Efficacy and Safety of Risperidone in Mood Disorders / 신경정신의학

ABSTRACT

OBJECTIVE: Although typical neuroleptics are commonly used in the treatment of bipolar disorder and psychotic depression, newer atypical antipsychoticss, like risperidone, may be more effective and better tolerated. This study evaluated the efficacy and safety of lithium/risperidone combination therapy in patients with mood disorders. METHODS: A total of 97 patients were included if they met DSM-IV criteria for bipolar I disorder, manic episode and major depressive disorder with psychotic feature and were treated with lithium/risperidone combination therapy and lithium/haloperidol combination therapy. Patients were rated using the CGI(Clinical global impression) GAF(Global assessment of functioning) Adverse events also assessed by medical personnel. RESULTS: Of 97 patients, 81 were diagnosed with bipolar I disorder, manic episode and 16 with major depressive disorder with psychotic feature. 81 patients who diagnosed with bipolar manic disorder were divided into two groups, with lithium/risperidone combination group and lithium/haloperidol combination group. There was no significant difference in age, sex, baseline CGI scores, and baseline GAF scores between two groups. 31 patients who received lithium and risperidone(2.07+/-0.46)were much more improved based on CGI scores than 50 patients who received lithium and haloperidol(2.58+/-0. 85) 25(80.6%)of lithium/risperidone combination group were rated much improved or very much improved, and 25(50%)of lithium/haloperidol combination group were rated response. Mean dose of risperdidone in responders(CGI< or =)is lower than partial respnders(CGI=3)4.50+/-1.92mg/d versus 4.88+/-3.31mg/d) While 16%(8 of 50)patients discontinued haloperidol and lithium because of delirium and confusion, lithium/risperidone combination group did not experienced intolerable side events. No patients was experienced worsening of manic symptoms while receiving lithium/risperidone. Antidepressant/risperidone combination group were much more improved based on CGI and GAF score. CONCLUSIONS: This study suggests risperidone is effective and well tolerated when added to lithium. We found no evidence of risperidone leading to an induction of manic symptoms.