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Sample records for injectable risperidone efficacy

  1. Risperidone Injection

    ... depressive disorder; a disease that causes episodes of depression, episodes of severe mania, and other abnormal moods). Risperidone is in a class of medications called atypical antipsychotics. It works by ...

  2. Risperidone long-acting injection: a review of its long term safety and efficacy

    Michael K Rainer

    2008-08-01

    Full Text Available Michael K RainerMemory-Clinic and Psychiatric Department, Donauspital, Vienna, AustriaAbstract: A long-acting form of the second-generation antipsychotic drug risperidone is now broadly available for the treatment of schizophrenia and closely related psychiatric conditions. It combines the advantage of previously available depot formulations for first-generation drugs with the favorable characteristics of the modern “atypical” antipsychotics, namely higher efficacy in the treatment of the negative symptoms of schizophrenia and reduced motor disturbances. Published clinical studies show an objective clinical efficacy (as per psychiatric symptom scores and relapse data that exceeds that of oral atypical antipsychotics when patients are switched to the long-acting injectable form, a low incidence of treatment-emergent extrapyramidal side effects, and very good acceptance by patients. Available data for maintenance treatment of bipolar disorder show equivalence with the oral form instead of superiority, but are still limited. As it seems likely that efficacy benefits are mostly due to the fact that the injectable form reduces the demand for patient compliance to one physician visit every 2 weeks instead of self-administration on a daily or twice-daily basis, additional potential could exist in other psychiatric disorders where atypical antipsychotic drugs are of benefit but where patient adherence to treatment schedules is typically low.Keywords: risperidone, schizophrenia, psychotic disorders, patient compliance; delayed-action preparations, injections, intramuscular

  3. Risperidone long-acting injection: a review of its long term safety and efficacy

    Rainer, Michael K

    2008-01-01

    Michael K RainerMemory-Clinic and Psychiatric Department, Donauspital, Vienna, AustriaAbstract: A long-acting form of the second-generation antipsychotic drug risperidone is now broadly available for the treatment of schizophrenia and closely related psychiatric conditions. It combines the advantage of previously available depot formulations for first-generation drugs with the favorable characteristics of the modern “atypical” antipsychotics, namely higher efficacy in the ...

  4. A Post-hoc Comparison of Paliperidone Palmitate to Oral Risperidone During Initiation of Long-acting Risperidone Injection in Patients with Acute Schizophrenia

    Pandina, Gahan; Lane, Rosanne; Nuamah, Isaac; Remmerie, Bart; Coppola, Danielle; Hough, David

    2011-01-01

    Objective: First-month data of a 13-week acute schizophrenia study were used to compare paliperidone palmitate to oral risperidone during initiation of long-acting injectable risperidone. Design: Double-blind, randomized study. Setting: Outpatient or inpatient. Participants: Adults with established (≥1 year) schizophrenia. Those assigned to risperidone long-acting injectable (n=460) received 25mg on Days 8 and 22 with oral risperidone (l–6mg) supplementation for the first 28 days. The paliperidone palmitate group (n=453) received 150mg eq. on Day 1, l00mg eq. on Day 8, and oral placebo supplementation for the first 28 days. Measurements: Positive and Negative Syndrome Scale, Personal and Social Performance Scale, Clinical Global Impression-Severity score, and responder rate (percentage of patients with ≥30% reduction in PANSS total score). An analysis of covariance model estimated least-square mean differences between treatment groups. A post-hoc analysis of efficacy data for the period of interest, i.e., at the time points before and after the first 28 days, was conducted. Results: Positive and Negative Syndrome Scale, Personal and Social Performance Scale, Clinical global Impression-Severity scores showed similar efficacy between the treatment groups during the first weeks of treatment, corresponding to the risperidone long-acting injection initiation period. Mean Positive and Negative Syndrome Scale total score at baseline was 84.7 for paliperidone palmitate and 84.4 for oral risperidone, on Day 22 was 73.6 and 74.1, respectively, and on Day 36 was 71.8 and 72.8, respectively. Overall incidence of adverse events in the first 28 days was generally similar (45% for paliperidone palmitate vs. 35% for oral risperidone), except for injection site pain (4.6% vs. 0.7%). Similar active moiety plasma concentrations were obtained during this period. Conclusion: During the first month, paliperidone palmitate without oral supplementation has similar efficacy and

  5. Combination treatment with risperidone long-acting injection and psychoeducational approaches for preventing relapse in schizophrenia

    Zhao Y

    2013-10-01

    Full Text Available Yueren Zhao,1–3 Taro Kishi,1 Nakao Iwata,1 Manabu Ikeda3,4 1Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Aichi, Japan; 2Department of Psychiatry, Okehazama Hospital Fujita Kokoro Care Center, Toyoake, Aichi, Japan; 3Department of Neuropsychiatry, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan; 4Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Kumamoto, Japan Abstract: A recent meta-analysis showed that long-acting injectable (LAI antipsychotics were not superior to oral antipsychotics for preventing relapse in patients with schizophrenia. We therefore designed a treatment strategy combining risperidone LAI and COMPASS (COMprehensive Psycho-educational Approach and Scheme Set, an original psychoeducational program supporting treatment with risperidone LAI and evaluating subjective treatment satisfaction, transition of symptoms, and effectiveness in preventing symptomatic relapse. The aim of this study was to examine whether addition of COMPASS to risperidone LAI was more effective in preventing relapse in schizophrenia patients than risperidone LAI alone, with the latter group consisting of patients enrolled in a Phase III trial of risperidone LAI in Japan. Patients were followed up for 6 months, with COMPASS continuously implemented from the transition to the observation phase. The primary efficacy measurements were relapse rate (rates of rehospitalization and discontinuation due to inefficacy. Secondary efficacy measurements were the Brief Psychiatric Rating Scale (BPRS and Global Assessment of Functioning (GAF scores. Of the 96 patients originally enrolled, 19 (19.8% were discontinued from all causes. During the 6-month study period, ten of the 96 patients (10.4% relapsed, compared with a 12.2% relapse rate in patients enrolled in a Phase III trial of risperidone LAI in Japan. Patients showed significant improvements in BPRS total

  6. A comparison of continuous subcutaneous paliperidone infusion and repeated subcutaneous injection of risperidone free-base in rats.

    Marchese, G; Pittau, B; Casu, G; Peddio, G; Spada, G P; Pira, M; Deriu, A; Portesani, F; Pisu, C; Lazzari, P; Pani, L

    2010-03-01

    It is proposed that to achieve a therapeutic effect in schizophrenia patients, dopamine D(2)-receptor occupancy by antipsychotics within the striatum must exceed 60-65%. However, at high levels of D(2)-receptor occupancy, the risk of extrapyramidal symptoms (EPS) is increased. Following oral dosing of antipsychotics, peaks and troughs in plasma drug concentrations may be mirrored by fluctuations in D(2)-receptor occupancy. Paliperidone, a novel antipsychotic available as extended-release tablets (paliperidone ER), is the major active metabolite of risperidone and exhibits a plasma pharmacokinetic profile with reduced peak-trough fluctuations and consistent D(2)-receptor occupancy compared with conventional oral antipsychotic formulations. Using formulations that resemble those in clinical practice, this study provides a preclinical evaluation of the pharmacological properties of paliperidone ER and risperidone immediate-release formulation in terms of consistent antipsychotic efficacy over time and extrapyramidal symptom liability. Significant fluctuations in inhibition of d-amphetamine-induced hyperlocomotion were observed for repeated subcutaneous (SC) risperidone injections, whereas stable inhibitory efficacy was demonstrated during continuous SC paliperidone infusion. Similarly, significant fluctuations in latency on-bar were observed with repeated SC risperidone injections, whereas significantly lower latency on-bar was demonstrated following continuous SC paliperidone infusion. These results in an animal model suggest that although risperidone and paliperidone demonstrate similar pharmacologic effects, continuous administration of paliperidone achieves more stable antipsychotic efficacy with reduced motor impairment, akin to the effects observed with paliperidone ER in clinical studies. PMID:19640686

  7. Paliperidone palmitate and risperidone long-acting injectable in subjects with schizophrenia recently treated with oral risperidone or other oral antipsychotics

    Alphs L

    2013-03-01

    in the symptoms of schizophrenia irrespective of previous recent treatment with oral risperidone only or other oral antipsychotics. For subjects who had previously received oral risperidone only, the difference in formulation was the main change in the intervention because the molecule delivered remained the same or similar. These data support the contribution of a long-acting formulation to improving the treatment response and suggest that nonadherence may be a significant contributor to inadequate efficacy of oral formulations in subjects with schizophrenia.Keywords: paliperidone palmitate, risperidone long-acting injection, schizophrenia

  8. Paliperidone palmitate and risperidone long-acting injectable in subjects with schizophrenia recently treated with oral risperidone or other oral antipsychotics

    Alphs, Larry; Bossie, Cynthia A; Sliwa, Jennifer Kern; Fu, Dong-Jing; Ma, Yi-Wen; Hulihan, Joseph

    2013-01-01

    Background This post hoc subgroup analysis of a randomized, double-blind trial evaluated the response to treatment with two long-acting injectable atypical antipsychotics, ie, paliperidone palmitate and risperidone long-acting injectable (RLAI), in subjects with schizophrenia experiencing clinically significant symptoms despite recent treatment with oral risperidone only or other oral antipsychotics. Methods Adult subjects were eligible for the 13-week, double-blind, double-dummy trial (NCT00589914) if they had an established diagnosis of schizophrenia for at least one year and a Positive and Negative Syndrome Scale (PANSS) total score of 60–120 inclusive at screening. Subjects received either paliperidone palmitate (234 mg, day 1; 156 mg, day 8; then once-monthly flexible dosing) or RLAI (25–50 mg biweekly, with oral risperidone supplementation on days 1–28), plus matched placebo injections/tablets. Results This post hoc analysis reports data on 747 subjects who, within 2 weeks of starting double-blind study medication, had reportedly received oral risperidone only (paliperidone palmitate group, n = 126; RLAI group, n = 107), other oral antipsychotics (paliperidone palmitate group, n = 199; RLAI group, n = 203), or no antipsychotic (paliperidone palmitate group, n = 56; RLAI group, n = 56). Mean PANSS total scores improved significantly at end point across all subgroups (mean change from baseline ranged from −17.5 to −19.5, all P < 0.0001). Clinical Global Impression-Severity and Personal and Social Performance scale measures also significantly improved from baseline (all P < 0.0001). Conclusion Treatment with paliperidone palmitate or RLAI resulted in a significant reduction in the symptoms of schizophrenia irrespective of previous recent treatment with oral risperidone only or other oral antipsychotics. For subjects who had previously received oral risperidone only, the difference in formulation was the main change in the intervention because the

  9. Risperidone Long-Acting Injections: Successful Alternative Deltoid Muscle Injections for Refractory Schizophrenia

    Saxena, Arjun; Grace, Jeffery; Olympia, Josie L.; Trigoboff, Eileen; Watson, Thomas; Cushman, Sharon; Newcomer, David

    2008-01-01

    Treatment-resistant paranoid schizophrenia is often addressed with long-term intramuscular preparations of conventional antipsychotics (haloperidol and fluphenazine), which can be associated with the development of painful, lumpy nodules at the injection site. In this article, we present a case example of a 58-year-old male patient with paranoid schizophrenia who was treated with risperidone long-acting injection given into the deltoid muscle instead of the US Food and Drug Administration (FD...

  10. Maintenance therapy with once-monthly administration of long-acting injectable risperidone in patients with schizophrenia or schizoaffective disorder: a pilot study of an extended dosing interval

    Naessens Ineke

    2007-01-01

    Full Text Available Abstract Background Several clinical studies have established the efficacy, safety, and tolerability of long-acting risperidone administered once every 2 weeks in patients with schizophrenia or schizoaffective disorder. This report evaluates preliminary efficacy, safety, tolerability, and pharmacokinetic data for a novel (once-monthly administration of long-acting injectable risperidone 50 mg in patients with schizophrenia or schizoaffective disorder. Methods Clinically stable patients participated in a 1-year, open-label, single-arm, multicenter pilot study. During the 4-week lead-in phase, patients received long-acting risperidone 50 mg injections every 2 weeks, with 2 weeks of oral risperidone supplementation. Injections of long-acting risperidone 50 mg every 4 weeks followed for up to 48 weeks, without oral supplementation. The primary endpoint was relapse; other assessments included PANSS, CGI-S, adverse event reports, and determination of risperidone and 9-hydroxyrisperidone plasma concentrations. Results Twelve patients in the intent-to-treat population (n = 67 met relapse criteria (17.9%. Relapse risk at 1 year was estimated as 22.4%. Non-statistically significant improvements in symptoms (PANSS and clinical status (CGI-S at endpoint were observed. The most common adverse events included schizophrenia aggravated not otherwise specified (19.5%, anxiety (16.1%, insomnia (16.1%, and headache (11.5%. There were no unexpected safety and tolerability findings. Mean plasma concentrations for risperidone and 9-hydroxyrisperidone were generally stable during the study. Conclusion Once-monthly dosing of long-acting risperidone was well tolerated, associated with a relatively low relapse rate (similar to that reported with other antipsychotics, and maintained the clinically stable baseline status of most patients. Although the results suggest that some symptomatically stable patients with schizophrenia or schizoaffective disorder might be safely

  11. Emerging treatments in the management of bipolar disorder – focus on risperidone long acting injection

    El-Hage, Wissam; Surguladze, Simon A.

    2010-01-01

    Bipolar disorder is a life-long psychiatric illness characterized by a high frequency of relapses and substantial societal costs. Almost half of the patients are prescribed second generation antipsychotics for treatment of manic states, or as the maintenance therapy. Risperidone long acting injection (RLAI) as a monotherapy or as adjunctive therapy to lithium or valproate for the maintenance treatment of bipolar I disorder was approved by Food and Drug Administration (FDA) in United States in...

  12. Efficacy and safety of risperidone oral solution in agitation associated with dementia in the elderly

    Laks Jerson; Engelhardt Eliasz; Marinho Valeska; Rozenthal Marcia; Souza Fernando de Castro e; Bacaltchuk Josué; Stoppe Jr. Alberto; Ferreira R.C.R.; Bottino Cassio; Scalco Mônica

    2001-01-01

    BACKGROUND: Behavioral and psychological symptoms in dementia (BPSD) contribute to caregiver burden and institutionalization of elderly. Neuroleptics are prescribed to control agitation. Side effects of typical neuroleptics are harmful, making atypical neuroleptics an indication. OBJECTIVES: To evaluate efficacy and tolerability of risperidone oral solution (ROS) given once daily to demented elderly outpatients with BPSD (agitation). METHOD: Patients (n=26), 76.35±8.63 years, Diagnostic and S...

  13. Changes in prolactin levels and sexual functioning after switching from long-acting injectable risperidone to paliperidone palmitate in young psychotic patients: a case series

    Itziar Montalvo; Laura Ortega; Xavi López; Montse Solé; Rosa Monseny; Joan Franch; Javier Labad

    2012-01-01

    Statement of the problem : Long-acting injectable (LAI) antipsychotics have been developed to increase compliance in schizophrenia. Risperidone-LAI was the first LAI atypical antipsychotic, as a biweekly injection. Paliperidone Palmitate (PP) is a recently developed LAI atypical antipsychotic that is administered monthly. PP is hydrolized to paliperidone (9-hydroxyrisperidone), the primary active metabolite of risperidone. Although both risperidone and paliperidone are associated with increas...

  14. Efficacy and safety of risperidone oral solution combination clonazepam oral versus haloperidol intramuscular injection for treatment of acute psychotic agitation in schizophrenia%利培酮口服液合用氯硝西泮与氟哌啶醇针剂肌内注射治疗精神分裂症急性激越症状疗效和安全性的研究

    房茂胜; 王刚; 张庆娥; 郑洪波; 张璐璐; 汪波; 周建初; 赵靖平; 李乐华; 陈红辉; 李毅; 刘连忠; 叶萌; 黄继忠; 诸索宇

    2010-01-01

    Objective To compare the efficacy and safety between risperidone oral solution combination clonazepam oral and haloperidol IM injection on controlling psychotic agitation in patients of acute schizophrenia or schizophrenic-affective disorder and to explore the possibility of decreasing efficacy of 6 week acute treatment from switching IM injection to oral.Method Altogether 205 patients exhibiting agitation were randomly assigned to receive either oral treatment with risperidone oral solution puls clonazepam ( n = 104) or intramuscular injection treatment with haloperidol ( n = 101 ).The primary efficacy outcome measure was the change in scores based on PANSS-EC in session Ⅰ ( the first five days), and the response rate based on the PANSS score in session Ⅱ ( the following 6 weeks).Safety was evaluated using the Simpson-Angus Scale (ASA), Barnes Akathisia Scale (BAS), adverse events and lab test.Result Mean acute-agitation score improvement was significant after 5 day treatment in both groups (P <0.01 ) and were similar in both groups ( P > 0.05).While the cooperation was better and the advert events, especially extrapyramidal symptoms was lower in risperidone oral solution groups than that in haloperidol IM injection group(P <0.05).The mean PANSS-EC and PANSS scores remained stable after switching from IM injection to oral.The efficacy was not differenct in both groups after 6 week treatment (P > 0.05).There was no significant difference at the rate of total advert events ( P > 0.05 ) while there were yet significantly higher rates of extrapyramidal symptoms in switching drug group than that in oral group ( P < 0.05 ).Conclusion Risperidone oral solution plus oral clonazepam has similar therapeutic effect to haloperidol IM injection in the treatment of acute agitation, but risperidone oral solution plus clonazepam has better compliance and tolerability.The illness is stable after switching from haloperidol IM injection to risperidone oral solution

  15. Efficacy and safety of risperidone oral solution in agitation associated with dementia in the elderly

    Laks Jerson

    2001-01-01

    Full Text Available BACKGROUND: Behavioral and psychological symptoms in dementia (BPSD contribute to caregiver burden and institutionalization of elderly. Neuroleptics are prescribed to control agitation. Side effects of typical neuroleptics are harmful, making atypical neuroleptics an indication. OBJECTIVES: To evaluate efficacy and tolerability of risperidone oral solution (ROS given once daily to demented elderly outpatients with BPSD (agitation. METHOD: Patients (n=26, 76.35±8.63 years, Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM-IV criteria for dementia. RSO was given, starting dose of 0.25 mg and increments of 0.25 mg every week. Mini-Mental State Examination (MMSE assessed cognitive status, Behavioral and Emotional Activities Manifested in Dementia (BEAM-D and Clinical Global Impression (CGI measured BPSD, Extrapiramidal Symptom Rating Scale (ESRS evaluated extrapyramidal symptoms. Cardiovascular side effects were evaluated clinically. RESULTS: There was a 26% reduction in agitation and no cardiovascular side effects in the range from 1.0 to 1.25 mg. Side effects were more prevalent above 2.5 mg. CONCLUSION: Risperidone oral solution improved agitation with good tolerability from 0.5 to 1.25 mg. A single dose with increments of 0.25 mg may be more acceptable to patients and caregivers.

  16. An open-label, multicenter evaluation of the long-term safety and efficacy of risperidone in adolescents with schizophrenia

    Pandina Gahan

    2012-06-01

    Full Text Available Abstract Background Data on the long-term efficacy, safety, and tolerability of risperidone in adolescents with schizophrenia are limited. The objective of this study was to evaluate the efficacy and safety of maintenance risperidone treatment in adolescents with schizophrenia. Methods This open-label study of adolescents aged 13 to 17 years with schizophrenia was a single extension study of two short-term double-blind risperidone studies and also enrolled subjects directly in open-label risperidone treatment. The risperidone dose was flexible and ranged from 2 to 6 mg/day. Most subjects enrolled for 6 months; a subset enrolled for 12 months. Assessment tools included the Positive and Negative Syndrome Scale total and factor scores, Clinical Global Impressions, Children’s Global Assessment Scale, adverse event (AE monitoring, vital signs, laboratory testing, and extrapyramidal symptom rating scales. Results A total of 390 subjects were enrolled; 48 subjects had received placebo in a previous double-blind study; 292 subjects had received risperidone as part of their participation in one of two previous controlled studies; and 50 subjects were enrolled directly for this study. A total of 279 subjects enrolled for 6 months of treatment, and 111 subjects enrolled for 12 months of treatment. Overall, 264 (67.7% subjects completed this study: 209 of the 279 subjects (75% in the 6-month group and 55 of the 111 subjects (50% in the 12-month group. The median mode dose was 3.8 mg/day. At 6 months, all three groups experienced improvement from open-label baseline in symptoms of schizophrenia as well as general assessments of global functioning. Improvements were generally maintained for the duration of treatment. The most common AEs (≥10% of subjects were somnolence, headache, weight increase, hypertonia, insomnia, tremor, and psychosis. Potentially prolactin-related AEs (PPAEs were reported by 36 (9% subjects. The AE profile in this study was

  17. Efficacy and Safety of Risperidone and Quetiapine in Adolescents With Bipolar II Disorder Comorbid With Conduct Disorder.

