Literature DB >> 15169694

Rapid antimanic effect of risperidone monotherapy: a 3-week multicenter, double-blind, placebo-controlled trial.

Robert M A Hirschfeld1, Paul E Keck, Michelle Kramer, Keith Karcher, Carla Canuso, Marielle Eerdekens, Fred Grossman.   

Abstract

OBJECTIVE: This study evaluated the efficacy and safety of risperidone monotherapy in the treatment of acute bipolar mania.
METHOD: Patients with DSM-IV bipolar I disorder experiencing an acute manic episode (baseline Young Mania Rating Scale score >/==" BORDER="0">20) were randomly assigned to 3 weeks of treatment with risperidone (flexible dose: 1-6 mg/day) or placebo. The primary efficacy measure was the mean baseline-to-endpoint change in total score on the Young Mania Rating Scale. Secondary efficacy measures included the Clinical Global Impression (CGI) severity rating and scores on the Montgomery-Asberg Depression Rating Scale, Positive and Negative Syndrome Scale, and Global Assessment Scale (GAS). Safety assessments consisted of monitoring adverse events, vital signs, electrocardiogram and laboratory results, and scores on the Extrapyramidal Symptom Rating Scale.
RESULTS: Subjects (N=259) received treatment with either risperidone (N=134) or placebo (N=125). The mean modal dose of risperidone was 4.1 mg/day. Improvement in mean Young Mania Rating Scale total score (adjusted for covariates) was significantly greater in the risperidone than in the placebo group at endpoint (mean change=-10.6 [SD=9.5] versus -4.8 [SD=9.5], respectively), with significant between-group differences seen as early as 3 days after start of treatment (change with risperidone: mean=-6.8 [SD=5.8]; change with placebo: mean=-4.0 [SD=5.8]) and continuing throughout all time points. Improvements in CGI severity ratings and scores on the Montgomery-Asberg Depression Rating Scale, Positive and Negative Syndrome Scale, and GAS were also significantly greater among patients receiving risperidone than those given placebo. The most common adverse event reported among risperidone patients was somnolence. While Extrapyramidal Symptom Rating Scale scores were significantly greater in patients receiving risperidone, mean total and subscale scores were low.
CONCLUSIONS: Risperidone monotherapy was significantly more efficacious than placebo in the treatment of acute mania and demonstrated a rapid onset of action. Risperidone was well tolerated by patients in this study.

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Year:  2004        PMID: 15169694     DOI: 10.1176/appi.ajp.161.6.1057

Source DB:  PubMed          Journal:  Am J Psychiatry        ISSN: 0002-953X            Impact factor:   18.112


  46 in total

Review 1.  Polytherapy in bipolar disorder.

Authors:  Daniel Lin; Hiram Mok; Lakshmi N Yatham
Journal:  CNS Drugs       Date:  2006       Impact factor: 5.749

Review 2.  Risperidone alone or in combination for acute mania.

Authors:  J M Rendell; H J Gijsman; M S Bauer; G M Goodwin; G R Geddes
Journal:  Cochrane Database Syst Rev       Date:  2006-01-25

Review 3.  Long-acting risperidone: a review of its role in the treatment of bipolar disorder.

Authors:  David E Kemp; Fatih Canan; Benjamin I Goldstein; Roger S McIntyre
Journal:  Adv Ther       Date:  2009-06-26       Impact factor: 3.845

Review 4.  The International College of Neuro-Psychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 2: Review, Grading of the Evidence, and a Precise Algorithm.

Authors:  Konstantinos N Fountoulakis; Lakshmi Yatham; Heinz Grunze; Eduard Vieta; Allan Young; Pierre Blier; Siegfried Kasper; Hans Jurgen Moeller
Journal:  Int J Neuropsychopharmacol       Date:  2017-02-01       Impact factor: 5.176

5.  Population pharmacokinetics of oral risperidone in children, adolescents and adults with psychiatric disorders.

Authors:  An Thyssen; An Vermeulen; Eliane Fuseau; Marc-Antoine Fabre; Erik Mannaert
Journal:  Clin Pharmacokinet       Date:  2010-07       Impact factor: 6.447

Review 6.  The psychopathology and treatment of bipolar disorder.

Authors:  David J Miklowitz; Sheri L Johnson
Journal:  Annu Rev Clin Psychol       Date:  2006       Impact factor: 18.561

7.  Treating bipolar disorder in the primary care setting: the role of aripiprazole.

Authors:  J Sloan Manning; Susan L McElroy
Journal:  Prim Care Companion J Clin Psychiatry       Date:  2009

Review 8.  Antipsychotic-induced extrapyramidal side effects in bipolar disorder and schizophrenia: a systematic review.

Authors:  Keming Gao; David E Kemp; Stephen J Ganocy; Prashant Gajwani; Guohua Xia; Joseph R Calabrese
Journal:  J Clin Psychopharmacol       Date:  2008-04       Impact factor: 3.153

Review 9.  The comorbidity of ADHD and bipolar disorder: any less confusion?

Authors:  Caroly Pataki; Gabrielle A Carlson
Journal:  Curr Psychiatry Rep       Date:  2013-07       Impact factor: 5.285

10.  Risperidone in the treatment of bipolar mania.

Authors:  Martha Sajatovic; Madhusoodanan Subramoniam; Matthew A Fuller
Journal:  Neuropsychiatr Dis Treat       Date:  2006-06       Impact factor: 2.570

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