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Differential early onset of therapeutic response with risperidone vs conventional antipsychotics in patients with chronic schizophrenia

Glick, Ira D.a; Shkedy, Zivb; Schreiner, Andreasc

International Clinical Psychopharmacology: September 2006 - Volume 21 - Issue 5 - pp 261-266
Original Articles

The present post-hoc analysis investigated the speed of onset of therapeutic effect of the atypical antipsychotic, risperidone, in direct comparison with conventional antipsychotics. Data were pooled from four double-blind active comparator-controlled clinical trials involving 757 patients with schizophrenia treated for up to 8 weeks with either risperidone (4–6 mg/day) or a conventional antipsychotic such as haloperidol (10 or 20 mg/day), perphenazine (mean dose 28 mg/day), or zuclopenthixol (mean dose 38 mg/day). Primary outcome was assessed using the Positive and Negative Syndrome Scale. A significantly greater proportion of patients treated with risperidone achieved ≥20% reduction from baseline Positive and Negative Syndrome Scale total score at weeks 1, 2, 6, and at end point (last observation carried forward: P≤0.04). A significant difference exists in mean reduction from baseline to end point in Positive and Negative Syndrome Scale total scores in favor of patients treated with risperidone compared with those treated with conventional antipsychotics (−18.4 vs −13.5; P=0.0013). The mean time to response was 23.8 days with risperidone and 28.2 days with conventional drugs (hazard ratio 1.3; 95% confidence interval 1.1–1.5). These findings are clinically relevant because the faster onset of therapeutic effect with atypical antipsychotics can be important in the acute setting and have a considerable impact on healthcare systems.

aDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA

bCentre for Statistics, Limburgs Universitair Centrum, Diepenbeek, Belgium

cMedical & Scientific Affairs, Janssen-Cilag, Neuss, Germany

Correspondence and requests for reprints to Professor Ira D. Glick, MD, Department of Psychiatry and Behavioral Sciences, Stanford School of Medicine, Stanford University Medical Center, 401 Quarry road, Stanford, CA 94305, USA.

Tel: +1 650 723 3519; fax: +1 650 723 2507; e-mail:

Sponsorship: This work was supported by an unrestricted grant from Janssen-Cilag Pharmaceuticals, Beerse, Belgium.

Disclosure: Data contained in this paper were presented at a lecture given at the 7th World Congress of Biological Psychiatry, Berlin, Germany, 1–6 July 2001 as a preliminary communication.

Received 13 January 2006 Accepted 14 March 2006

© 2006 Lippincott Williams & Wilkins, Inc.