    Masi, Gabriele; Milone, Annarita; Stawinoga, Agnieszka; Veltri, Stefania; Pisano, Simone

    2015-10-01

    Although a frequent co-occurrence between bipolar disorder (BD) and conduct disorder (CD) in youth has been frequently reported, data about pharmacological management are scarce and focused on BD type I. Second generation antipsychotics are frequently used in clinical practice, but no comparative studies are available. The aim of this exploratory study was to compare efficacy and safety of risperidone and quetiapine in a sample of adolescents presenting a BD type II comorbid with CD. Twenty-two patients diagnosed with a structured interview according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (male/female ratio, 12/10; mean (SD) age 15.0 (1.4) years) were randomized in 2 treatment groups (quetiapine [n = 12] vs risperidone [n = 10]), treated with flexible doses, and followed up for 12 weeks. Efficacy measures assessed manic symptoms, aggression, anxiety, depression, global clinical severity, and impairment. Safety measures included body mass index, serum prolactin, extrapyramidal adverse effects, and electrocardiogram. At the end of the study, all patients improved in all efficacy measures. Both treatments showed similar efficacy in reducing manic symptoms and aggression. Quetiapine was more effective in improving anxiety and depressive symptoms. A change in body mass index was found, and in a post hoc analysis, it was significant only in the risperidone group. Prolactin significantly increased only in the risperidone group. In BD type II, CD comorbidity, quetiapine, or risperidone monotherapy may be effective and relatively safe, although the small sample size, the limited duration of the study, and the design (lack of a blind assessments and of a placebo group) make it difficult to draw definitive conclusions. PMID:26226481

  18. Minocycline and risperidone prevent microglia activation and rescue behavioral deficits induced by neonatal intrahippocampal injection of lipopolysaccharide in rats.

    Furong Zhu

    Full Text Available BACKGROUND: Various signs of activation of microglia have been reported in schizophrenia, and it is hypothesized that microglia activation is closely associated with the neuropathology of schizophrenia. METHODS: Neonatal intrahippocampal injection of lipopolysaccharide (LPS, an activator of microglia, was performed in rats at postnatal day 7 (P7, and they were separately given saline, risperidone (0.5 mg/kg, minocycline (40 mg/kg or a combination of both of them at P42 for consecutive 14 days. Behavioral changes (locomotion activity, social interaction, novel object recognition and prepulse inhibition were examined and the number of microglia was assessed by using immunohistochemistry in adulthood. RESULTS: The adult rats in LPS-injected group showed obvious behavioral alteration (e. g. deficits in social interaction, novel object recognition and prepulse inhibition and a dramatic increase of number of activated microglial cells in the hippocampus and other brain regions such as cerebral cortex and thalamus compared to those in saline-injected group. Interestingly, application of either minocycline, risperidone or both of them significantly rescued behavioral deficits and attenuated microglia activation. CONCLUSION: Our results suggest that inhibition of microglia activation may be one of mechanisms underlying the antipsychotic effect of minocycline and risperidone.

  19. Minocycline and Risperidone Prevent Microglia Activation and Rescue Behavioral Deficits Induced by Neonatal Intrahippocampal Injection of Lipopolysaccharide in Rats

    Ding, Yu-qiang; Liu, Yong; Zhang, Xianghui; Wu, Renrong; Guo, Xiaofeng; Zhao, Jingping

    2014-01-01

    Background Various signs of activation of microglia have been reported in schizophrenia, and it is hypothesized that microglia activation is closely associated with the neuropathology of schizophrenia. Methods Neonatal intrahippocampal injection of lipopolysaccharide (LPS), an activator of microglia, was performed in rats at postnatal day 7 (P7), and they were separately given saline, risperidone (0.5 mg/kg), minocycline (40 mg/kg) or a combination of both of them at P42 for consecutive 14 days. Behavioral changes (locomotion activity, social interaction, novel object recognition and prepulse inhibition) were examined and the number of microglia was assessed by using immunohistochemistry in adulthood. Results The adult rats in LPS-injected group showed obvious behavioral alteration (e. g. deficits in social interaction, novel object recognition and prepulse inhibition) and a dramatic increase of number of activated microglial cells in the hippocampus and other brain regions such as cerebral cortex and thalamus compared to those in saline-injected group. Interestingly, application of either minocycline, risperidone or both of them significantly rescued behavioral deficits and attenuated microglia activation. Conclusion Our results suggest that inhibition of microglia activation may be one of mechanisms underlying the antipsychotic effect of minocycline and risperidone. PMID:24705495

  20. Switching from risperidone long-acting injectable to paliperidone long-acting injectable or oral antipsychotics: analysis of a Medicaid claims database

    Voss, Erica A.; Ryan, Patrick B.; Stang, Paul E.; Hough, David; Alphs, Larry

    2015-01-01

    This report examines relapse risk following a switch from risperidone long-acting injectable (RLAI) to another long-acting injectable antipsychotic [paliperidone palmitate (PP)] versus a switch to oral antipsychotics (APs). Truven Health’s MarketScan Multistate Medicaid Database compared relapses following switches from RLAI. New user cohorts for these two groups were created on the basis of first incidence of exposure to the ‘switched to’ drug. Groups were balanced using 1:1 propensity score...

  1. A six month randomized controlled trial of long acting injectable risperidone 50 and 100mg in treatment resistant schizophrenia.

    Meltzer, H Y; Lindenmayer, J-P; Kwentus, J; Share, D B; Johnson, R; Jayathilake, K

    2014-04-01

    It has been suggested that atypical antipsychotic drugs (A-APDs) other than clozapine may be effective to improve positive symptoms in some patients with treatment resistant schizophrenia (TRS), if both the dose is higher, and the duration of the trial longer, than those which have been ineffective in non-TRS (NTRS) patients. This hypothesis was tested with long acting injectable risperidone (Risperdal Consta®, RLAI). One hundred sixty TRS patients selected for persistent moderate-severe delusions or hallucinations, or both, were randomized to RLAI, 50 or 100mg biweekly, in a six month, outpatient, double-blind, multicenter trial. We hypothesized that RLAI, 100mg, would be more effective than RLAI, 50mg. However, both doses produced clinically significant and equivalent improvement in PANSS Total, Positive, and Negative subscale scores, as well as key cognitive, global and functional measures, with increasing response during the course of the study, confirming the value of longer clinical trial duration for patients with TRS, but not superiority of the higher dose. The overall response rate was comparable to that previously reported for clozapine and high dose olanzapine, another A-APD, in TRS. Both doses of RLAI were equally well tolerated, producing minimal extrapyramidal side effects and few drop outs. Plasma levels of the active moiety, risperidone+9-hydroxyrisperidone, during treatment with RLAI 100mg, were comparable to those for 6-8 mg/day oral risperidone, which have not been effective in TRS. Further study of RLAI, ≥ 50-100mg biweekly, should compare it with clozapine and oral risperidone in TRS, with duration of treatment ≥ six months. PMID:24630262

  2. Clinical utility of the risperidone formulations in the management of schizophrenia

    Madaan V

    2011-10-01

    Full Text Available Vishal Madaan1, Durga P Bestha2, Venkata Kolli2, Saurabh Jauhari2, Roger C Burket1 1University of Virginia Health System, Charlottesville, VA, USA; 2Creighton University Medical Center, Omaha, NE, USA Abstract: Risperidone is one of the early second-generation antipsychotics that came into the limelight in the early 1990s. Both the oral and long-acting injectable formulations have been subject to numerous studies to assess their safety, efficacy, and tolerability. Risperidone is currently one of the most widely prescribed antipsychotic medications, used for both acute and long-term maintenance in schizophrenia. Risperidone has better efficacy in the treatment of psychotic symptoms than placebo and possibly many first-generation antipsychotics. Risperidone fares better than placebo and first-generation antipsychotics in the treatment of negative symptoms. Risperidone's long acting injectable preparation has been well tolerated and is often useful in patients with medication nonadherence. Risperidone has a higher risk of hyperprolactinemia comparable to first-generation antipsychotics (FGAs but fares better than many second-generation antipsychotics with regards to metabolic side effects. In this article, we briefly review the recent literature exploring the role of risperidone formulations in schizophrenia, discuss clinical usage, and highlight the controversies and challenges associated with its use. Keywords: risperidone, schizophrenia, formulation, antipsychotic, side effects

  3. Antipsychotic-induced metabolic effects in the female rat: Direct comparison between long-acting injections of risperidone and olanzapine.

    Ersland, Kari M; Skrede, Silje; Røst, Therese H; Berge, Rolf K; Steen, Vidar M

    2015-12-01

    Several antipsychotics have well-known adverse metabolic effects. Studies uncovering molecular mechanisms of such drugs in patients are challenging due to high dropout rates, previous use of antipsychotics and restricted availability of biological samples. Rat experiments, where previously unexposed animals are treated with antipsychotics, allow for direct comparison of different drugs, but have been hampered by the short half-life of antipsychotics in rodents. The use of long-acting formulations of antipsychotics could significantly increase the value of rodent models in the molecular characterization of therapeutic and adverse effects of these agents. However, as long-acting formulations have rarely been used in rodents, there is a need to characterize the basic metabolic phenotype of different antipsychotics. Using long-acting olanzapine injections as a positive control, the metabolic effects of intramuscular long-acting risperidone in female rats were investigated for the first time. Like olanzapine, risperidone induced rapid, significant hyperphagia and weight gain, with concomitant increase in several plasma lipid species. Both drugs also induced weight-independent upregulation of several genes encoding enzymes involved in lipogenesis, but this activation was not confirmed at the protein level. Our findings shed light on the role of drug administration, drug dose and nutritional status in the development of rodent models for adverse metabolic effects of antipsychotic agents. PMID:26378122

  4. Are the Long-Acting Intramuscular Formulations of Risperidone or Paliperidone Palmitate Associated with Post-Injection Delirium/Sedation Syndrome? An Assessment of Safety Databases

    Alphs, Larry; Gopal, Srihari; Karcher, Keith; Kent, Justine; Kern Sliwa, Jennifer; Kushner, Stuart; Nuamah, Isaac; Singh, Jaskaran

    2011-01-01

    Long-acting injectable (LAI) formulations of antipsychotics are valuable treatment alternatives for patients with psychotic disorders, and understanding their safe use is critical. Post-injection delirium/sedation syndrome (PDSS) has been reported following treatment with one atypical antipsychotic LAI. Clinical databases of risperidone LAI and paliperidone palmitate were explored to identify if cases of PDSS had been observed. No cases of PDSS were identified in 15 completed trials of 3,164 ...

  5. Preparation and in-vitro characterization of Risperidone-cyclodextrin inclusion complexes as a potential injectable product

    D Shukla

    2009-12-01

    Full Text Available "n  "n Background and the purpose of the study: This investigation deals with risperidone cyclodextrin (CD complexation for parenteral administration to improve its aqueous solubility which would be beneficial over immediate and sustained release formulations available in market especially for agitated and non-cooperative psychotic patients. "nMethods: The phase solubility study of the drug with β-CD, hydroxypropyl (HP-β-CD and γ-CD was conducted and CDs with higher stability constants were selected for complexation. The complexes of Risperidone with β-CD and HP-β-CD were prepared by precipitation and vacuum drying methods, respectively. Fourier transform-infrared, X-ray diffraction and differential scanning calorimetry techniques were used for characterization of complexes. Drug precipitation study of complex's solution in water for injection and 100 ml of 0.1 M pH 7.4 phosphate buffer saline and stability study in accelerated condition were also carried out. "nResults: The stability constants of the CD were in the following order: β-CD (341.953±11.87 M-1 > HP-β-CD (170.817± 5.93 M-1 > γ-CD (93.716 ± 3.25 M-1. CDs with high stability constants were selected to prepare the drug CD complex. The complexation efficiencies of β-CD and HP-β-CD were 95.23 ± 2.27% and 97.59 ±1.97%, respectively. Both types of CDs exhibited complexation at 1:2 molar stoichiometric ratio. The drug precipitation study indicated complete solubility (100% drug dissolution without a trace of precipitate within 5 mins. The complexes were found to be stable for a period of 3 months under accelerated stability conditions. Major conclusion:Stable complexes of risperidone were successfully formulated using both β-CD and HP-β-CD by simple and highly efficient methods of complexation for parenteral administration.

  6. Comparison of Subjective Experiences and Effectiveness of First-Generation Long-Acting Injectable Antipsychotics and Risperidone Long-Acting Injectables in Patients With Schizophrenia.

    Chen, Wen-Yin; Lin, Shih-Ku

    2016-10-01

    We conducted a cross-sectional study to compare the subjective experiences and clinical effects of first-generation long-acting injectable (FGA-LAI) antipsychotics with those of risperidone long-acting injectables (RIS-LAIs) in 434 schizophrenia patients. Compared with the RIS-LAI group, the patients treated with FGA-LAIs had a significantly longer duration of illness and LAI treatment and were older. Our results suggest that patients treated with FGA-LAI have more satisfactory subjective experiences compared with patients treated with RIS-LAI and that both FGA-LAI and RIS-LAI treatments can prevent relapses and hospitalization. Additional longitudinal studies determining the long-term benefits of RIS-LAI are warranted. PMID:27580495

  7. Risperidone long-acting injection in Schizophrenia Spectrum Illnesses compared to first generation depot antipsychotics in an outpatient setting in Canada

    Lammers, Laura; Zehm, Bree; Williams, Richard

    2013-01-01

    Background Depot formulations of antipsychotics provide a potential solution to the poor adherence to oral therapies in schizophrenia. However, there have been few comparative studies on the effectiveness and tolerability of first and second generation depot antipsychotics in a real clinical practice setting. The objectives of the present study were to compare safety and outcomes in patients with schizophrenia initiated on risperidone long-acting injection (RLAI) or first generation antipsych...

  8. [The study of therapeutic efficacy of two forms of risperidone--rileptid and rispolept in patients with schizophrenia].

    Akhapkin, R V

    2008-01-01

    Generic drugs represent a big part of the Russian pharmaceutical market, a number of registered copies of the same drug manufactured by different pharmaceutical companies being estimated as several tens of drugs that does not mean their equally high quality and complete interchangeability. A choice of optimal price-to-quality ratio of a drug among a great number of analogues is possible only with taking into account a number of factors related to a manufacturer, a drug and a patient. The most important index of interchangeability of generic drugs is their therapeutic equivalence to the original one. A study aimed to compare the therapeutic equivalence of two preparations of risperidone--original rispolept and generic rileptid--has been carried out. The comparison of efficacy and tolerability of the therapy has not revealed differences both in any of the parameters and in any stages of the study. In conclusion, the full therapeutic equivalence of generic drug rileptid to original rispolept is revealed. PMID:18833105

  9. Effectiveness of injectable risperidone long-acting therapy for schizophrenia: data from the US, Spain, Australia, and Belgium

    Macfadden Wayne

    2011-04-01

    Full Text Available Abstract Background Because wide variations in mental health care utilization exist throughout the world, determining long-term effectiveness of psychotropic medications in a real-world setting would be beneficial to physicians and patients. The purpose of this analysis was to describe the effectiveness of injectable risperidone long-acting therapy (RLAT for schizophrenia across countries. Methods This was a pragmatic analysis of data from two prospective observational studies conducted in the US (Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation [SOURCE]; ClinicalTrials.gov registration number for the SOURCE study: NCT00246194 and Spain, Australia, and Belgium (electronic Schizophrenia Treatment Adherence Registry [eSTAR]. Two separate analyses were performed to assess clinical improvement during the study and estimate psychiatric hospitalization rates before and after RLAT initiation. Clinical improvement was evaluated using the Clinical Global Impressions-Severity (CGI-S and Global Assessment of Functioning (GAF scales, and change from baseline was evaluated using paired t tests. Psychiatric hospitalization rates were analyzed using incidence densities, and the bootstrap resampling method was used to examine differences between the pre-baseline and post-baseline periods. Results The initial sample comprised 3,069 patients (US, n = 532; Spain, n = 1,345; Australia, n = 784; and Belgium, n = 408. In all, 24 months of study participation, completed by 39.3% (n = 209, 62.7% (n = 843, 45.8% (n = 359, and 64.2% (n = 262 of patients from the US, Spain, Australia, and Belgium, respectively, were included in the clinical analysis. Improvements compared with baseline were observed on both clinical assessments across countries (P P P Conclusions RLAT in patients with schizophrenia was associated with improvements in clinical and functional outcomes and decreased hospitalization rates in the US, Spain, Australia, and Belgium, despite

  10. Paliperidone palmitate and risperidone long-acting injectable in subjects with schizophrenia recently treated with oral risperidone or other oral antipsychotics

    Alphs L; Bossie CA; Sliwa JK; Fu DJ; Ma YW; Hulihan J

    2013-01-01

    Larry Alphs,1 Cynthia A Bossie,1 Jennifer Kern Sliwa,2 Dong-Jing Fu,1 Yi-Wen Ma,3 Joseph Hulihan11CNS Medical Affairs, 2Medical Information, Janssen Scientific Affairs, LLC, Titusville, NJ, USA; 3Biostatistics, B&P, Janssen Research & Development LLC, Titusville, NJ, USABackground: This post hoc subgroup analysis of a randomized, double-blind trial evaluated the response to treatment with two long-acting injectable atypical antipsychotics, ie, paliperidone palmitate and risper...

  11. Effects of Risperidone and Paliperidone Pretreatment on Locomotor Response Following Prenatal Immune Activation

    Richtand, Neil M.; Ahlbrand, Rebecca; Horn, Paul; Stanford, Kevin; Bronson, Stefanie L.; McNamara, Robert K.

