BACKGROUND: In elderly schizophrenia patients remission is difficult to determine due to long disease duration, exposure to differing treatments, long-standing side-effects, non-adherence, cognitive decline and physical comorbidity. METHOD: Retrospective chart reviews were undertaken of 48 elderly (60+ years) schizophrenia patients admitted to a university-affiliated tertiary psychiatric center in 2006. These patients were experiencing an exacerbation of symptoms at admission. Remission criteria used were those of the American Psychiatric Association's "Remission in Schizophrenia Working Group", and clinical status and improvement were quantified using the Clinical Global Impression scale (CGI). RESULTS: Of 25 patients treated with long-acting risperidone (LAR), 19 (76%) continued uninterrupted treatment for 6 months or longer. In six patients treatment was discontinued due to insufficient response. The clinical severity ratings with the CGI of all patients were in the range 5-7 prior to treatment. Following six months of LAR treatment, mean dose 36.0 mg/2 weeks (range: 25-50), 18 patients were rated as "improved" or "very much improved" on the CGI-global improvement item scale. In 15/25 patients (60%) symptomatic remission was achieved. CONCLUSION: LAR may be effective in achieving remission among elderly schizophrenia patients. Tolerability was high and adherence rates improved. However, the results must be treated with caution owing to the inherent bias in this retrospective analysis.
BACKGROUND: In elderly schizophreniapatients remission is difficult to determine due to long disease duration, exposure to differing treatments, long-standing side-effects, non-adherence, cognitive decline and physical comorbidity. METHOD: Retrospective chart reviews were undertaken of 48 elderly (60+ years) schizophreniapatients admitted to a university-affiliated tertiary psychiatric center in 2006. These patients were experiencing an exacerbation of symptoms at admission. Remission criteria used were those of the American Psychiatric Association's "Remission in Schizophrenia Working Group", and clinical status and improvement were quantified using the Clinical Global Impression scale (CGI). RESULTS: Of 25 patients treated with long-acting risperidone (LAR), 19 (76%) continued uninterrupted treatment for 6 months or longer. In six patients treatment was discontinued due to insufficient response. The clinical severity ratings with the CGI of all patients were in the range 5-7 prior to treatment. Following six months of LAR treatment, mean dose 36.0 mg/2 weeks (range: 25-50), 18 patients were rated as "improved" or "very much improved" on the CGI-global improvement item scale. In 15/25 patients (60%) symptomatic remission was achieved. CONCLUSION: LAR may be effective in achieving remission among elderly schizophreniapatients. Tolerability was high and adherence rates improved. However, the results must be treated with caution owing to the inherent bias in this retrospective analysis.