Predictors of Treatment Response with Risperidone in Schizophrenia / 대한정신약물학회지

OBJECTIVES: In double-blind controlled studies with schizophrenic patients, risperidone was demonstrated to have an efficacy comparable to haloperidol and to have a lower incidence of extrapyramidal side effects. The purpose of this study was to assess the effect of risperidone in the treatment of schizophrenia and to identify clinical factors associated with risperidone response under naturalistic clinical setting. METHODS: By retrospective chart review, we assessed response to risperidone and factors associated with response to resperidone in 62 consecutive DSM-IV schizophrenic patients treated with the drug at the Department of Psychiatry, Keimyung University Dongsan Medical Center. We divided the 62 patients into two groups, responders and non-responders, by responsiveness to resperidone according to a four-point scale used in previous studies; responders included moderate to marked responded patients and non-responders included none to minimal responded patients. RESULTS: Among the total patients of 62, 31(50%) were categorized as responders. In comparing responders(N=31) with non-responders, there were no differences between the two groups in sex, age, education, age at first onset, duration of illness, number of admissions, and family history, but the patients who were married and had the paranoid-typed symptoms were significantly more frequent in responders. There were no significant differences in dose of risperidone and frequency of extrapyramidal side effects between the two groups. Antipsychotic-naive patients were significantly more frequent in responders(p=0.009). CONCLUSION: These results suggest that marital status and paranoid type of schizophrenic symptoms may be useful as the clinical predictors associated with risperidone response in schizophrenic patients, and that risperidone is an appropriate first-line antipsychotic agent in antipsychotic-naive schizophrenic patients.

Two Cases of Twin to Twin Transfusion Syndrome

Two cases of monochorial twins with twin-to-twin transfusion syndrome were presented. In both of two cases, cases, there were marked difference in hemoglobin levels between two identical twins but in one of two cases, the anemic two was more larger than the pletoric one in birth weight unusually. In one of two cases, both anemic infant and plethoric one survived, but in the other case, both succumbed.