    2011-01-01

    Aim Limited data are available regarding pharmacological characteristics of effective interventions for psychosis prevention. Enrollment challenges in psychosis prevention trials impede screening diverse interventions for efficacy. Relevant animal models could help circumvent this barrier. We previously described prevention with risperidone of abnormal behavior following neonatal hippocampal lesion. We aimed to extend those findings evaluating risperidone and paliperidone following prenatal immune activation, a developmental model of a schizophrenia risk factor. We evaluated a later developmental time point to determine persistent effects of drug treatment. Methods Pregnant Sprague-Dawley rats were injected with poly I:C or saline on gestational day 14. Offspring of poly I:C and saline treated dams received risperidone (0.45 mg/kg/d), paliperidone (0.05 mg/kg/d), or vehicle from postnatal days 35 to 70. Locomotor responses to novelty, saline injection, and amphetamine (1 and 5 mg/kg) were determined at three months, i.e., 21 days following antipsychotic discontinuation. Results Risperidone and paliperidone had persistent effects on behavioral response to amphetamine (1 mg/kg) at 3 months, ameliorating the impact of prenatal immune activation on offspring of poly I:C-treated dams. Risperidone, but not paliperidone, also exerted persistent effects in offspring of saline-treated dams on locomotor response to saline and amphetamine (5 mg/kg) injection. Conclusions Risperidone and paliperidone pretreatment of poly I:C offspring during peri-pubertal development stabilized response to amphetamine exposure persisting into early adulthood. Prenatal immune activation provides a model for evaluating effects of an environmental risk factor for schizophrenia, and has potential utility for identifying pharmacological approaches to early intervention. PMID:21440257

  12. Signalling profile differences: paliperidone versus risperidone

    Clarke, W P; Chavera, T A; Silva, M; Sullivan, L C; Berg, K A

    2013-01-01

    BACKGROUND AND PURPOSE Paliperidone is an active metabolite of the second-generation atypical antipsychotic, risperidone recently approved for the treatment of schizophrenia and schizoaffective disorder. Because paliperidone differs from risperidone by only a single hydroxyl group, questions have been raised as to whether there are significant differences in the effects elicited between these two drugs. EXPERIMENTAL APPROACH We compared the relative efficacies of paliperidone versus risperidone to regulate several cellular signalling pathways coupled to four selected GPCR targets that are important for either therapeutic or adverse effects: human dopamine D2, human serotonin 2A receptor subtype (5-HT2A), human serotonin 2C receptor subtype and human histamine H1 receptors. KEY RESULTS Whereas the relative efficacies of paliperidone and risperidone were the same for some responses, significant differences were found for several receptor-signalling systems, with paliperidone having greater or less relative efficacy than risperidone depending upon the receptor–response pair. Interestingly, for 5-HT2A-mediated recruitment of β-arrestin, 5-HT2A-mediated sensitization of ERK, and dopamine D2-mediated sensitization of adenylyl cyclase signalling, both paliperidone and risperidone behaved as agonists. CONCLUSIONS AND IMPLICATIONS These results suggest that the single hydroxyl group of paliperidone promotes receptor conformations that can differ from those of risperidone leading to differences in the spectrum of regulation of cellular signal transduction cascades. Such differences in signalling at the cellular level could lead to differences between paliperidone and risperidone in therapeutic efficacy or in the generation of adverse effects. PMID:23826915

  13. Risperidone long-acting injection in the treatment of schizophrenia: 24-month results from the electronic Schizophrenia Treatment Adherence Registry in Canada

    Williams R

    2014-02-01

    Full Text Available Richard Williams,1 Ranjith Chandrasena,2 Linda Beauclair,3 Doanh Luong,4 Annette Lam4 On behalf of the e-STAR study group 1Vancouver Island Health Authority, Victoria, BC, Canada; 2Chatham-Kent Health Alliance, Chatham, ON, Canada; 3Allan Memorial Institute, Montreal, QC, Canada; 4Janssen Inc., Toronto, ON, Canada Objective: To assess outcomes over 24 months in Canadian patients with schizophrenia initiated on risperidone long-acting injection (RLAI and participating in the electronic Schizophrenia Treatment Adherence Registry (e-STAR. Materials and methods: Patients with schizophrenia or schizoaffective disorder were enrolled from 24 sites after an independent decision to initiate RLAI. Subsequent patient management was based on usual clinical practice at each site and was not protocol-driven. Relevant data were collected retrospectively by chart review for 12 months prior to RLAI and prospectively for 24 months following RLAI initiation. Results: Patients (n=188 had a mean age of 39.2 years, were 66.3% male, and 27.7% were inpatients at baseline. Twenty-four months after initiating therapy (initial dose =28.7 mg, 34.1% (95% confidence interval 27.2%–42.2% of patients had discontinued RLAI with a mean time to discontinuation of 273.4±196 days. Over the treatment period, there were significant (P<0.001 changes from baseline in Clinical Global Impression-Severity (CGI-S; 3.48 versus [vs] 4.31 at baseline, Global Assessment of Functioning (GAF; 56.1 vs 48.1, and Personal and Social Performance (PSP; 59.1 vs 46.9 scale scores. In addition, after 12 months, there were significant (P<0.001 decreases in the percentage of patients hospitalized (23.9% vs 58.5% pre-RLAI, mean length of stay (11.4 vs 30.4 days, and number of hospitalizations (0.32 vs 0.87 compared to the 12-month pre-RLAI period. Reductions in hospitalization continued into the second 12 months of therapy, when only 9% of patients were hospitalized and mean length of stay was 2.0 days

  14. Time-Dependence of Risperidone and Asenapine Sensitization and Associated D2 receptor Mechanism

    Gao, Jun; Li, Ming

    2013-01-01

    When an antipsychotic drug is given repeatedly and intermittently, there is often a long-term increase in its behavioral efficacy, termed antipsychotic sensitization. With the passage of time, the magnitude of antipsychotic sensitization may increase or decrease depending on the principle of Time-Dependent Sensitization (TDS) or memory decay, respectively. In the present study, we examined the time-dependent feature and possible dopamine D2 receptor mechanism of sensitization induced by the antipsychotics risperidone and asenapine in the conditioned avoidance response test. Well-trained male adult Sprague-Dawley rats were first repeatedly treated with risperidone (1.0 mg/kg) or asenapine (0.2 mg/kg) and tested for avoidance response daily for 5 consecutive days. Eight, 18 or 38 days after the 5th drug treatment, all rats were retested drug-free to assess the residual impact of prior risperidone or asenapine treatment. Drug-pretreated rats had significantly lower avoidance than vehicle-pretreated ones on this test, and the group differences increased with the passage of time. In the subsequent drug challenge test at 10, 20 or 40 days after the 5th drug treatment, all rats were injected with a low dose of risperidone (0.3 mg/kg) or asenapine (0.1 mg/kg). Drug-pretreated rats again made significantly less avoidances than controls, confirming the drug-induced sensitization effect. Finally, in the quinpirole (a D2/3 receptor agonist, 1.0 mg/kg, sc)-induced hyperlocomotion test, risperidone-pretreated rats exhibited a significantly higher level of motor activity than the vehicle-pretreated ones. These findings suggest that risperidone and asenapine sensitization is long-lasting, follows the TDS principle, and is likely mediated by D2 receptor supersensitivity. PMID:24103641

  15. Optimizing limbic selective D2/D3 receptor occupancy by risperidone: a [123I]-epidepride SPET study.

    Bressan, Rodrigo A; Erlandsson, Kjell; Jones, Hugh M; Mulligan, Rachel S; Ell, Peter J; Pilowsky, Lyn S

    2003-02-01

    Selective action at limbic cortical dopamine D2-like receptors is a putative mechanism of atypical antipsychotic efficacy with few extrapyramidal side effects. Although risperidone is an atypical antipsychotic with high affinity for D2 receptors, low-dose risperidone treatment is effective without inducing extrapyramidal symptoms. The objective was to test the hypothesis that treatment with low-dose risperidone results in 'limbic selective' D2/D3 receptor blockade in vivo. Dynamic single photon emission tomography (SPET) sequences were obtained over 5 hours after injection of [123I]-epidepride (approximately 150 MBq), using a high-resolution triple-headed brain scanner (Marconi Prism 3000XP). Kinetic modelling was performed using the simplified reference region model to obtain binding potential values. Estimates of receptor occupancy were made relative to a normal volunteer control group (n = 5). Six patients treated with low-dose risperidone (mean = 2.6 mg) showed moderate levels of D2/D3 occupancy in striatum (49.9%), but higher levels of D2/D3 occupancy in thalamus (70.8%) and temporal cortex (75.2%). Occupancy values in striatum were significantly different from thalamus (F (1,4) = 26.3, p < 0.01) and from temporal cortex (F (1,4) = 53.4, p < 0.01). This is the first study to evaluate striatal and extrastriatal occupancy of risperidone. Low dose treatment with risperidone achieves a similar selectivity of limbic cortical over striatal D2/D3 receptor blockade to that of atypical antipsychotics with lower D2/D3 affinity such as clozapine, olanzapine and quetiapine. This finding is consistent with the relevance of 'limbic selective' D2/D3 receptor occupancy to the therapeutic efficacy of atypical antipsychotic drugs. PMID:12544369

  16. Adjunctive long-acting risperidone in patients with bipolar disorder who relapse frequently and have active mood symptoms

    Haskins John T; Turkoz Ibrahim; Adler Caleb M; Macfadden Wayne; Turner Norris; Alphs Larry

    2011-01-01

    Abstract Background The objective of this exploratory analysis was to characterize efficacy and onset of action of a 3-month treatment period with risperidone long-acting injection (RLAI), adjunctive to an individual's treatment regimen, in subjects with symptomatic bipolar disorder who relapsed frequently and had significant symptoms of mania and/or depression. Methods Subjects with bipolar disorder with ≥4 mood episodes in the past 12 months entered the open-label stabilization phase preced...

  17. RISPERIDONE VERSUS HALOPERIDOL IN ACUTE AND TRANSIENT PSYCHOTIC DISORDER

    Chaudhuri, Bijoy Pratim; Bhagabati, Dipesh; Medhi, Dipanjali

    2000-01-01

    The mechanism of action of a relatively new antipsychotic drug-Risperidone differs from conventional antipsychotics like Haloperidol. We compared low dosages of Risperidone with near equivalent dosages of Haloperidol in first episode drug naive Acute and Transient Psychotic disorder. A single blind randomised four-week study protocol was employed. Highly significant and comparable efficacy as assessed by Brief Psychiatric Rating Scale and Global Assessment of Functioning Scale was seen at the...

  18. Medication adherence in patients with psychotic disorders: an observational survey involving patients before they switch to long-acting injectable risperidone

    Baylé FJ

    2015-09-01

    Full Text Available Franck Jean Baylé,1 Arnaud Tessier,2,3 Sophie Bouju,4 David Misdrahi2,3 1Sainte-Anne Hospital (SHU, Paris V-Descartes University, Paris, 2Hôpital Charles Perrens, Pôle de Psychiatrie Adulte, 3CNRS UMR 5287-INCIA, Bordeaux University, Bordeaux, 4Janssen-Cilag France, Issy Les Moulineaux, Paris, France Background: Maintaining antipsychotic therapy in psychosis is important in preventing relapse. Long-acting depot preparations can prevent covert non-adherence and thus potentially contribute to better patient outcomes. In this observational survey the main objective is to evaluate medication adherence and its determinants for oral treatment in a large sample of patients with psychosis.Methods: In this cross-sectional survey medication adherence for oral treatment was assessed by patients using the patient-rated Medication Adherence Questionnaire (MAQ. Data were collected by physicians on patients with a recent acute psychotic episode before switching to long-acting injectable risperidone. Other evaluations included disease severity (Clinical Global Impression – Severity, patients’ insight (Positive and Negative Syndrome Scale item G12, treatment acceptance (clinician-rated Compliance Rating Scale, and therapeutic alliance (patient-rated 4-Point ordinal Alliance Scale.Results: A total of 399 psychiatrists enrolled 1,887 patients (mean age 36.8±11.9 years; 61.6% had schizophrenia. Adherence to oral medication was “low” in 53.2% of patients, “medium” in 29.5%, and “high” in 17.3%. Of patients with psychiatrist-rated active acceptance of treatment, 70% had “medium” or “high” MAQ scores (P<0.0001. Medication adherence was significantly associated with therapeutic alliance (4-Point ordinal Alliance Scale score; P<0.0001. Patient age was significantly associated with adherence: mean age increased with greater adherence (35.6, 36.7, and 38.6 years for patients with “low”, “medium”, and “high” levels of adherence

  19. Risperidone Treatment in 12 Children With Developmental Disorders and Attention-Deficit/Hyperactivity Disorder

    Eapen, Valsamma; Gururaj, A K

    2005-01-01

    Background: Risperidone is a novel antipsychotic drug that has been tried in the treatment of several child psychiatric disorders. In an open clinical study, we evaluated the safety and efficacy of risperidone in children with developmental disorder and behavioral problems including attention-deficit/hyperactivity disorder (ADHD).

  20. Efficacy and safety of risperidone oral solution in agitation associated with dementia in the elderly Eficácia e segurança de risperidona solução oral na agitação associada a demência em idosos

    Jerson Laks; Eliasz Engelhardt; Valeska Marinho; Marcia Rozenthal; Fernando de Castro e Souza; Josué Bacaltchuk; Alberto Stoppe Jr.; R.C.R. Ferreira; Cassio Bottino; Mônica Scalco

    2001-01-01

    BACKGROUND: Behavioral and psychological symptoms in dementia (BPSD) contribute to caregiver burden and institutionalization of elderly. Neuroleptics are prescribed to control agitation. Side effects of typical neuroleptics are harmful, making atypical neuroleptics an indication. OBJECTIVES: To evaluate efficacy and tolerability of risperidone oral solution (ROS) given once daily to demented elderly outpatients with BPSD (agitation). METHOD: Patients (n=26), 76.35±8.63 years, Diagnostic and S...

  1. Evidence based administration of risperidone and paliperidone for the treating conduct disorder

    Ahmad Ghanizadeh

    2013-01-01

    Full Text Available Background: This study evaluates the evidence-based administration of risperidone and paliperidone for the treating children and adolescents with conduct disorder (CD. Materials and Methods: A review of the current literature from clinical trials that investigated the efficacy of risperidone and paliperidone on CD considering the inclusion criteria and search strategies was performed by a search of PubMed and Google Scholar databases. Results: Out of 53 titles, 31 were irrelevant. The abstract of 22 potentially related articles were studied. Only six articles reported the results of clinical trial. However, one of them reported the effect of risperidone on conduct behaviors in autistic disorders. One study was a re-analysis of two previous studies, one study reported the effects of maintenance versus withdrawal of risperidone treatment and two studies included children with sub-average intelligence. Headache, somnolence and increased appetite are among the most common reported adverse effects. No study examined the effect of paliperidone on CD was found. Conclusion: Current literature suggests that risperidone could be effective for treating some conduct behaviors in children and adolescents. The effect of risperidone on CD is not a well-researched area. There is no well-controlled evidence based reports about the safety and efficacy of risperidone for the treatment of CD. Further trials should examine the efficacy of these medications on CD rather than conduct behaviors or disruptive behavior disorders.

  2. Risperidone Dosing in Children and Adolescents with Autistic Disorder: A Double-Blind, Placebo-Controlled Study

    Kent, Justine M.; Kushner, Stuart; Ning, Xiaoping; Karcher, Keith; Ness, Seth; Aman, Michael; Singh, Jaskaran; Hough, David

    2013-01-01

    Efficacy and safety of 2 risperidone doses were evaluated in children and adolescents with autism. Patients (N = 96; 5-17 years), received risperidone (low-dose: 0.125 mg/day [20 to 45 kg] or high-dose: 1.25 mg/day [20 to 45 kg]) or placebo. Mean baseline (range 27-29) to endpoint change…

  3. Paliperidone ER and oral risperidone in patients with schizophrenia: a comparative database analysis

    Schooler Nina

    2011-02-01

    Full Text Available Abstract Background To compare the efficacy and tolerability of paliperidone extended-release (ER with risperidone immediate-release using propensity score methodology. Methods Six double-blind, randomized, placebo-controlled, short-term clinical trials for acute schizophrenia with availability of individual patient-level data were identified (3 per compound. Propensity score pairwise matching was used to balance observed covariates between the paliperidone ER and risperidone patient populations. Scores were generated using logistic regression models, with age, body mass index, race, sex, baseline Positive and Negative Syndrome Scale (PANSS total score and baseline Clinical Global Impressions–Severity (CGI-S score as factors. The dosage range of paliperidone ER (6-12 mg/day was compared with 2 risperidone dosage ranges: 2-4 and 4-6 mg/day. The primary efficacy measure was change in PANSS total score at week 6 end point. Tolerability end points included adverse event (AE reports and weight. AEs with rates ≥5% and with a ≥2% difference between paliperidone ER and risperidone were identified. Results Completion rates for placebo-treated subjects in paliperidone ER trials (n = 95 and risperidone trials (n = 122 groups were 36.8% and 51.6%, respectively; end point changes on PANSS total scores were similar (p = 0.768. Completion rates for subjects receiving paliperidone ER 6-12 mg/day (n = 179, risperidone 2-4 mg/day (n = 113 or risperidone 4-6 mg/day (n = 129 were 64.8%, 54.0% and 66.7%, respectively (placebo-adjusted rates: paliperidone ER vs risperidone 2-4 mg/day, p = 0.005; paliperidone ER vs risperidone 4-6 mg/day, p = 0.159. PANSS total score improvement with paliperidone ER was greater than with risperidone 2-4 mg/day (difference in mean change score, -6.7; p Conclusions This indirect database analysis suggested that paliperidone ER 6-12 mg/day may be more efficacious than risperidone 2-4 mg/day and as efficacious as risperidone 4-6 mg

  4. Pharmacogenetics of clinical response to risperidone.

    Llerena, Adrián; Berecz, Roland; Peñas-Lledó, Eva; Süveges, Agnes; Fariñas, Humberto

    2013-01-01

    Despite risperidone's proven safety and efficacy, existing pharmacogenetic knowledge could be applied to improve its clinical use. The present work aims to summarize the information about genetic polymorphisms affecting risperidone adverse reactions and efficacy during routine clinical practice. The most relevant genes involved in the metabolism of the drug (i.e., CYP2D6, CYP3A and ABCB1) appear to have the greatest potential to predict differences in plasma concentrations of the drug and its interactions, but also relate to side effects, such as neuroleptic syndrome, weight gain or polydipsia. Other genes that have been found in association at least twice with any adverse reactions including metabolic changes, extrapyramidal symptoms or prolactine increase are: 5HT2A; 5HT2C; 5HT6; DRD2; DRD3; and BDNF. Some of these genes (5HTR2A, DRD2 and DRD3), along with 5-HTTLPR and COMT, have also been reported to be related with negative clinical outcomes. However, there is not yet enough evidence to support their routine screening during clinical practice. PMID:23327578

  5. Evidence based administration of risperidone and paliperidone for the treating conduct disorder

    Ahmad Ghanizadeh

    2013-01-01

    Background: This study evaluates the evidence-based administration of risperidone and paliperidone for the treating children and adolescents with conduct disorder (CD). Materials and Methods: A review of the current literature from clinical trials that investigated the efficacy of risperidone and paliperidone on CD considering the inclusion criteria and search strategies was performed by a search of PubMed and Google Scholar databases. Results: Out of 53 titles, 31 were irrelevant. The abstra...

  6. Paliperidone ER and oral risperidone in patients with schizophrenia: a comparative database analysis

    Schooler Nina; Lindenmayer Jean-Pierre; Bossie Cynthia A; Turkoz Ibrahim; Canuso Carla M

    2011-01-01

    Abstract Background To compare the efficacy and tolerability of paliperidone extended-release (ER) with risperidone immediate-release using propensity score methodology. Methods Six double-blind, randomized, placebo-controlled, short-term clinical trials for acute schizophrenia with availability of individual patient-level data were identified (3 per compound). Propensity score pairwise matching was used to balance observed covariates between the paliperidone ER and risperidone patient popula...

