms.

Adult↗