  7. Paliperidone ER and oral risperidone in patients with schizophrenia: a comparative database analysis

    2011-01-01

    Background To compare the efficacy and tolerability of paliperidone extended-release (ER) with risperidone immediate-release using propensity score methodology. Methods Six double-blind, randomized, placebo-controlled, short-term clinical trials for acute schizophrenia with availability of individual patient-level data were identified (3 per compound). Propensity score pairwise matching was used to balance observed covariates between the paliperidone ER and risperidone patient populations. Scores were generated using logistic regression models, with age, body mass index, race, sex, baseline Positive and Negative Syndrome Scale (PANSS) total score and baseline Clinical Global Impressions–Severity (CGI-S) score as factors. The dosage range of paliperidone ER (6-12 mg/day) was compared with 2 risperidone dosage ranges: 2-4 and 4-6 mg/day. The primary efficacy measure was change in PANSS total score at week 6 end point. Tolerability end points included adverse event (AE) reports and weight. AEs with rates ≥5% and with a ≥2% difference between paliperidone ER and risperidone were identified. Results Completion rates for placebo-treated subjects in paliperidone ER trials (n = 95) and risperidone trials (n = 122) groups were 36.8% and 51.6%, respectively; end point changes on PANSS total scores were similar (p = 0.768). Completion rates for subjects receiving paliperidone ER 6-12 mg/day (n = 179), risperidone 2-4 mg/day (n = 113) or risperidone 4-6 mg/day (n = 129) were 64.8%, 54.0% and 66.7%, respectively (placebo-adjusted rates: paliperidone ER vs risperidone 2-4 mg/day, p = 0.005; paliperidone ER vs risperidone 4-6 mg/day, p = 0.159). PANSS total score improvement with paliperidone ER was greater than with risperidone 2-4 mg/day (difference in mean change score, -6.7; p < 0.05) and similar to risperidone 4-6 mg/day (0.2; p = 0.927). Placebo-adjusted AEs more common with paliperidone ER were insomnia, sinus tachycardia and tachycardia; more common with risperidone

  8. Profile of paliperidone palmitate once-monthly long-acting injectable in the management of schizophrenia: long-term safety, efficacy, and patient acceptability – a review

    González-Rodríguez A

    2015-05-01

    Full Text Available Alexandre González-Rodríguez,1 Rosa Catalán,1–4 Rafael Penadés,1–4 Clemente Garcia-Rizo,1,3,4 Miquel Bioque,1,4 Eduard Parellada,1,3–5 Miquel Bernardo1–4 1Barcelona Clinic Schizophrenia Unit (BCSU, Neuroscience Institute, Hospital Clinic of Barcelona, 2Department of Psychiatry and Clinical Psychobiology, University of Barcelona, 3Institut d’Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS, Barcelona, Spain; 4Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM, Madrid, Spain; 5Department of Pharmacology, University of Barcelona, Barcelona, Spain Background and objectives: Short-term studies focused on once-monthly paliperidone palmitate (PP at doses of 25 mg eq, 50 mg eq, 75 mg eq, 100 mg eq, or 150 mg eq have shown its efficacy and tolerability in the treatment of schizophrenia patients. However, few open-label and long-term studies are available regarding this new pharmacological formulation. Thus, our main aim was to review the scientific evidence on efficacy, safety, tolerability, and preference of PP in these populations. Method: Electronic searches were conducted by using PubMed and ISI Web of Knowledge databases. All relevant studies published from 2009 until January 2015 were included without any language restriction if patients met diagnostic criteria for schizophrenia, and adequate information on efficacy, safety, and tolerability of once-monthly PP was available. Results: Nineteen studies were identified irrespective of the study design and duration of the follow-up period. Randomized, double-blind, placebo-controlled trials found that schizophrenia patients receiving PP showed a significant improvement in psychotic symptoms and similar adverse events compared to placebo and suggested that all doses of PP were efficacious and well tolerated. Other studies demonstrated noninferiority of PP compared to risperidone long-acting injectable in recently diagnosed schizophrenia patients, chronically

  9. Cost Effectiveness of Long-Acting Risperidone in Sweden

    Marja Hensen; Bart Heeg; Mickael Lthgren; Ben van Hout

    2010-01-01

    Background: In Sweden, risperidone long-acting injectable (RLAI) is generally used in a population of schizophrenia patients who are at a high risk of being non-compliant. However, RLAI might also be suitable for use in the general schizophrenia population. Objectives: To analyse the clinical and economic effects of RLAI in the Swedish treatment practice using a discrete-event simulation (DES) model. Treatment outcomes and direct costs were analysed for both the high-risk non-compliant patien...

  10. A Case of Priapism with Risperidone

    Almari Ginory

    2014-01-01

    Full Text Available Priapism is a urologic emergency defined as a prolonged, possibly painful, penile erection. There are several known causes of priapism including psychotropic medications. One of the mechanisms by which antipsychotics are believed to induce priapism is through alpha-1 antagonism. This is case of a 50-year-old male with a history of schizophrenia with previous priapism related to trazodone, who presents with new onset priapism associated with risperidone. In this case, the treatment of priapism includes discontinuation of the offending agent and drainage of the corpus cavernosum twice along with intracavernosal phenylephrine injections. It is important to educate patients on priapism as a possible side effect of medications. It is also important to consider previous episodes of medication-induced priapism when prescribing psychotropic medications as this may increase the patient’s future risk of priapism.

  11. EFFICACY OF TRANSFORAMINAL EPIDURAL STEROID INJECTION IN LUMBOSACRAL RADICULOPATHY

    Saheel

    2016-02-01

    Full Text Available BACKGROUND Lumbosacral radiculopathy is a common medical and socioeconomic problem with a lifetime prevalence estimated to be around 40%-60%. In 1930, Evans reported that sciatica could be treated by epidural injection. The use of epidural corticosteroid injection for the treatment of axial and radicular back pain was first reported in 1953. Lumbar Transforminal Epidural Steroid Injections (TFESIs are performed to provide symptomatic relief in patients with radicular pain. A transforaminal epidural steroid injection (TFESI using a small volume of local anaesthetic will anaesthetize the spinal nerve and also partially anaesthetize the dura, the posterior longitudinal ligament, the intervertebral disc and facet joint. For these reasons, fluoroscopy-guided TFESI has become the preferred approach to epidural space. AIMS AND OBJECTIVES To study the role of transforaminal epidural steroid injection in management of radiculopathy. SETTINGS AND DESIGN This prospective study was conducted in the Department of Orthopaedics, SKIMS Medical College and Hospital, Bemina, Srinagar, J and K, India, for a 2-year period from November 2012 to October 2014; 110 cases, both male and female in the age group of 20-60 years having back pain with radiculopathy of varied types and duration without neurodeficit were enrolled in the study. MATERIALS AND METHODS After selecting a patient for giving transforaminal block, we used a local anaesthetic (2% Xylocaine. Contrast media, e.g. Iohexol was used to demarcate the correct positioning of the needle. A spinal needle (20-25 gauge and 5mL syringe were used to deliver the drug. CONCLUSION Transforaminal epidural steroid injections with long acting anaesthetic is an excellent form of conservative treatment in management of low back ache with radicular pain. It is relatively safe, simple, economical and shortens the time of recovery from severe pain, avoids risks and complications of surgery and also avoids long periods of bed

  12. Valproate-Risperidone versus Valproate-Lithium combination in acute mania

    M Barekatain

    2005-09-01

    Full Text Available Background: We evaluated the efficacy of valproate plus risperidone versus valproate plus lithium combination in the treatment of acute mania. Methods: In 2-week, randomized, double-blind, parallel group study, 46 acute manic patients according to DSM-IV criteria were randomly assigned to receive combination of valproate 20 mg/ kg/day plus risperidone 2-4 mg/day (n=23 or lithium600-1200 mg/day (n=23. The assessment of efficacy measures were according to Young Mania Rating Scale (YMRS and Clinical Global Impressions-Severity (CGI-S and Improvement (CGI-I scale. Other effectiveness measures included YMRS response (YMRS reduction >50 % and YMRS remission (YMRS total scores <12. Results: In each group, 16 of 23 patients (70 % completed the study. YMRS response, CGI-Improvement, and reduction in the total scores of YMRS and CGI-S observed in both groups, significantly greater for valproate-risperidone than valproate-lithium combination group (P=0.006, P=0.015, P=0.004, and P=0.007, respectively.YMRS remission were shown in both groups without statistical significance (P=0.073. The total scores of YMRS at 4th, 8th, and 14th days of trial were lower in valproate-risperidone than valproate-lithium combination group (P=0.017, P=0.005, and P=0.004, respectively. The rate of adverse events and mean weight gain in both groups were not statistically different. Conclusion: In acute manic patients, both combinations of valproate with lithium or with risperidone had efficacy in acutely manic patients, but valproate-risperidone combination was more effective. Both treatments were safe and well tolerated. Considering the small sample size and limited period of observation, further studies need to be conducted to find out the best combination in the treatment of acute mania. Key words: Acute mania, Valproate, Risperidone, Lithium, Combination Therapy

  13. Valproate-Risperidone versus Valproate-Lithium combination in acute mania

    M Barekatain; A. Fatemi; N BASHARDOOST; A Darougheh; M Salehi; GH Asadollahi

    2005-01-01

    Background: We evaluated the efficacy of valproate plus risperidone versus valproate plus lithium combination in the treatment of acute mania. Methods: In 2-week, randomized, double-blind, parallel group study, 46 acute manic patients according to DSM-IV criteria were randomly assigned to receive combination of valproate 20 mg/ kg/day plus risperidone 2-4 mg/day (n=23) or lithium600-1200 mg/day (n=23). The assessment of efficacy measures were according to Young Mania Rating Scale (YMRS) ...

  14. Efficacy of injectable and oral paste formulations of ivermectin against gastrointestinal parasites in ponies.

    Torbert, B J; Kramer, B S; Klei, T R

    1982-08-01

    A controlled test was used in ponies to compare the antiparasitic efficacy of ivermectin (22,23-dihydro-avermectin B1) in an injectable micelle solution administered IM with the efficacy of the same drug in an oral paste formulation. Parasite infections were naturally acquired in southern Louisiana. The drug was tested in both formulations at a dosage level of 0.2 mg/kg of body weight. Ivermectin in both formulations tested had an efficacy greater than 98% against Gasterophilus intestinalis and G nasalis larvae. Trichostrongylus axei, Habronema spp, Strongylus vulgaris, S. edentatus, and species of small strongyles present. Efficacy of ivermectin against Oxyuris equi larvae was 100% in the paste formulation and 93% in the injectable formulation. The ponies were less uniformly infected with S equinus, Draschia megastoma, Parascaris equorum, O equi adults, Anoplocephala perfoliata, and A magna. However, observations indicated that the drug in either formulation was also effective against these parasites, except Anoplocephala spp. PMID:6896613

  15. Adjunctive Aripiprazole Treatment for Risperidone-Induced Hyperprolactinemia: An 8-Week Randomized, Open-Label, Comparative Clinical Trial

    Jingyuan Zhao; Xueqin Song; Xiaoqing Ai; Xiaojing Gu; Guangbiao Huang; Xue Li; Lijuan Pang; Minli Ding; Shuang Ding; Luxian Lv

    2015-01-01

    Objective The present study aimed to evaluate the efficacy and safety of adjunctive aripiprazole treatment in schizophrenia patients with risperidone-induced hyperprolactinemia. Methods One hundred and thirteen patients who were receiving a stable dose of risperidone were randomly assigned to either adjunctive aripiprazole treatment (10 mg/day) (aripiprazole group) or no additional treatment (control group) at a 1:1 ratio for 8 weeks. Schizophrenia symptoms were measured using the Positive an...

  16. SAFETY AND EFFICACY OF PHARMACOLOGICAL VITREOLYSIS BY INTRAVITREAL INJECTION OF HYALURONIDASE

    Rajalingam; Karunakar; Sabiha; Rao; Lokabhi Reddy

    2015-01-01

    AIM: To study the safety and efficacy of pharmacological vitreolysis by intravitreal injection by hyaluronidase . METHODS: a prospective comparative interventional case series of 20 eyes of 20 patients who underwent intravitreal injection of Hyaluronidase 100 IU in one eye in a tertiary eye care centre by a single surgeon between June 2012 to June 2014 at Sarojini Devi Eye Hos pital.20 eyes of 20 patients were taken with other eye being taken as control RESULTS: ...

  17. Self-efficacy estimates for drug use practices predict risk reduction among injection drug users

    Celentano, David D.; Cohn, Sylvia; Davis, Richard O.; Vlahov, David

    2002-01-01

    We used baseline outcome efficacy (OE) estimates for human immunodeficiency virus (HIV) risk reduction to predict subsequent risk reduction 6 months hence among 792 injection drug users in a prospective study. Declines in drug use, frequency of injection, and needle sharing were found among those with high OE scores after adjustment for baseline behavior and antecedent factors. No OE effect was found in multivariate analysis for shooting gallery attendance, a risk that substantially declined ...

  18. Review of risperidone for the treatment of pediatric and adolescent bipolar disorder and schizophrenia

    Jeffrey R Bishop

    2008-03-01

    Full Text Available Jeffrey R Bishop1,2, Mani N Pavuluri21Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA; 2Department of Psychiatry, Pediatric Mood Disorders Program and Center for Cognitive Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USAAbstract: Risperidone is a commonly used medication for the treatment of bipolar disorder and schizophrenia in children and adolescents. It has been studied as a monotherapy treatment in early onset schizophrenia and as both monotherapy and combination therapy for pediatric bipolar disorder. Studies to date indicate that risperidone is an effective treatment for positive and negative symptoms of schizophrenia and mania symptoms of bipolar disorder. In young patient populations, side effects such as weight gain, extrapyramidal side effects, and prolactin elevation require consideration when evaluating the risk benefit ratio for individual patients. Here we review published studies of risperidone for the treatment of bipolar disorder and schizophrenia in children and adolescents to provide practitioners with an overview of published data on the efficacy and safety of risperidone in these patient populations.Keywords: risperidone, bipolar disorder, schizophrenia, children, adolescents

  19. Comparative Pharmacology of Risperidone and Paliperidone.

    Corena-McLeod, Maria

    2015-06-01

    Antipsychotics, risperidone, and risperidone's active metabolite, paliperidone (9-hydroxyrisperidone), are related molecules used for the treatment of schizophrenia and related disorders. Differences in receptor binding, 5-HT2A/D2 (serotonin/dopamine) binding ratios, and mitochondrial proteomics suggest that the effects of risperidone and paliperidone on neuronal firing, regulation of mitochondrial function, and movement are different. This review seeks to explore the most significant differences at the molecular level between risperidone and paliperidone, as reported in preclinical studies. Although risperidone shows higher affinity for 5-HT receptors, paliperidone does not fit this profile. Thus, the risperidone 5-HT2A/D2 binding ratio is significantly lower than the paliperidone 5-HT2A/D2 binding ratio. Paliperidone, similar to lithium and valproate, affects expression levels and phosphorylation of complex I and V proteins in synaptoneurosomal preparations of rat prefrontal cortex, suggesting that paliperidone behaves as a mood stabilizer. It is apparent that the presence of a hydroxyl group in the paliperidone molecule confers increased hydrophilicity to this drug compared with its parent, risperidone; thus, this contributes to differential effects on mitochondrial movement, protein expression, and phosphorylation. These differences are reflected in synaptic plasticity and neuronal firing and have only recently been implicated in the mechanisms of mitochondrial function and movement. PMID:25943458

  20. Development of Risperidone PLGA Microspheres

    Susan D’Souza

    2014-01-01

    Full Text Available The aim of this study was to design and evaluate biodegradable PLGA microspheres for sustained delivery of Risperidone, with an eventual goal of avoiding combination therapy for the treatment of schizophrenia. Two PLGA copolymers (50 : 50 and 75 : 25 were used to prepare four microsphere formulations of Risperidone. The microspheres were characterized by several in vitro techniques. In vivo studies in male Sprague-Dawley rats at 20 and 40 mg/kg doses revealed that all formulations exhibited an initial burst followed by sustained release of the active moiety. Additionally, formulations prepared with 50 : 50 PLGA had a shorter duration of action and lower cumulative AUC levels than the 75 : 25 PLGA microspheres. A simulation of multiple dosing at weekly or 15-day regimen revealed pulsatile behavior for all formulations with steady state being achieved by the second dose. Overall, the clinical use of Formulations A, B, C, or D will eliminate the need for combination oral therapy and reduce time to achieve steady state, with a smaller washout period upon cessation of therapy. Results of this study prove the suitability of using PLGA copolymers of varying composition and molecular weight to develop sustained release formulations that can tailor in vivo behavior and enhance pharmacological effectiveness of the drug.

  1. POST MARKETING SURVEILLANCE STUDY ON RISPERIDONE IN PATIENTS SUFFERING FROM SCHIZOPHRENIA

    J R Zaveri

    2011-04-01

    Full Text Available Schizophrenia is one of the commonest psychiatric ailments. It has been estimated that approximately 1% of the population and 15% of the adults suffers from this disease. Risperidone, atypical antipsychotic, acts mainly by 5HT2 blockade action. Produce virtually no extra pyramidal side effects at low dose, has a broad efficacy. But extra pyramidal dysfunction can appear at higher doses. We conducted a post marketing surveillance study on risperidone in 40 patients suffering from schizophrenia at Psychiatric department of Civil Hospital, Ahmedabad. In this study we specially studied its efficacy and safety. The results of this study are consistent with phase III clinical studies on risperidone carried out in Indian patients except its effects on food intake. As far as the efficacy of risperidone in patient with schizophrenia is concerned, it provided good symptomatic relief In term of safety, 7 patients out of 40, experience adverse effects like decrease appetite, constipation, insomnia, EPS and NMS. Patient with NMS was admitted in hospital and was died later on. [National J of Med Res 2011; 1(2.000: 34-36

  2. THE EFFICACY OF ORAL GLUCOSE FOR RELIEVING PAIN FOLLOWING INTRAMUSCULAR INJECTION IN TERM NEONATES

    F. Sajedi

    2006-09-01

    Full Text Available Pain in neonates can be associated with various risks and it seems essential to find a simple and acceptable method for relieving pain. Pharmacologic agents are not recommended in neonates for pain relief in minor procedures but orally administered glucose solution is found to be effective. The objective of this study was to assess the efficacy of oral 30% glucose during intramuscular injection in term neonates. Sixty-four healthy term neonates were recruited for this study during 1 month. The inclusion criteria were gestational age 37-42 weeks, birth weight 2500-4000 gr, and Apgar score > 7. The intervention consists of administration of either 2 ml of oral 30% glucose or 2ml of sterile water 2 minutes before injection. The primary out come measure was the cumulative Neonatal Infant Pain Scale (NIPS score at 3 minutes after injection. Thirty-two neonates received 30% glucose and 32 neonates received sterile water. The cumulative NIPS score at 3 minutes after injection for neonates given 30% glucose was significantly (P = 0.000 lower than for neonates given sterile water. The heart rate immediately after injection for neonates given 30% glucose was significantly (P = 0.002 lower than for neonates given sterile water. Oral 30% glucose given 2 minutes before injection was effective in reducing neonatal pain following injection. It is a simple, safe and fast acting analgesic and should be considered for minor invasive procedures in term neonates.

  3. Can Aidi injection alleviate the toxicity and improve the clinical efficacy of radiotherapy in lung cancer?

    Xiao, Zheng; Liang, Rui; Wang, Cheng-qiong; Xu, Shaofeng; Li, Nana; He, Yuejuan; Tang, Fushan; Chen, Ling; Ma, Hu

    2016-01-01

    Abstract Background/Introduction: Aidi injection plus radiotherapy is widely used for lung cancer in China. Can Aidi injection alleviate the toxicity and improve the clinical efficacy of radiotherapy in lung cancer? Has Aidi injection the attenuation and synergistic efficacy to radiotherapy? There is lack of strong evidence to prove it. Objectives: To reveal its real attenuation and synergistic efficacy to radiotherapy and provide sufficient evidence for adjuvant chemotherapy strategies to lung cancer, we systematically evaluated all related studies. Data Sources: We collected all studies about Aidi injection plus radiotherapy for lung cancer in Medline, Embase, Web of Science, China national knowledge infrastructure database (CNKI), Chinese scientific journals full-text database (VIP), Wanfang database, China biological medicine database (CBM) (established to June 2015), and Cochrane Central Register of Controlled Trials (June 2015), evaluated their quality according to the Cochrane evaluation handbook of randomized controlled trials (5.1.0), extracted data following the PICO principles and synthesized the data by Meta analysis. Results: Sixteen randomized controlled trials (RCTs) with 1192 lung cancer patients were included, with general methodological quality in most trials. The merged relative risk (RR) values and their 95% CI of meta-analysis for objective response rate (ORR), disease control rate (DCR), and quality of life (QOL) were as follows: 1.54, (1.39,1.70), 1.10 (1.02, 1.19), and 2.13 (1.68, 2.68). The merged RR values and their 95% CI of meta-analysis for myelosuppression and neutropenia, radiation pneumonitis, and radiation esophagitis were as follows: 0.51 (0.38, 0.69), 0.53 (0.42, 0.65), 0.52 (0.41, 0.67), and 0.52 (0.40, 0.68). All were statistically significant. The possibility of publication bias was small which objectively reported the results. Conclusions: The evidence available indicates that Aidi injection plus radiotherapy can significantly

  4. THE EFFICACY OF ORAL GLUCOSE FOR RELIEVING PAIN FOLLOWING INTRAMUSCULAR INJECTION IN TERM NEONATES

    F Sajedi; Z. Kashaninia; M. Rahgozar L. Radrazm

    2006-01-01

    Pain in neonates can be associated with various risks and it seems essential to find a simple and acceptable method for relieving pain. Pharmacologic agents are not recommended in neonates for pain relief in minor procedures but orally administered glucose solution is found to be effective. The objective of this study was to assess the efficacy of oral 30% glucose during intramuscular injection in term neonates. Sixty-four healthy term neonates were recruited for this study during 1 month. Th...

  5. Postmortem Femoral Blood Concentrations of Risperidone

    Linnet, Kristian; Johansen, Sys Stybe

    2014-01-01

    Postmortem femoral blood concentrations of the antipsychotic drug risperidone and the active metabolite 9-hydroxyrisperidone were determined by an achiral LC-MS/MS method in 38 cases. The cause of death was classified as unrelated to risperidone in 30 cases, in which the sum of the concentration of...... the drug and metabolite ranged from below the limit of quantification to 0.058 mg/kg (median 0.0098 mg/kg). This concentration range, which largely corresponds to published in vivo plasmalevels under therapy, may serve as a reference for judgment of postmortem cases involving risperidone. In one case......, risperidone was judged to be a contributing factor to death, and the sum of concentrations was 0.29 mg/kg. This concentration is of the same order of magnitude as observed for plasma levels in clinical intoxication cases. For the remaining seven cases, the cause of death was unclear. The measurements observed...

  6. Risperidone for Aggressive Behavior in ADHD

    J Gordon Millichap

    2007-05-01

    Full Text Available The effects of risperidone augmentation for treatment-resistant aggression in children with ADHD were evaluated in a placebo-controlled pilot study at the University of Miami Miller School of Medicine, FL.

  7. Comparative Pharmacology of Risperidone and Paliperidone

    Corena-McLeod, Maria

    2015-01-01

    Antipsychotics, risperidone, and risperidone’s active metabolite, paliperidone (9-hydroxyrisperidone), are related molecules used for the treatment of schizophrenia and related disorders. Differences in receptor binding, 5-HT2A/D2 (serotonin/dopamine) binding ratios, and mitochondrial proteomics suggest that the effects of risperidone and paliperidone on neuronal firing, regulation of mitochondrial function, and movement are different. This review seeks to explore the most significant differe...

  8. Aripiprazole and Risperidone for Treatment of Methamphetamine-Associated Psychosis in Chinese Patients.

    Wang, Gang; Zhang, Yao; Zhang, Sheng; Chen, Huijing; Xu, Zaifeng; Schottenfeld, Richard S; Hao, Wei; Chawarski, Marek Cezary

    2016-03-01

    We evaluated tolerability and efficacy of aripiprazole and risperidone for treatment of methamphetamine (METH) associated psychotic symptoms in China. Patients with acute METH-associated psychotic symptoms (N=42) and with Positive and Negative Syndrome Scale (PANSS) total score between 60 and 120 were randomized to aripiprazole (initial dose 5-10mg per day followed by flexible doses 5-15 mg per day) or risperidone (initial dose 2-4 mg per day followed by flexible doses 4-6 mg per day) from day 3 to 25 of inpatient hospital stay. Outcome measures included PANSS and Clinical Global Impressions-Severity of Illness scale (CGI-S), METH craving Visual Analogue Scale (VAS), Simpson Angus Scale (SAS), Barnes Assessments Akathasia Rating Scale (BARS), and self-reported adverse effects evaluated during treatment. Retention was evaluated using Kaplan-Meier survival analysis and the MIXED models procedure was used to compare the groups on measures of psychotic and extra-pyramidal symptoms. Patients in both aripiprazole and risperidone groups showed statistically significant reductions in psychotic symptomatology from baseline during treatment (p<0.001) with no statistically significant differences between the treatment groups (p=0.73 and p=0.15, respectively). Risperidone-treated patients reported significantly greater METH craving reductions (p<0.001). Overall, 71% of patients completed the entire study, but the aripiprazole group had a significantly lower retention than the risperidone group (p=0.007), primarily due to medication related adverse effects. Aripiprazole-treated patients also had significantly more akathisia (p=0.03) and agitation (p=0.02) than risperidone-treated patients. Patients in both groups who tolerated their medications and completed the entire study achieved comparable reductions of psychotic symptoms. PMID:26733277

  9. Risperidone

    ... of interest in life, and strong or inappropriate emotions) in adults and teenagers 13 years of age ... ever used street drugs or large amounts of alcohol; if you have ever overused prescription medications; if ...

  10. Risperidone

    ... of mania and depression that happen together) in adults and in teenagers and children 10 years of age and older with bipolar disorder (manic depressive disorder; a disease that causes episodes of depression, episodes of mania, and other ...

  11. Efficacy of Botulinum Toxin Injections in the Treatment of Various Types of Facial Region Disorders

    Arzu Çoban

    2012-12-01

    Full Text Available OBJECTIVE: Local injection of botulinum toxin is a highly effective treatment option for a wide range of movement disorders and there are reliable sources of information on its indications, effects and safety in clinical practice. In this study, we report our experience with botulinum toxin in the treatment of facial region disorders. METHODS: Patients who had been followed in the Botulinum Toxin Outpatient Clinic of the Neurology Department were retrospectively evaluated. Two preparations of botulinum toxin type A (BT-A were used. The efficacy of BT-A injections was rated according to the improvement in symptoms as follows: marked - 75-100% improvement, good - 50-74%, moderate - 25-49%, and insufficient - less than 25% symptom relief. RESULTS: One hundred eighty-two patients (73 male, 109 female with various facial region disorders were included. The efficacy rates for patients who had very good and good improvement were high in the treatment of blepharospasm, hemifacial spasm, facial synkinesis, and Meige syndrome and moderate for oromandibular dystonia and hypersalivation. Ptosis was the most common side effect. CONCLUSION: According to our results, botulinum toxin was very effective treatment for blepharospasm, Meige syndrome, hemifacial spasm and facial synkinesis, whereas it demonstrated good efficacy in oromandibular dystonia and hypersalivation.

  12. Safety and Efficacy of Permacol Injection in the Treatment of Fecal Incontinence

    Ayers, Jennifer; Ayantunde, Abraham; Praveen, Bandipalyam V

    2016-01-01

    Purpose Permacol has been gaining popularity in recent times for the treatment of fecal incontinence (FI). This study aims to evaluate the safety and efficacy of anal submucosal Permacol injection in the treatment of FI. Methods All consecutive patients who underwent Permacol injection for FI over a 3-year period were included. Patients' data relating to obstetric history, anorectal/pelvic operations, type of FI, preoperative anorectal physiology results and follow-up details for outcome measures were collected. Preoperative and postoperative Cleveland Clinic Florida Incontinence Scores (CCFISs) were noted. Patients were surveyed by using a telephone questionnaire to assess the quality of life and other outcome measures. Data were analysed using SPSS ver.19.0. Results Thirty patients (28 females and 2 males) with a median age of 67 years were included in the study. Of those patients, 37%, 50%, and 13% were noted to have passive, mixed and urge FI, respectively. Six of the patients (20%) had repeat Permacol injections, 5 of whom had sustained responses to the first Permacol injection for a mean of 11 months. There was a significant improvement in the CCFIS from a baseline median of 12.5, mean 12.8 interquartile range [IQR], 6–20), to a median of 3.5, mean 4.8 (IQR, 0–20), P patients surveyed by telephone 89% were satisfied with their overall experience and the improvement in their symptoms following Permacol injections. Conclusion This study has demonstrated that Permacol injection for the treatment of FI is safe and effective and has no associated major complications. However, the results are not permanent; consequently, a significant proportion of the patients with an initial response may require repeat injections.

  13. Efficacy of peripheral streptomycin injection in the treatment of idiopathic trigeminal neuralgia

    To evaluate the efficacy of peripheral streptomycin injection in relieving the pain of idiopathic trigeminal neuralgia Study Design: Quasi experimental study. Place and duration of Study: Oral and Maxillofacial Surgery Department, Armed Forces Institute of Dentistry Rawalpindi, from 1st June 2006 to 31st December 2007. Patients and Methods: Thirty patients of idiopathic trigeminal neuralgia were selected. They received five consecutive injections of streptomycin 1g in 3 ml of 2% Lignocaine (Septodont) with 1: 100,000 adrenaline at one week interval. Follow up was carried out at one, two and six months after the last injection. Results: Age ranged from 15-78 years (mean 44.67). Male to female ratio was 1:1.14. Right side of the face was involved in 70% and left side in 30% cases. Mandibular division of trigeminal nerve was involved in 43.3% and maxillary division in 40% of the cases. In the rest both maxillary and mandibular divisions were involved. Pain was significantly decreased from baseline to 1 month (p < 0.001). The level of pain was increased a bit but the increase was significant at two months (p = 0.006) and at 6 months (p = 0.020). Conclusion: Best treatment modality for this devastating disease is yet to evolve. Within the confines of the study it can be stated that efficacy combined with low post treatment morbidity makes streptomycin a useful treatment option. (author)

  14. Injectable fipronil for cattle: Plasma disposition and efficacy against Rhipicephalus microplus.

    Cid, Yara P; Ferreira, Thais P; Magalhães, Viviane S; Correia, Thais R; Scott, Fábio B

    2016-04-15

    Fipronil is a phenylpyrazole class insecticide. It is widely used as an insecticide in agriculture and in the control of ectoparasites in veterinary medicine. The application of fipronil in an injectable form (subcutaneously) becomes an innovation, since there is no commercially available preparation containing fipronil herein. The present study aimed at fipronil usage, applied subcutaneously in cattle, to control Rhipicephalus microplus. The assessing criteria used in the research have been the construction of the plasma concentration curve and efficacy studies. A method using High Performance Liquid Chromatograph with ultraviolet detection was developed for determination of fipronil in bovine plasma samples, providing a fast and simple process with good reproducibility and low limit of quantification. The validation of the analytical method showed linearity, selectivity, precision, accuracy, sensitivity and stability, thus proving it as suitable for routine analysis. This method showed to be an important investigative tool in the analysis of fipronil plasma concentration in cattle. Fipronil administered via subcutaneous in bovine reached the systemic circulation (Cmax=378.06±137.44 ng/mL), was quickly absorbed (t(max)=10±0.87 h), and its elimination occurred slowly (t(1/2)=12 days), while maintaining quantifiable blood plasma levels (23.79±12.16 ng/mL) for up to 21 days after the treatment with a 1 mg/kg dosage. The in vivo efficacy tests proved that fipronil applied subcutaneously in a single dose of 1 mg/kg in cattle exhibited a mean efficacy of 82.41% against R. microplus. The potential of subcutaneous injection as an alternative treatment route in cattle encourage the development of an injectable formulation of fipronil. PMID:26995714

  15. Risperidone Mono - Therapy as Prophylaxis in Bipolar Affective Disorders

    Trivedi, Mohit; Pinto, Denzil; Safeekh, A.T.

    2004-01-01

    Risperidone has been found to be useful in the treatment of acute bipolar disorders. This is a case report where risperidone mono therapy has been found to be effective in prophylaxis of bipolar affective disorder. The pharmacological and clinical implications of risperidone in the management of BPAD are discussed

  16. Comparison of efficacy of kinesiological taping and subacromial injection therapy in subacromial impingement syndrome.

    Subaşı, Volkan; Çakır, Tuncay; Arıca, Zuhal; Sarıer, Rahime Nur; Filiz, Meral Bilgilisoy; Doğan, Şebnem Koldaş; Toraman, Naciye Füsun

    2016-03-01

    The aim of the study was to compare the efficacy of kinesiological taping and subacromial injection therapy in patients with subacromial impingement syndrome (SIS). Seventy patients diagnosed with SIS were randomly assigned to group 1 (n = 35, injection group) or group 2 (n = 35, kinesiological taping group). Betamethasone plus prilocaine was injected to subacromial space in the patients in group 1. In group 2, tape was applied three times for a period of five consecutive days with a 2-day recovery interval. A 3-month exercise program was prescribed for both groups including stretching and strengthening exercises. All patients were assessed at baseline and at 1 and 3 months post-intervention. Assessments were made by visual analog scale (VAS) for pain, range of motion (ROM) measurements, specific tests, and Shoulder Pain and Disability Index (SPADI). Significant differences were detected in VAS and SPADI scores as well as ROM measurements in both groups when compared to baseline (p > 0.05). No significant differences were detected between the groups except for active flexion degree in favor of group 1 (p = 0.004). Both kinesiological taping and steroid injection in conjunction with an exercise program were found to be effective in the treatment of SIS. Kinesio taping may be an alternative treatment option in the rehabilitation of SIS especially when a non-invasive technique is needed. PMID:25403253

  17. Hyperprolactinaemia - a risperidone side-effect.

    Grahovac, Tanja; Ruzić, Klementina; Medved, Paola; Pavesić-Radonja, Aristea; Dadić-Hero, Elizabeta

    2010-03-01

    A 47 year old patient has been treated for psychotic depression for the last 5 years. The illness began manifesting through the symptoms of depressive thoughts, intrapsychic tension, projectivity, derealisation phenomena and pre-psychotic fears. She was treated with a combination of antidepressives, anxiolitics and hypnotics in ambulatory conditions. The therapy applied did not obtain the effects expected due to which an atypical antipsychotic was administered subsequently - risperidone, a 2 mg dose in the evening. After commencing the antipsychotic treatment, the symptoms started to weaken and a steady remission was obtained. Two years after a regular risperidone administration (in combination with fluoxetine, alprazolam and flurazepam) the patient reported some "bleeding" in October 2006. Hormonal blood tests were performed and high prolactin values were registered (2567.0 mIJ/L),due to which a gradual risperidone retractement was indicated. Medicamentous hyperprolactinaemia is a well known side effect of risperidone. A gradual risperidone retractement lead to a lowered and normal prolactin level within a month. PMID:20305606

  18. A Comparison of Risperidone and Buspirone for Treatment of Behavior Disorders in Children with Phenylketonuria

    Afshin FAYYAZI

    2014-12-01

    and Lang W .Neurobehavioral Problems Associated with Phenylketonuria. Psychiatry (Edgemont 2009; 7(12:29–32.Luciana M, Hanson K L,Whitley C B.A preliminary report on dopamine system reactivity in PKU: acute effects of haloperidol on neuropsychological, physiological, and neuroendocrine functions. Psychopharmacology 2004;175: 18–25.Pappadopulos E, Woolston S, Chait A, Perkins M, Connor DF, Jensen P S. Pharmacotherapy of Aggression in Children and Adolescents: Efficacy and Effect Size. J CDN ACAD Child Adolesc Psychiatry 2006; 15(1:27-39.Shea S, Turgay A, Carroll A, Schulz M, Orlik H ,Smith I and et al. Risperidone in the Treatment of Disruptive Behavioral Symptoms in Children With Autistic and Other Pervasive Developmental Disorders. Pediatrcs 2004; 114:634-641.Miral S, Gencer O, Inal-Emiroglu F.N, Baykara B, Baykara A, Dirik E. Risperidone versus haloperidol in children and adolescents with AD: a randomized, controlled, doubleblind trial. Eur Child Adolesc Psychiatry 2008; 17:1–8.Aman M.G, Hollway J.A, McDougle C.J, Scahill L, Tierney E, McCracken J.T and et al. Cognitive effects of risperidone in children with autism and irritable behavior. J. Child Adolesc. Psychopharmacol 2008; 18:227–236.Pandina G.J, Bossie C.A, Youssef E, Zhu Y, Dunbar F. Risperidone improves behavioral symptoms in children with autism in a randomized, double-blind, placebocontrolled trial. J Autism Dev Disord 2007; 37:367–373.Luby J, Mrakotsky C, Stalets M.M, Belden A, Heffelfinger A, Williams M and et al. Risperidone in preschool children with autistic spectrum disorders: an investigation of safety and efficacy. J. Child Adolesc. Psychopharmacol 2006; 16:575–587.Nagaraj R, Singhi P, Malhi P. Risperidone in children with autism: randomized, placebo controlled, double blind study. J. Child Neurol 2006; 21:450–455.Haas M, Karcher K, Pandina GJ. Treating Disruptive Behavior Disorders with Risperidone: A 1-Year, Open-Label Safety Study in Children and Adolescents. Journal of Child and

  19. Treatment of anorexia nervosa with long-term risperidone in an outpatient setting: case study

    Kracke, Elsa J; Tosh, Aneesh K.

    2014-01-01

    Introduction There are currently few studies focusing on the efficacy of long-term atypical antipsychotics to treat anorexia nervosa in the pediatric population. Case description This case report follows the treatment of a 17 year-old female with anorexia nervosa over her four-year undergraduate career. After two years of multidisciplinary treatment, low-dose risperidone was initiated due to persistence of her disease. She expressed decreased rigidity around meal times, her weight improved an...

  20. Anti-depressive effectiveness of olanzapine, quetiapine, risperidone and ziprasidone: a pragmatic, randomized trial

    Løberg Else-Marie; Kroken Rune A; Jørgensen Hugo A; Kjelby Eirik; Johnsen Erik

    2011-01-01

    Abstract Background Efficacy studies indicate anti-depressive effects of at least some second generation antipsychotics (SGAs). The Bergen Psychosis Project (BPP) is a 24-month, pragmatic, industry-independent, randomized, head-to-head comparison of olanzapine, quetiapine, risperidone and ziprasidone in patients acutely admitted with psychosis. The aim of the study is to investigate whether differential anti-depressive effectiveness exists among SGAs in a clinically relevant sample of patient...

  1. Risperidone Versus Yokukansan in the Treatment of Severe Alzheimer’s Disease

    Yuko Furuhashi; Kouichi Shin

    2011-01-01

    PURPOSE: Patients with AD commonly exhibit behavioral and psychological symptoms of dementia (BPSD). This study is aimed to compare the efficacy of yokukansan (YKS) and risperidone (RIS) on BPSD in patients with severe Alzheimer’s disease (AD). METHODS: Thirty eight inpatients with AD were investigated. Patients were randomly as-signed to the YKS group (N = 18) or the RIS group (N = 20) and treated for 4 weeks. The primary outcomes were changes in the scores on the Neuropsychiatric Inventory ...

  2. Comparative efficacy and safety of local and systemic methotrexate injection in cesarean scar pregnancy

    Peng P

    2015-01-01

    Full Text Available Ping Peng,1 Ting Gui,1 Xinyan Liu,1 Weilin Chen,1 Zhenzhen Liu2 1Department of Obstetrics and Gynecology, 2Department of Ultrasonography, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China Objective: To investigate the efficacy of methotrexate (MTX injection in treatment of cesarean scar pregnancy (CSP. Method: A randomized controlled study was performed in 104 CSP patients receiving either local or systemic MTX injection at the Peking Union Medical College Hospital from the year 2008 to 2013. Results: Complete cure was defined as regression of ultrasonographic findings and normalization of serum β-hCG within 60 days. It was regarded as delayed cure if additional dilation and curettage (D&C was needed. The overall cure rate (complete cure plus delayed cure was 69.2% versus 67.3% for local injection versus systemic administration (P>0.05. The median time for serum β-hCG remission and uterine mass disappearance after systemic administration (42 [21–69] days and 40 [20–67] days were significantly lower than those receiving local injection (56 [24–92] days and 53 [23–88] days, with P=0.029 and 0.046, respectively. The mean pretreatment serum β-hCG (human chorionic gonadotropin level and lesion size in cured group (21,941±18,351 mIU/mL and 2.9±1.3 cm, respectively were significantly lower than those in the failed group (37,047±30,864 mIU/mL and 3.6±1.3 with P=0.038 and 0.044, respectively. Conclusion: MTX injection is effective in CSP treatment. Systemic administration shows similar overall cure rate compared to local injection, but requires shorter time for serum β-hCG remission and uterine mass disappearance. Keywords: cesarean scar pregnancy, methotrexate injection, local, systemic

  3. Study on the Long-term Efficacy and Security of Risperidone in the Treatment of Schizophrenia%利培酮治疗精神分裂症长期疗效和安全性对照研究

    杨保成

    2015-01-01

    Objective To summarize the long-term ef icacy and safety of risperidone treatment of schizophrenic patients, to find the best treatment for schizophrenia patients. Methods This research materials selection in February 2012~September 2014 in our hospital for diagnosis and treatment of 74 cases of schizophrenia patients, in a random method wil be divided into two groups, namely, the experimental group and control group. Of 37 cases of control group research object tolbutamide wil benefit as the main drug treatment, and 37 cases of experimental research object and ketone of culture as the main drug treatment, at the same time, contrast and analysis of two groups of subjects basic information such as long-term ef icacy and safety. Results The study found that the experimental group in such aspects as the research object in the long-term ef icacy and safety of has the absolute advantage, comparative dif erence is significant ( <0.05). Conclusion Clinical long-term ef icacy and safety of risperidone treatment of schizophrenia is significant, in addition to schizophrenic patients long-term treatment can ef ectively improve ef iciency, but also has the clinical advantages of smal side ef ects, it is recommended that promotion.%目的总结利培酮治疗精神分裂症长期疗效和安全性,寻找适合精神分裂症患者的最佳治疗方案。方法本次研究资料选取2012年2月~2014年9月在本院进行诊治的74例精神分裂症患者,以随机法将其划分成两个小组,即实验组以及对照组。其中,37例对照组研究对象以氨磺必利为主要药物进行治疗,而37例实验组研究对象则以利培酮为主要药物进行治疗,同时对比及分析两组研究对象长期疗效和安全性等基本信息。结果本次研究发现,实验组研究对象在长期疗效和安全性等方面都存在着绝对性优势,比较差异较为显著(<0.05)。结论临床上利培酮治疗精神分裂症长期疗效和安全性较

  4. Risperidone in the treatment of conduct disorder in preschool children without intellectual disability

    Durak Sibel

    2011-04-01

    Full Text Available Abstract Background The DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th edition Textrevision highlights the especially poor outcomes of early-onset conduct disorder (CD. The strong link between the patient's age at treatment and its efficacy points the importance of early intervention. Risperidone is one of the most commonly studied medications used to treat CD in children and adolescents. The aim of this study is to obtain preliminary data about the efficacy and tolerability of risperidone treatment in otherwise typically developing preschool children with conduct disorder and severe behavioral problems. Method We recruited 12 otherwise normally developing preschoolers (ten boys and two girls with CD for this study. We could not follow up with 4 children at control visits properly; thus, 8 children (six girls, two boys; mean age: 42.4 months completed the study. We treated the patients with risperidone in an open-label fashion for 8 weeks, starting with a daily dosage of 0.125 mg/day or 0.25 mg/day depending on the patient's weight (20 kg children: 0.25 mg/day. Dosage titration and increments were performed at 2-week interval clinical assessments. The Turgay DSM-IV Based Disruptive Behavior Disorders Child and Adolescent Rating & Screening Scale (T-DSM-IV-S as well as the Clinical Global Impression Scale (CGI assessed treatment efficacy; the Extrapyramidal Symptom Rating Scale (ESRS and laboratory evaluations assessed treatment safety. Results The mean daily dosage of risperidone at the end of 8 weeks was 0.78 mg/day (SD: 0.39 with a maximum dosage of 1.50 mg/day. Based on the CGI global improvement item, we classified all patients as "responders" (very much or much improved. Risperidone was associated with a 78% reduction in the CGI Severity score. We also detected significant improvements on all of the subscales of the T-DSM-IV-S. Tolerability was good, and serious adverse effects were not observed. We detected

  5. Efficacy and Tolerability of Fixed-Dose Combination of Dexketoprofen and Dicyclomine Injection in Acute Renal Colic

    Porwal, A.; A. D. Mahajan; Oswal, D. S.; Erram, S. S.; D. N. Sheth; Balamurugan, S.; V. Kamat; R. P. Enadle; Badadare, A.; Bhatnagar, S. K.; Walvekar, R. S.; Dhorepatil, S.; R. C. Naik; Basu, I; Kshirsagar, S. N.

    2012-01-01

    Objective. To evaluate the efficacy and tolerability of a fixed-dose combination of dexketoprofen and dicyclomine (DXD) injection in patients with acute renal colic. Patients and Methods. Two hundred and seventeen patients were randomized to receive either DXD (n = 109) or fixed-dose combination of diclofenac and dicyclomine injection (DLD; n = 108), intramuscularly. Pain intensity (PI) was self-evaluated by patients on visual analogue scale (VAS) at baseline and at 1, 2, 4, 6, and 8 hours. E...

  6. Efficacy and Safety of Intravesical OnabotulinumtoxinA Injection in Patients with Detrusor Hyperactivity and Impaired Contractility

    Chung-Cheng Wang; Cheng-Ling Lee; Hann-Chorng Kuo

    2016-01-01

    We investigated the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with detrusor hyperactivity and impaired contractility (DHIC). Twenty-one patients with urodynamically proven DHIC and 21 age-matched patients with overactive bladder (OAB) with urodynamic detrusor overactivity were treated with intravesical injections of 100 U of onabotulinumtoxinA. The overactive bladder symptom score, urgency severity score, patient perception of bladder condition, global respo...

  7. Efficacy of Silk Channel Injections with Insecticides for Management of Lepidoptera Pests of Sweet Corn.

    Sparks, A N; Gadal, L; Ni, X

    2015-08-01

    The primary Lepidoptera pests of sweet corn (Zea mays L. convar. saccharata) in Georgia are the corn earworm, Helicoverpa zea (Boddie), and the fall armyworm, Spodoptera frugiperda (J. E. Smith). Management of these pests typically requires multiple insecticide applications from first silking until harvest, with commercial growers frequently spraying daily. This level of insecticide use presents problems for small growers, particularly for "pick-your-own" operations. Injection of oil into the corn ear silk channel 5-8 days after silking initiation has been used to suppress damage by these insects. Initial work with this technique in Georgia provided poor results. Subsequently, a series of experiments was conducted to evaluate the efficacy of silk channel injections as an application methodology for insecticides. A single application of synthetic insecticide, at greatly reduced per acre rates compared with common foliar applications, provided excellent control of Lepidoptera insects attacking the ear tip and suppressed damage by sap beetles (Nitidulidae). While this methodology is labor-intensive, it requires a single application of insecticide at reduced rates applied ∼2 wk prior to harvest, compared with potential daily applications at full rates up to the day of harvest with foliar insecticide applications. This methodology is not likely to eliminate the need for foliar applications because of other insect pests which do not enter through the silk channel or are not affected by the specific selective insecticide used in the silk channel injection, but would greatly reduce the number of applications required. This methodology may prove particularly useful for small acreage growers. PMID:26470329

  8. Efficacy of Optical Internal Urethrotomy and Intralesional Injection of Vatsala-Santosh PGI Tri-Inject (Triamcinolone, Mitomycin C, and Hyaluronidase in the Treatment of Anterior Urethral Stricture

    Santosh Kumar

    2014-01-01

    Full Text Available Purpose. To study the efficacy of optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase in the treatment of anterior urethral stricture. Material and Methods. A total of 103 patients with symptomatic anterior urethral stricture were evaluated on the basis of clinical history, physical examination, uroflowmetry, and retrograde urethrogram preoperatively. All patients were treated with optical internal urethrotomy followed by injection of tri-inject at the urethrotomy site. Tri-inject was prepared by diluting the combination of triamcinolone 40 mg, mitomycin C 2 mg, and hyaluronidase 3000 in 5–10 mL of saline according to length of stricture. An indwelling 18 Fr silicone catheter was left in place for a period of 7–21 days. All patients were followed up for 6–18 months postoperatively on the basis of history, uroflowmetry, and, if required, retrograde urethrogram and micturating urethrogram every 3 months. Results. The overall recurrence rate after first OIU is 19.4% (20 out of 103 patients, that is, a success rate of 80.6%. Overall recurrence rate after second procedure was 5.8% (6 out of 103 patients, that is, a success rate of 94.2%. Conclusion. Optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase is a safe and effective minimally invasive therapeutic modality for short segment anterior urethral strictures.

  9. 小剂量利培酮强化抗抑郁剂治疗双相抑郁发作的疗效和安全性研究%Efficacy and safety of low dosage risperidone added on valproate and citalopram in the treatment of acute bipolar depression

    王健; 王刚; 马辛

    2014-01-01

    目的考察小剂量利培酮强化抗抑郁剂治疗对双相抑郁发作的疗效和安全性。方法符合入组标准的住院患者,先接受2周的丙戊酸钠( valproate,VPA)合并西酞普兰( citalopram,CIT)治疗。2周末相对于基线的蒙哥马利抑郁量表( Montgomery and Asberg Depression Scale,MADRS)减分率0.05)。 CGI-I 2组对比,差异具有统计学意义(P0.05)。随机治疗第1周末BPRS阳性因子评分VPA+CIT+RIS组较VPA+CIT组明显降低,差异有统计学意义(P<0.05),显示VPA+CIT+RIS组较VPA+CIT组在改善阳性精神病性症状方面起效更快。在随机治疗第2周,VPA+CIT+RIS组有效率为66.0%,VPA+CIT组为33.3%,显示VPA+CIT+RIS组较VPA+CIT组起效更快。结论 VPA+CIT+RIS与VPA+CIT治疗双相抑郁发作均安全有效。在快速起效及降低转相风险方面,VPA+CIT+RIS组优于VPA+CIT组。%Objective To evaluate the augmentation efficacy and safety of low dosage risperidone, added on the usual treatment ( valproate and citalopram) in the acute treatment of bipolar depression. Methods A total of 46 inpatients with a diagnostic criteria for acute depression episode with bipolar disorder according to DSM-IV-TR were first given valproate and citalopram treatment. The subjects who achieve little clinical response( i. e. reduction from baseline in total MADRS score by<50%) at the end of 2-week will enter into the randomized open-label 6-week treatment phase. The eligible subjects will be randomized to treatment with valproate & citalopram or valproate & citalopram & risperidone in a 1:1 ratio. Efficacy rating scales to be used in the study include MADRS, YMRS, BPRS( total score and positive subscale), CGI-S, and CGI-I. The evaluations of safety and tolerability include SAS, treatment-emergent mania, clinical laboratory tests, vital signs , ECG, and adverse events reports. Results At the end of treatment, the scores of MADRS, BPRS, GIC-I, and CGI-S in both treatment groups decreased significantly compared

  10. Efficacy of multimodal cocktail periarticular injection with or without steroid in total knee arthroplasty

    YUE De-bo; WANG Bai-liang; LIU Kun-peng; GUO Wan-shou

    2013-01-01

    Background Multimodal cocktail periarticular injection (MCPI) with a large volume of low concentration local anesthetics,adrenaline,and anti-inflammatory agents such as non-steroidal anti-inflammatory drug or steroids have shown good pain control and improvement in range of motion after surgery.This study compares the efficacy of pain control after total knee arthroplasty,using multimodal cocktail periarticular injection with steroid or without steroid.Methods This is a prospective,double-blinded,randomized and control study.Seventy-two patients with osteoarthritis that met clinical criteria for total knee arthroplasty were recruited into the study,and were randomized to receive either multimodal cocktail periarticular injection with steroid or without steroid.Pain was assessed by visual analogue scale (VAS) at preoperative and postoperative at rest,and during activity.The range of motion was recorded preoperatively and postoperatively.The amount of daily and cumulative morphine consumption were measured by patient-controlled analgesia in the first 72 hours postoperatively.The duration of celecoxib usage was also recorded at the last follow-up.Results There were no differences between the non-steroid and steroid groups with regard to VAS at rest and during activity,or range of motion,at any postoperative observation time.The postoperative Knee Society Knee Score in the steroid group improved significantly as compared with that in non-steroid group at the one-month (84.1±13.1 and 65.9±12.1; P <0.0045),three-month follow-up (90.2±16.3 and 72.5±16.6; P <0.0027),but after postoperative six-month the Knee Society Knee Score showed no significant difference between the groups.There was no significant difference in consumption of the morphine about daily or total consumption within 72 hours between the two groups.The duration of celecoxib usage in patients in the steroid group was significantly shorter than that in the non-steroid group ((7.2±0.7) compared with

  11. Risperidone treatment increases CB1 receptor binding in rat brain

    Secher, Anna; Husum, Henriette; Holst, Birgitte;

    2010-01-01

    showed that risperidone treatment altered CB(1) receptor binding in the rat brain. Risperidone-induced adiposity and metabolic dysfunction in the clinic may be explained by increased CB(1) receptor density in brain regions involved in appetite and regulation of metabolic function....... positively correlated with visceral fat mass. Risperidone treatment increased CB(1) receptor binding in the arcuate nucleus (40%), hippocampus (25-30%) and amygdala (35%) without concurrent alterations in the CB(1) receptor mRNA. Risperidone treatment increased adiponectin mRNA. CONCLUSION: The present study...

  12. Efficacy of injections of phosphatidylcholine into fat deposits-a non-surgical alternative to liposuction in body-contouring

    Karl-G Heinrich

    2005-01-01

    Full Text Available Injecting phosphatidylcholine has been used in South America as a non-surgical treatment in body contouring. The objective of this study was to demonstrate the efficacy of injecting phosphatidylcholine in the reduction of localised fat deposits. 86 patients were included in the study. Patients received 1-3 treatments in localised fat deposits in various areas of the body using phosphatidylcholine. After treatment with phosphatidylcholine (250 mg / 5 ml, fat deposits show an average circumferential reduction per application of 2.70 cm. No patient showed irregularities, dimples or any serious side effect after treatment. Results remained stable during the time of follow up. All patients showed remarkable reductions of the fat deposits treated with phosphatidylcholine. Using the correct technique, injecting phosphatidylcholine may be a safe and efficacious alternative to liposuction in patients objecting to surgery.

  13. Flash Chromatography Application for Risperidone Purification

    Trush, G. S.; Halkevych, I. Y.

    2015-01-01

    Relevance. Biological samples for forensic-chemical investigation are complicated multi-component systems.Aim of our investigations is the study of robustness and validity of purification technique applying the flash chromatography for purification of acidic extracts from biological tissues.Methods and results. It is established that 78.4 – 83.4 % of risperidone was isolated from liver tissues by water acidified with oxalic acid, than proteins precipitated by ammonia sulphate, and finally pur...

  14. Risperidone in the treatment of bipolar mania

    Sajatovic, Martha; Subramoniam, Madhusoodanan; Fuller, Matthew A

    2006-01-01

    Atypical antipsychotic medications have assumed growing importance for the treatment of bipolar disorder, an illness that affects approximately 1.2%–3.7% of the general population in a given year. Current practice guidelines for the treatment of bipolar mania support the use of atypical antipsychotic medications as monotherapy or as a component of polytherapy, and in clinical settings the use of atypical antipsychotics to treat bipolar disorder is widespread. Risperidone is an atypical antips...

  15. Efficacy of oral and intraperitoneal administration of CBMIDA for removing uranium in rats after parenteral injections of depleted uranium

    The efficacy of oral administration of the chelating agent catechol-3, 6-bis(methyliminodiacetic acid) (CBMIDA) for removing uranium from rats after intraperitoneal (i.p.) and intramuscular (i.m.) injections of depleted uranium (DU) was examined and the results with those by the i.p. injection of CBMIDA were compared. In Experiment 1, after a single i.p. injection of 8 mg kg-1 of DU of rat's body weight, 35 8-week-old male rats were divided into seven groups consisting of five rats each. Three groups were administered with CBMIDA 240, 720 or 1200 mg kg-1 of rat's body weight orally once a day, and three other groups received an i.p. injection of 240, 480 or 720 mg kg-1 CBMIDA for 3 d, starting 30 min after DU injection on the first day. One DU group received no CBMIDA. The remaining five intact rats were used as a control group. Rats were killed 6 d after DU injection. In Experiment 2, the 35 male rats that received a single i.m. injection of 8 mg kg-1 DU were divided into seven groups, and the rats of each group received the same doses of CBMIDA on the same schedules of treatment as those described in Experiment 1. The results obtained in Experiment 1 indicated that orally administered CBMIDA significantly increased the excretion of uranium at doses of 720 and 1200 mg kg-1 and decreased uranium concentrations, particularly in the kidney, at all the doses tested, and the effects were almost equal to those of the i.p. injection. The lack of increases in creatinine and blood urea nitrogen in serum indicated that CBMIDA is efficacious in preventing the renal dysfunction caused by uranium. In Experiment 2, oral administration of CBMIDA significantly increased uranium excretion and significantly decreased uranium concentrations, particularly in the kidneys, at all the doses tested, and the effects were almost equal to those of the i.p. injection. However, these effects of CBMIDA on the i.m.-injected DU were lower than those of the i.p.-injected DU in Experiment 1. These

  16. Efficacy and Safety of Intravesical OnabotulinumtoxinA Injection in Patients with Detrusor Hyperactivity and Impaired Contractility.

    Wang, Chung-Cheng; Lee, Cheng-Ling; Kuo, Hann-Chorng

    2016-03-01

    We investigated the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with detrusor hyperactivity and impaired contractility (DHIC). Twenty-one patients with urodynamically proven DHIC and 21 age-matched patients with overactive bladder (OAB) with urodynamic detrusor overactivity were treated with intravesical injections of 100 U of onabotulinumtoxinA. The overactive bladder symptom score, urgency severity score, patient perception of bladder condition, global response assessment, voiding diary, and procedure-related adverse events (AE) at baseline, two weeks, one, three, and six months after treatment were assessed. The results showed that the subjective symptom scores improved significantly in both groups, and the scores did not differ between the groups. The decrease in urgency episodes and urgency urinary incontinence were noted in OAB patients but not in DHIC patients. Although the incidence of AEs was comparable between the groups, the therapeutic efficacy lasted for a mean of 4.9 ± 4.8 months in DHIC patients and 7.2 ± 3.3 months in OAB patients (p = 0.03). We concluded that the efficacy of intravesical onabotulinumtoxinA injection for DHIC patients was limited and short-term. Nevertheless, AEs did not increase in DHIC. Intravesical onabotulinumtoxinA might not be a good indication in patients with DHIC and high post-voiding residual urine. Physicians should inform patients of the potential benefits and risks of onabotulinumtoxinA injection for treatment of DHIC. PMID:26999209

  17. Efficacy and Safety of Intravesical OnabotulinumtoxinA Injection in Patients with Detrusor Hyperactivity and Impaired Contractility

    Chung-Cheng Wang

    2016-03-01

    Full Text Available We investigated the efficacy and safety of intravesical onabotulinumtoxinA injection in patients with detrusor hyperactivity and impaired contractility (DHIC. Twenty-one patients with urodynamically proven DHIC and 21 age-matched patients with overactive bladder (OAB with urodynamic detrusor overactivity were treated with intravesical injections of 100 U of onabotulinumtoxinA. The overactive bladder symptom score, urgency severity score, patient perception of bladder condition, global response assessment, voiding diary, and procedure-related adverse events (AE at baseline, two weeks, one, three, and six months after treatment were assessed. The results showed that the subjective symptom scores improved significantly in both groups, and the scores did not differ between the groups. The decrease in urgency episodes and urgency urinary incontinence were noted in OAB patients but not in DHIC patients. Although the incidence of AEs was comparable between the groups, the therapeutic efficacy lasted for a mean of 4.9 ± 4.8 months in DHIC patients and 7.2 ± 3.3 months in OAB patients (p = 0.03. We concluded that the efficacy of intravesical onabotulinumtoxinA injection for DHIC patients was limited and short-term. Nevertheless, AEs did not increase in DHIC. Intravesical onabotulinumtoxinA might not be a good indication in patients with DHIC and high post-voiding residual urine. Physicians should inform patients of the potential benefits and risks of onabotulinumtoxinA injection for treatment of DHIC.

  18. Treatment Efficacy of Electromyography versus Fiberscopy-Guided Botulinum Toxin Injection in Adductor Spasmodic Dysphonia Patients: A Prospective Comparative Study

    Jae Wook Kim

    2014-01-01

    Full Text Available Introduction. This study prospectively evaluates and compares the treatment efficacy of botulinum toxin injection under electromyography guidance (EMG group and percutaneous botulinum toxin injection under flexible fiberscopic guidance (fiberscopy group. Methods. Thirty patients with adductor spasmodic dysphonia (ADSD, who had never received treatment, were randomly allocated into EMG- or fiberscopy-guided botulinum toxin injections between March 2008 and February 2010. We assessed acoustic and aerodynamic voice parameters, and the voice handicap index (VHI before injection and at 1, 3, and 6 months after injection. Results. The mean total dosage of botulinum toxin was similar for both groups: 1.7 ± 0.5 U for the EMG group and 1.8 ± 0.4 U for the fiberscopy group (P>0.05. There were no significant differences in outcomes between the two groups in either the duration of effectiveness or complications such as breathy voice and aspiration. Conclusion. Botulinum toxin injection under fiberscopic guidance is a viable alternative to EMG-guided botulinum toxin injection for the treatment of adductor spasmodic dysphonia when EMG equipment is unavailable.

  19. Preparation and Biological Evaluation of Radioiodinated Risperidone and Lamotrigine as Models for Brain Imaging

    Brain imaging technology is becoming an important tool in both research and clinical care. Due to the sensitivity of brain imaging technology, neuroscientists are able to visualize brain structure and function from the level of individual molecules to the whole brain, recognize and diagnose neurological disorders, develop new strategies for treatment and determine how therapies work. The study aimed to take advantages from drugs that are able to cross the brain barrier for the development of potential radiopharmaceuticals for non-invasive brain imaging. Risperidone and lamotrigine were successfully labeled with 125I via direct electrophilic substitution reaction at 80 degree C. The reaction parameters affecting the preparation process were studied. 125I-risperidone and 125I-lamotrigine gave maximum labeling yield of 89 % ± 3.75 and 97.5 % ± 1.0 %, respectively and their stability were up to 6 and 24 h, respectively. Biodistribution studies showed that maximum uptake of 125I-risperidone and 125I-lamotrigine in the brain of mice were 4.27 % ± 0.38 and 2.45 % ± 0.18 of the injected activity/g tissue organ, at 10

  20. Risperidone-associated ejaculatory and urinary dysfunction in male adolescents.

    Holtmann, Martin; Gerstner, Sandra; Schmidt, Martin H

    2003-01-01

    We report two male adolescents who developed partial or complete retrograde ejaculation during risperidone treatment. Additionally, one patient complained of bladder outflow obstruction, and the other reported a reduced ejaculatory volume and decreased viscosity of semen. On rechallenge with risperidone, patient A showed a prompt recurrence of the ejaculatory dysfunction. The side effects were highly disturbing and led to reduced treatment compliance in both patients. The impact of risperidone, a strong alpha(1)-receptor antagonist, on the adrenergic system might induce retrograde ejaculation by altering the sympathetic tonus, allowing semen to pass retrogradely into the bladder during ejaculation. The reduced ejaculatory volume may be caused by risperidone-induced hyperprolactinemia. Clinicians should regularly inquire about sexual dysfunction and symptoms suggestive of hyperprolactinemia before starting risperidone treatment and regularly thereafter. PMID:12804132

  1. Effects of Environmental Manipulations and Treatment with Bupropion and Risperidone on Choice between Methamphetamine and Food in Rhesus Monkeys.

    Banks, Matthew L; Blough, Bruce E

    2015-08-01

    Preclinical and human laboratory choice procedures have been invaluable in improving our knowledge of the neurobiological mechanisms of drug reinforcement and in the drug development process for candidate medications to treat drug addiction. However, little is known about the neuropharmacological mechanisms of methamphetamine vs food choice. The aims of this study were to develop a methamphetamine vs food choice procedure and determine treatment effects with two clinically relevant compounds: the monoamine uptake inhibitor bupropion and the dopamine antagonist risperidone. Rhesus monkeys (n=6) responded under a concurrent schedule of food delivery (1-g pellets, fixed-ratio (FR) 100 schedule) and intravenous methamphetamine injections (0-0.32 mg/kg/injection, FR10 schedule) during 7-day bupropion (0.32-1.8 mg/kg/h) and risperidone (0.001-0.0056 mg/kg/h) treatment periods. For comparison, effects of removing food pellets or methamphetamine injections and FR response requirement manipulations were also examined. Under saline treatment conditions, food was preferred over no methamphetamine or small unit methamphetamine doses (0.01-0.032 mg/kg/injection). Larger methamphetamine doses resulted in greater methamphetamine preference and 0.32 mg/kg/injection methamphetamine maintained near exclusive preference. Removing food availability increased methamphetamine choice, whereas removing methamphetamine availability decreased methamphetamine choice. Methamphetamine choice was not significantly altered when the FR response requirements for food and drug were the same (FR100:FR100 or FR10:FR10). Risperidone treatment increased methamphetamine choice, whereas bupropion treatment did not alter methamphetamine choice up to doses that decreased rates of operant behavior. Overall, these negative results with bupropion and risperidone are concordant with previous human laboratory and clinical trials and support the potential validity of this preclinical methamphetamine vs food

  2. A Double-Blind, Placebo-Controlled Study of Risperidone for the Treatment of Adolescents and Young Adults with Anorexia Nervosa: A Pilot Study

    Hagman, Jennifer; Gralla, Jane; Sigel, Eric; Ellert, Swan; Dodge, Mindy; Gardner, Rick; O'Lonergan, Teri; Frank, Guido; Wamboldt, Marianne Z.

    2011-01-01

    Objective: The purpose of this double-blind, placebo-controlled exploratory pilot study was to evaluate the safety and efficacy of risperidone for the treatment of anorexia nervosa. Method: Forty female subjects 12 to 21 years of age (mean, 16 years) with primary anorexia nervosa in an eating disorders program were randomized to receive…

  3. Efficacy of a single ultrasound-guided injection for the treatment of hip osteoarthritis.

    Atchia, Ismaël

    2011-01-01

    Intra-articular injection is effective for osteoarthritis, but the best single injection strategy is not known, nor are there established predictors of response. The objectives of this study were to assess and predict response to a single ultrasound-guided injection in moderate to severe hip osteoarthritis.

  4. Efficacy and Tolerability of Fixed-Dose Combination of Dexketoprofen and Dicyclomine Injection in Acute Renal Colic

    A. Porwal

    2012-01-01

    Full Text Available Objective. To evaluate the efficacy and tolerability of a fixed-dose combination of dexketoprofen and dicyclomine (DXD injection in patients with acute renal colic. Patients and Methods. Two hundred and seventeen patients were randomized to receive either DXD (n=109 or fixed-dose combination of diclofenac and dicyclomine injection (DLD; n=108, intramuscularly. Pain intensity (PI was self-evaluated by patients on visual analogue scale (VAS at baseline and at 1, 2, 4, 6, and 8 hours. Efficacy parameters were proportion of responders, difference in PI (PID at 8 hours, and sum of analogue of pain intensity differences (SAPID. Tolerability was assessed by patients and physicians. Results. DXD showed superior efficacy in terms of proportion of responders (98.17% versus 81.48; P<0.0001, PID at 8 hours (P=0.002, and SAPID0–8 hours (P=0.004. The clinical global impression for change in pain was significantly better for DXD than DLD. The incidence of adverse events was comparable in both groups. However, global assessment of tolerability was rated significantly better for DXD. Conclusion. DXD showed superior efficacy and tolerability than DLD in patients clinically diagnosed to be suffering from acute renal colic.

  5. Spectrophotometric estimation of risperidone in tablets

    B. K. Jayanna; Devaraj, T. D.; Roopa, K. P.; G. Nagendrappa; H R Arun Kumar; Gowda, N.

    2014-01-01

    A simple, rapid and highly sensitive spectrophotometric method is developed for the determination of risperidone in tablet formulation. The method is based on the oxidation of drug using potassium permanganate in alkaline medium and excess potassium permanganate oxidizes 1,10-phenanthroline Fe(II). The measurement of decrease in absorbance of 1,10-phenanthroline Fe (II) was done at 415 nm. The beer′s law is obeyed in the concentration range of 5.0 to 40.0 μg/ml and molar absorptivity is found...

  6. Evaluation of the long-term efficacy of CT-guided epidural steroid injection for the treatment of sciatica

    Objective: To evaluate the long-term efficacy of CT-guided epidural steroid injection for the treatment of sciatica. Methods: CT-guided epidural steroid injection was performed in 180 patients with sciatica from May 1998 to March 2004, and all patients had failure to previous conservative treatment. Visual analogue scale was used to evaluate the pain of the patient before and after the treatment. Results: Follow-up was taken for 112 cases during 1-6 years after the treatment, 89 patients (79.5%) had successful long-term outcome and 80 patients (71.4%) were satisfied. Conclusions: CT-guided epidural steroid injection can reduce low back pain and radical pain. It should be preferentially considered as the first choice when conservative treatments are failed. (authors)

  7. Efficacy and safety of 10,600-nm carbon dioxide fractional laser on facial skin with previous volume injections

    Josiane Hélou

    2013-01-01

    Full Text Available Background: Fractionated carbon dioxide (CO 2 lasers are a new treatment modality for skin resurfacing. The cosmetic rejuvenation market abounds with various injectable devices (poly-L-lactic acid, polymethyl-methacrylate, collagens, hyaluronic acids, silicone. The objective of this study is to examine the efficacy and safety of 10,600-nm CO 2 fractional laser on facial skin with previous volume injections. Materials and Methods: This is a retrospective study including 14 patients treated with fractional CO 2 laser and who have had previous facial volume restoration. The indication for the laser therapy, the age of the patients, previous facial volume restoration, and side effects were all recorded from their medical files. Objective assessments were made through clinical physician global assessment records and improvement scores records. Patients′ satisfaction rates were also recorded. Results: Review of medical records of the 14 patients show that five patients had polylactic acid injection prior to the laser session. Eight patients had hyaluronic acid injection prior to the laser session. Two patients had fat injection, two had silicone injection and one patient had facial thread lift. Side effects included pain during the laser treatment, post-treatment scaling, post-treatment erythema, hyperpigmentation which spontaneously resolved within a month. Concerning the previous facial volume restoration, no granulomatous reactions were noted, no facial shape deformation and no asymmetry were encountered whatever the facial volume product was. Conclusion: CO 2 fractional laser treatments do not seem to affect facial skin which had previous facial volume restoration with polylactic acid for more than 6 years, hyaluronic acid for more than 0.5 year, silicone for more than 6 years, or fat for more than 1.4 year. Prospective larger studies focusing on many other variables (skin phototype, injected device type are required to achieve better

  8. Efficacy of Methylprednisolone Acetate Injection for the Treatment of Plantar Heel Pain

    S. Abdolhossein Mehdi-Nasab

    2014-01-01

    Full Text Available Background: To assess the short term results of local methyl prednisolone acetate injection for the treatment of heel pain syndrome. Materials and Methods: This prospective study was carried out on 109 patients with plantar heel pain who were treated by local methyl prednisolone acetate injection. Reduction of pain and tenderness were the primary measurement outcome. Results: Rest pain, walking pain and tenderness at 3 weeks was relived in 70 and 67 and 74 patients, and after 3 months in 72, 68 and 81 patients respectively. Mean patient's pain score was 8.2±2.2 before injection, 4.1±1.5 at 3 weeks, and 3.9±1.4 at 3 months after injection. Conclusion: Local injection of methyl prednisolone acetate was associated with a fairly high satisfactory short term results in the treatment of heel pain.

  9. Efficacy of localised DTPA treatment for decorporation of Np injected intramuscularly as Np(IV) or Np(V)

    The efficacy of DTPA treatment for intramuscularly administered Np(IV) citrate and Np(V) in 0.1 M HNO3 was investigated in rats. Chelation treatment was performed near the site of the Np injection, at different post-injection times. For wounds contaminated with Np(IV) citrate, significant Np decorporation was obtained when treatment was performed at 2 min. Treatment efficacy gradually decreased with treatment delay and no decorporation was observed if treatment was delayed by 1 h. All other treatments were performed 20 min after the i.m. Np injection. Similar decorporation, 20 to 30% of administered Np(IV), was observed over range of Np mass from 10-4 to 10μg, but no decorporation of Np(V) was observed. Taking account of the biokinetics of Np(IV) and Np(V), it seems that most of the present results can be explained by the kinetics of Np deposition in the skeleton, which depends on the Np valence. (author)

  10. Better efficacy of methotrexate given by intramuscular injection than orally in patients with rheumatoid arthritis

    J. Wegrzyn; ADELEINE,P; Miossec, P

    2004-01-01

    Objective: To compare the clinical efficacy of methotrexate and tolerance to the drug in patients with rheumatoid arthritis who were switched from intramuscular to oral administration because of a shortage of the intramuscular preparation.

  11. Cervical interlaminar epidural steroid injection for unilateral cervical radiculopathy: Comparison of midline and paramedian approaches for efficacy

    Yoon, Ji Young; Kwon, Jong Won; Yoon, Young Cheol [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); Lee, Jong Seok [School of Business Administration, Hallym University, Chuncheon (Korea, Republic of)

    2015-06-15

    The objective of this study was to compare the clinical outcomes of the cervical interlaminar epidural steroid injection (CIESI) for unilateral radiculopathy by the midline or paramedian approaches and to determine the prognostic factors of CIESI. We retrospectively analyzed 182 patients who underwent CIESI from January 2009 to December 2012. Inclusion criteria were no previous spinal steroid injection, presence of a cross-sectional image, and presence of follow-up records. Exclusion criteria were patients with bilateral cervical radiculopathy and/or dominant cervical axial pain, combined peripheral neuropathy, and previous cervical spine surgery. Short-term clinical outcomes were evaluated at the first follow-up after CIESI. We compared the clinical outcomes between the midline and paramedian approaches. Possible prognostic factors for the outcome, such as age, gender, duration of radiculopathy, and cause of radiculopathy were also analyzed. Cervical interlaminar epidural steroid injections were effective in 124 of 182 patients (68.1%) at the first follow-up. There was no significant difference in the clinical outcomes of CIESI, between midline (69.6%) and paramedian (63.7%) approaches (p = 0.723). Cause of radiculopathy was the only significant factor affecting the efficacy of CIESI. Patients with disc herniation had significantly better results than patients with neural foraminal stenosis (82.9% vs. 56.0%) (p < 0.001). There is no significant difference in treatment efficacy between the midline and paramedian approaches in CIESI, for unilateral radiculopathy. The cause of the radiculopathy is significantly associated with the treatment efficacy; patients with disc herniation experience better pain relief than those with neural foraminal stenosis.

  12. Cervical interlaminar epidural steroid injection for unilateral cervical radiculopathy: Comparison of midline and paramedian approaches for efficacy

    The objective of this study was to compare the clinical outcomes of the cervical interlaminar epidural steroid injection (CIESI) for unilateral radiculopathy by the midline or paramedian approaches and to determine the prognostic factors of CIESI. We retrospectively analyzed 182 patients who underwent CIESI from January 2009 to December 2012. Inclusion criteria were no previous spinal steroid injection, presence of a cross-sectional image, and presence of follow-up records. Exclusion criteria were patients with bilateral cervical radiculopathy and/or dominant cervical axial pain, combined peripheral neuropathy, and previous cervical spine surgery. Short-term clinical outcomes were evaluated at the first follow-up after CIESI. We compared the clinical outcomes between the midline and paramedian approaches. Possible prognostic factors for the outcome, such as age, gender, duration of radiculopathy, and cause of radiculopathy were also analyzed. Cervical interlaminar epidural steroid injections were effective in 124 of 182 patients (68.1%) at the first follow-up. There was no significant difference in the clinical outcomes of CIESI, between midline (69.6%) and paramedian (63.7%) approaches (p = 0.723). Cause of radiculopathy was the only significant factor affecting the efficacy of CIESI. Patients with disc herniation had significantly better results than patients with neural foraminal stenosis (82.9% vs. 56.0%) (p < 0.001). There is no significant difference in treatment efficacy between the midline and paramedian approaches in CIESI, for unilateral radiculopathy. The cause of the radiculopathy is significantly associated with the treatment efficacy; patients with disc herniation experience better pain relief than those with neural foraminal stenosis.

  13. Increasing the efficacy of antitumor glioma vaccines by photodynamic therapy and local injection of allogeneic glioma cells

    Christie, Catherine E.; Peng, Qian; Madsen, Steen J.; Uzal, Francisco A.; Hirschberg, Henry

    2016-03-01

    Immunotherapy of brain tumors involves the stimulation of an antitumor immune response. This type of therapy can be targeted specifically to tumor cells thus sparing surrounding normal brain. Due to the presence of the blood-brain barrier, the brain is relatively isolated from the systemic circulation and, as such, the initiation of significant immune responses is more limited than other types of cancers. The purpose of this study was to show that the efficacy of tumor primed antigen presenting macrophage vaccines could be increased by: (1) PDT of the priming tumor cells, and (2) injection of allogeneic glioma cells directly into brain tumors. Experiments were conducted in an in vivo brain tumor model using Fisher rats and BT4C (allogeneic) and F98 (syngeneic) glioma cells. Preliminary results showed that vaccination alone had significantly less inhibitory effect on F98 tumor growth compared to the combination of vaccination and allogeneic cell (BT4C) injection.

  14. Efficacy of fingolimod is superior to injectable disease modifying therapies in second-line therapy of relapsing remitting multiple sclerosis

    Braune, Stefan; Lang, M.; Bergmann, A; ,

    2015-01-01

    Although fingolimod is registered in Europe for treatment of relapsing-remitting multiple sclerosis (RRMS) if earlier disease modifying therapy (DMT) has failed, no data regarding its efficacy in this patient group are available. This observational cohort study of the NeuroTransData network includes German RRMS outpatients with failure of earlier therapy with injectable DMT (iDMT), therefore switching to either another iDMT (n = 133) or to fingolimod (n = 300). Statistical comparison of clini...

  15. Clinical Controlled Study on the Effect of Risperidone Microsphere on Schizophrenia%利培酮微球治疗精神分裂症疗效的临床对照研究

    秦国兴; 甘建光; 田国强

    2013-01-01

    score differences ≤5 were selected as control group. The experiment group was given long - acting injection of 25. 0 mg or 37. 5 mg risperidone microspheres by intramuscular injection once every two weeks. While the control group was given 1 mg risperidone tablets two times a day per os, and the amount was increased to 3 ~6 mg/d within one week. The dosage, PANSS score, efficiency and adverse e-vents were observed in the two groups. Results The average dose of long - acting risperidone injection microsphere in the 2nd, 4th, and 6th month was respectively ( 31. 2 ± 7. 0 ) mg/2 weeks, (33.8 ±6.6) mg/2 weeks, ( 30. 2 ±7. 0 ) mg/2 weeks and the average dose of risperidone tablets in control group was (4.5 ±1.0) mg/d ,(4.1 ±0.8) mg/d, ( 4. 1 ± 0. 9 ) mg/d. The PANSS scores at different times before and after treatment in the two groups showed statistically significant differences ( Ftime = 53. 34, P (). 05 ) . The PANSS scores before treatment in both the two groups showed statistically significant differences compared with those in the 2nd, 4th and 6th month after treatment ( P 0. 05 ) . Conclusion Injections of long - acting risperidone microsphere and risperidone tablets have equivalent efficacy and safety, so it is a good choice for us to use the long - acting antipsychotic drug injection as a maintenance treatment of schizophrenia due to its inherent advantages of coerciveness.

  16. Risperidone as a treatment for childhood habitual behavior

    Omranifard, Victoria; Najafi, Mostafa; Sharbafchi, Mohammad Reza; Emami, Parisa; Maracy, Mohammad

    2013-01-01

    Objective: The aim of this study was to investigate the effect of adding risperidone to the general behavioral treatment of masturbation in children 3-7 years old. Methods: A 4 week randomized clinical controlled trial was designed in year 2009. Samples have been chosen from children who have been referred to the Child and Adolescence Psychiatric Clinic of Isfahan University of Medical Sciences. Ninety children were recruited at the study and randomly allocated into the risperidone and contro...

  17. Pu and Am decorporation in beagles: effects of magnitude of initial Ca-DTPA injection upon chelation efficacy

    To investigate the effects of magnitude of initial DTPA injection upon chelation efficacy, five young adult beagles were each given an intravenous injection of 237+239Pu(IV) citrate + 241Am(III) citrate, followed by a single intravenous injection of Ca-DTPA 0.5 hr later. Amounts of this chelating agent administered were 3, 10, 30, 100, and 300 μmole Ca-DTPA/kg body mass. Animals were sacrificed 7 days later. Total-body retention of both plutonium and americium was influenced strongly by the amount of DTPA administered, although the removal of Pu by DTPA was less pronounced than that of Am; and in the range of 30 μmole/kg, an increase of DTPA administration by a factor of 2 resulted in only a 25% decrease in residual body content. Plutonium retention at 7 days was reduced from about 77% in the dog given 3 μmole/kg to 14% in the animal injected with 300 μmole/kg. Corresponding values for americium were 40 and 9%. Also, liver content of both Pu and Am was reduced significantly by larger amounts of administered DTPA, decreasing from 18 to 2% for Pu with increasing levels of DTPA, and from 21 to 1% for Am. If there is a level of Ca-DTPA administration at 30 min after injection in a beagle at which no additional chelation of Pu or Am is produced with increasing dosage, it is greater than 300 μmole/kg. In a 70-kg human, this would be equivalent to the injection of 10 g Ca-DTPA

  18. Comparison of the efficacy of physical therapy and corticosteroid injection in the treatment of pes anserine tendino-bursitis.

    Sarifakioglu, Banu; Afsar, Sevgi Ikbali; Yalbuzdag, Seniz Akcay; Ustaömer, Kubra; Bayramoğlu, Meral

    2016-07-01

    [Purpose] The aims of this study were twofold. The first was to compare the functional capacity and pain of patients with knee osteoarthritis (KOA), with or without pes anserine tendino-bursitis (PATB). The second is to compare the efficacy of two treatment methods (physical therapy and corticosteroid injection) for patients with PATB. [Subjects and Methods] Sixty patient with KOA and PATB (Group 1) and 57 patients with KOA but without PATB (Group 2) were enrolled in the study. The patients' visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores and three-meter timed-up and go scores were measured. The PATB group was randomly divided into two groups (Group A and B). Physical therapy (PT) modalities were applied to the first group (Group A), and the second group (Group B) received corticosteroid injections to the pes anserine area. Eight weeks later, patients' parameters were measured again. [Results] Initial WOMAC scores and timed up-and-go times were significantly higher in Group 1 than in Group 2. Both treatments resulted in significant improvements in all measured parameters, but no significant difference was detected between Group A and B. [Conclusion] Patients with PATB tend to have more severe pain, more altered functionality, and greater disability than those with KOA but without PATB. Both corticosteroid injection and PT are effective methods of treatment for PATB. Injection therapy can be considered an effective, inexpensive and fast therapeutic method. PMID:27512249

  19. Very Low-Dose Risperidone in First-Episode Psychosis: A Safe and Effective Way to Initiate Treatment

    Patrick D. McGorry

    2011-01-01

    Full Text Available Patients experiencing a first psychotic episode have high rates of extrapyramidal symptoms (EPSs when treated with the doses of neuroleptics used in multiepisode or chronic schizophrenia. There is some evidence that lower doses may be equally, if not more, effective but less toxic in this population. Here, we report the results of a biphasic open label trial designed to assess the efficacy, safety, and tolerability of low-dose (2–4 mg/day risperidone treatment in a group of 96 first-episode nonaffective psychosis patients. At the end of the trial, 62% of patients met the response criteria although approximately 80% had achieved a response at some time during the study. Reports of EPS remained low, and there were no dystonic reactions. We conclude that even at a dose of 2 mg/day, risperidone was highly effective in reducing acute symptomatology in a real world sample of young first-episode psychosis patients.

  20. Spectrophotometric estimation of risperidone in tablets.

    Jayanna, B K; Devaraj, T D; Roopa, K P; Nagendrappa, G; Kumar, H R Arun; Gowda, N

    2014-09-01

    A simple, rapid and highly sensitive spectrophotometric method is developed for the determination of risperidone in tablet formulation. The method is based on the oxidation of drug using potassium permanganate in alkaline medium and excess potassium permanganate oxidizes 1,10-phenanthroline Fe(II). The measurement of decrease in absorbance of 1,10-phenanthroline Fe (II) was done at 415 nm. The beer's law is obeyed in the concentration range of 5.0 to 40.0 μg/ml and molar absorptivity is found to be 7.3932 × 10(4) l/mol/cm. The proposed method is well suited for the pharmaceutical formulations. PMID:25425761

  1. Spectrophotometric estimation of risperidone in tablets

    B K Jayanna

    2014-01-01

    Full Text Available A simple, rapid and highly sensitive spectrophotometric method is developed for the determination of risperidone in tablet formulation. The method is based on the oxidation of drug using potassium permanganate in alkaline medium and excess potassium permanganate oxidizes 1,10-phenanthroline Fe(II. The measurement of decrease in absorbance of 1,10-phenanthroline Fe (II was done at 415 nm. The beer′s law is obeyed in the concentration range of 5.0 to 40.0 μg/ml and molar absorptivity is found to be 7.3932 × 10 4 l/mol/cm. The proposed method is well suited for the pharmaceutical formulations.

  2. A comparison of low-dose risperidone to paroxetine in the treatment of panic attacks: a randomized, single-blind study

    Galynker Igor I

    2009-05-01

    Full Text Available Abstract Background Because a large proportion of patients with panic attacks receiving approved pharmacotherapy do not respond or respond poorly to medication, it is important to identify additional therapeutic strategies for the management of panic symptoms. This article describes a randomized, rater-blind study comparing low-dose risperidone to standard-of-care paroxetine for the treatment of panic attacks. Methods Fifty six subjects with a history of panic attacks were randomized to receive either risperidone or paroxetine. The subjects were then followed for eight weeks. Outcome measures included the Panic Disorder Severity Scale (PDSS, the Hamilton Anxiety Scale (Ham-A, the Hamilton Depression Rating Scale (Ham-D, the Sheehan Panic Anxiety Scale-Patient (SPAS-P, and the Clinical Global Impression scale (CGI. Results All subjects demonstrated a reduction in both the frequency and severity of panic attacks regardless of treatment received. Statistically significant improvements in rating scale scores for both groups were identified for the PDSS, the Ham-A, the Ham-D, and the CGI. There was no difference between treatment groups in the improvement in scores on the measures PDSS, Ham-A, Ham-D, and CGI. Post hoc tests suggest that subjects receiving risperidone may have a quicker clinical response than subjects receiving paroxetine. Conclusion We can identify no difference in the efficacy of paroxetine and low-dose risperidone in the treatment of panic attacks. Low-dose risperidone appears to be tolerated equally well as paroxetine. Low-dose risperidone may be an effective treatment for anxiety disorders in which panic attacks are a significant component. Trial Registration ClinicalTrials.gov Identifier: NCT100457106

  3. Once-monthly paliperidone injection for the treatment of schizophrenia

    Delia Bishara

    2010-09-01

    Full Text Available Delia BisharaPharmacy Department, South London and Maudsley NHS Foundation Trust, London, United KingdomAbstract: Paliperidone palmitate is a new long-acting antipsychotic injection for the treatment of acute and maintenance therapy in schizophrenia. Paliperidone (9-hydroxyrisperidone is the major active metabolite of risperidone and acts at dopamine D2 and serotonin 5HT2A receptors. As with other atypical antipsychotics, it exhibits a high 5HT2A:D2 affinity ratio. It also has binding activity as an antagonist at α1- and α2 adrenergic receptors and H1 histaminergic receptors, but has virtually no affinity for cholinergic receptors. Paliperidone palmitate has been shown to be effective in reducing Positive and Negative Syndrome Scale total scores in four short-term trials in acute schizophrenia. It was also effective as maintenance therapy in a long-term trial in which time to recurrence of symptoms was significantly longer in paliperidone-treated patients compared with placebo. In addition, paliperidone was shown to be noninferior to risperidone long-acting injection in one study, but this noninferiority was not established in another longer study comparing the two drugs. Treatment should be initiated with 234 mg on day 1 and 156 mg on day 8, followed by a recommended monthly maintenance dose of 39–234 mg based on efficacy and tolerability. Paliperidone palmitate is generally well tolerated, although it can cause weight gain and a rise in prolactin levels, which is generally greater in women than in men. Overall, paliperidone palmitate may have advantages over other currently available long-acting injections, and therefore may be a useful alternative for the treatment of schizophrenia, although further long-term trials comparing it with active treatments are warranted.Keywords: paliperidone palmitate, injection, schizophrenia, long-acting

  4. Relapse in patients with schizophrenia: a comparison between risperidone and haloperidol

    Sena Eduardo Pondé de; Santos-Jesus Rogério; Miranda-Scippa Ângela; Quarantini Lucas de Castro; Oliveira Irismar Reis de

    2003-01-01

    OBJECTIVES: To compare rates of rehospitalization and time to relapse in risperidone vs. haloperidol-treated schizophrenic patients discharged from the hospital. METHODS: Randomized controlled trial comparing risperidone and haloperidol regarding relapse in patients with schizophrenia treated with flexible doses during one year. RESULTS: Twenty patients were assigned to risperidone and 13 to haloperidol. One patient from each group withdrew consent and one patient in the risperidone group was...

  5. The efficacy and safety of urethral injection therapy for urinary incontinence in women: a systematic review

    Priscila Katsumi Matsuoka; Rafael Fagionato Locali; Aparecida Maria Pacetta; Edmund Chada Baracat; Jorge Milhem Haddad

    2016-01-01

    To evaluate the efficacy and safety of different bulking agents for treating urinary incontinence in women, a systematic review including only randomized controlled trials was performed. The subjects were women with urinary incontinence. The primary outcomes were clinical and urodynamic parameters. The results were presented as a weighted mean difference for non-continuous variables and as relative risk for continuous variables, both with 95% confidence intervals. Initially, 942 studies were ...

  6. Efficacy of lumbar epidural corticosteroid injections on clinical status of the patients with radiculopathy

    Jülide Öncü; Reşat İlişer; Göksel Çelebi; Banu Kuran; Gülgün Durlanık

    2014-01-01

    Objective: To investigate the effect of lumbar epidural steroid injection in patients with radiculopathy Materials-Methods: 37 patients with radiculopathy were recruited retrospectively in the study. Radicular, low back pain and paresthesia intensity were evaluated using visual analog scale (VAS); the evidence of nerve stretch was evaluated by straight leg rising (SRL), disability levels were evaluated using the Oswestry Disability Index (ODI) and the quality of life was evaluated by ...

  7. Effects of Risperidone on Cognitive-Motor Performance and Motor Movements in Chronically Medicated Children

    Aman, Michael G.; Hollway, Jill A.; Leone, Sarah; Masty, Jessica; Lindsay, Ronald; Nash, Patricia; Arnold, L. Eugene

    2009-01-01

    This study was designed to explore the placebo-controlled effects of risperidone on cognitive-motor processes, dyskinetic movements, and behavior in children receiving maintenance risperidone therapy. Sixteen children aged 4-14 years with disruptive behavior were randomly assigned to drug order in a crossover study of risperidone and placebo for 2…

  8. Adjunctive long-acting risperidone in patients with bipolar disorder who relapse frequently and have active mood symptoms

    Haskins John T

    2011-10-01

    Full Text Available Abstract Background The objective of this exploratory analysis was to characterize efficacy and onset of action of a 3-month treatment period with risperidone long-acting injection (RLAI, adjunctive to an individual's treatment regimen, in subjects with symptomatic bipolar disorder who relapsed frequently and had significant symptoms of mania and/or depression. Methods Subjects with bipolar disorder with ≥4 mood episodes in the past 12 months entered the open-label stabilization phase preceding a placebo-controlled, double-blind study. Subjects with significant depressive or manic/mixed symptoms at baseline were analyzed. Significant depressive symptoms were defined as Montgomery-Åsberg Depression Rating Scale (MADRS ≥16 and Young Mania Rating Scale (YMRS t tests; categorical differences were assessed using Fisher exact test. No adjustment was made for multiplicity. Results 162 subjects who relapsed frequently met criteria for significant mood symptoms at open-label baseline; 59/162 (36.4% had depressive symptoms, 103/162 (63.6% had manic/mixed symptoms. Most subjects (89.5% were receiving ≥1 medication for bipolar disorder before enrollment. Significant improvements were observed for the total population on the CGI-BP-S, MADRS, and YMRS scales (p Conclusions Exploratory analysis of changes in overall clinical status and depression/mania symptoms in subjects with symptomatic bipolar disorder who relapse frequently showed improvements in each of these areas after treatment with RLAI, adjunctive to a subject's individualized treatment. Prospective controlled studies are needed to confirm these findings.

  9. Safety and efficacy of botulinum toxin injection therapy for esophageal achalasia in Japan

    Yamaguchi, Daisuke; Tsuruoka, Nanae; Sakata, Yasuhisa; Shimoda, Ryo; Fujimoto, Kazuma; Iwakiri, Ryuichi

    2015-01-01

    Botulinum toxin injection is an accepted treatment modality for esophageal achalasia in western countries. This pilot study aimed to clarify the effectiveness of botulinum toxin injection for esophageal achalasia in Japanese patients. We enrolled 10 patients diagnosed with esophageal achalasia between 2008 and 2014. A total of 100 U botulinum toxin A was divided into eight aliquots and injected around the esophagogastric junction. We compared the lower esophageal sphincter pressure before and 1 week after treatment. Scores of subjective symptoms for esophageal achalasia were assessed using a visual analog scale (VAS) before and after 1 week of follow-up of treatment. Barium passage was improved in barium esophagography and passage of contrast agent was also improved. Mean Eckardt score was reduced from 5.5 to 1.6 after treatment (pesophageal manometric study, mean lower esophageal sphincter pressure was reduced from 46.9 to 29.1 mmHg after treatment (p = 0.002). One week after treatment, mean VAS score was reduced from 10 to 3.9 (pesophageal achalasia was safe and effective with few complications. Therefore, botulinum toxin could be used as minimally invasive therapy for esophageal achalasia in Japan. PMID:26566311

  10. Paliperidone ER in the Treatment of Borderline Personality Disorder: A Pilot Study of Efficacy and Tolerability

    Silvio Bellino; Paola Bozzatello; Camilla Rinaldi; Filippo Bogetto

    2011-01-01

    Antipsychotics are recommended for the treatment of impulsive dyscontrol and cognitive perceptual symptoms of borderline personality disorder (BPD). Three reports supported the efficacy of oral risperidone on BPD psychopathology. Paliperidone ER is the metabolite of risperidone with a similar mechanism of action, and its osmotic release reduces plasmatic fluctuations and antidopaminergic effects. The aim of this study is to evaluate efficacy and safety of paliperidone ER in BPD patients. 18 o...

  11. Factors associated with uptake, adherence, and efficacy of hepatitis C treatment in people who inject drugs: a literature review

    Mravčík V

    2013-10-01

    Full Text Available Viktor Mravčík,1,2 Lisa Strada,3 Josef Štolfa,4,5 Vladimir Bencko,6 Teodora Groshkova,7 Jens Reimer,3 Bernd Schulte3 1National Monitoring Centre for Drugs and Drug Addiction, 2Department of Addictology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; 3Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany; 4Department of General Practice, Institute for Postgraduate Medical Education in Prague, 5Department of General Practice, Second Faculty of Medicine, 6Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic; 7European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal Introduction and methods: Hepatitis C virus (HCV infections are highly prevalent amongst people who inject drugs (PWID. Despite well documented evidence of its effectiveness, suggested cost-effectiveness, and potential to reduce HCV prevalence rates, the uptake of antiviral HCV treatment by PWID is low. This nonsystematic literature review describes factors associated with the uptake, adherence, and efficacy of HCV treatment among PWID and discusses strategies to increase their uptake of treatment. Results: Low HCV treatment uptake among PWID is associated with a number of patient-related and provider-related barriers. Beliefs and fears about low efficacy and adverse effects on the patient’s part are common. A substantial number of factors are associated with the chaotic lifestyle and altered social functioning of PWID, which are often associated with decompensation or relapsing into drug addiction. This may lead to perceived low adherence with treatment and low efficacy on the provider’s part too, where lack of support, inadequate management of addiction, and other drug-related problems and poor treatment of side effects have been described. Practical issues such as the accessibility of treatment and finances also play a role

  12. Efficacy of holmium laser urethrotomy and intralesional injection of Santosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase and N-acetyl cysteine) on the outcome of urethral strictures

    Kumar, Santosh; Kishore, Lalit; Sharma, Aditya Prakash; Garg, Nitin; Singh, Shrawan Kumar

    2015-01-01

    Introduction To study the efficacy of holmium laser urethrotomy with intralesional injection of Santosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase and N-acetyl cysteine) in the treatment of urethral strictures. Material and methods A total of 50 patients with symptomatic urethral stricture were evaluated by clinical history, physical examination, uroflowmetry and retrograde urethrogram preoperatively. All patients were treated with holmium laser urethrotomy, followed by injec...

  13. Once-monthly paliperidone injection for the treatment of schizophrenia

    Bishara, Delia

    2010-01-01

    Paliperidone palmitate is a new long-acting antipsychotic injection for the treatment of acute and maintenance therapy in schizophrenia. Paliperidone (9-hydroxyrisperidone) is the major active metabolite of risperidone and acts at dopamine D2 and serotonin 5HT2A receptors. As with other atypical antipsychotics, it exhibits a high 5HT2A:D2 affinity ratio. It also has binding activity as an antagonist at α1-and α2 adrenergic receptors and H1 histaminergic receptors, but has virtually no affinity for cholinergic receptors. Paliperidone palmitate has been shown to be effective in reducing Positive and Negative Syndrome Scale total scores in four short-term trials in acute schizophrenia. It was also effective as maintenance therapy in a long-term trial in which time to recurrence of symptoms was significantly longer in paliperidone-treated patients compared with placebo. In addition, paliperidone was shown to be noninferior to risperidone long-acting injection in one study, but this noninferiority was not established in another longer study comparing the two drugs. Treatment should be initiated with 234 mg on day 1 and 156 mg on day 8, followed by a recommended monthly maintenance dose of 39–234 mg based on efficacy and tolerability. Paliperidone palmitate is generally well tolerated, although it can cause weight gain and a rise in prolactin levels, which is generally greater in women than in men. Overall, paliperidone palmitate may have advantages over other currently available long-acting injections, and therefore may be a useful alternative for the treatment of schizophrenia, although further long-term trials comparing it with active treatments are warranted. PMID:20856919

  14. Efficacy of fingolimod is superior to injectable disease modifying therapies in second-line therapy of relapsing remitting multiple sclerosis.

    Braune, Stefan; Lang, M; Bergmann, A

    2016-02-01

    Although fingolimod is registered in Europe for treatment of relapsing-remitting multiple sclerosis (RRMS) if earlier disease modifying therapy (DMT) has failed, no data regarding its efficacy in this patient group are available. This observational cohort study of the NeuroTransData network includes German RRMS outpatients with failure of earlier therapy with injectable DMT (iDMT), therefore switching to either another iDMT (n = 133) or to fingolimod (n = 300). Statistical comparison of clinical baseline characteristics showed more severely affected patients in the fingolimod group. A propensity-score matched group comparison was performed (n = 99 in each group) covering more than 2-year observation time. Fingolimod showed statistically significant superior efficacy in comparison to iDMT regarding annualized relapse rate (0.21 versus 0.33 per year), time-to-relapse and likelihood of relapse (iDMT hazard ratio 1.7), proportion and likelihood of patients with EDSS progression (15.10 versus 31.00%; iDMT hazard ratio 1.7), persistence on medication and likelihood of discontinuation (iDMT hazard ratio 3.0). Significantly more patients were free of relapse and EDSS progression with fingolimod than with their second iDMT (64.4 versus 46.5%, p < 0.03). This real-life evidence in German RRMS outpatients support data from controlled clinical studies and can quantitatively support clinical decision finding processes if iDMT therapy fails in RRMS. PMID:26645389

  15. Risperidone-induced Gingival Bleeding in a Pediatric Case: A Dose-dependent Side Effect.

    Hergüner, Sabri; Özayhan, Hatice Yardım; Erdur, Emire Aybuke

    2016-05-31

    There are several case reports on risperidone-related bleeding; however, to our knowledge, there is no report about gingival bleeding associated with risperidone in the literature. We presented a case who experienced gingival bleeding when risperidone dose was increased to 0.5 mg/day, and subsided after decreasing the dose to 0.25 mg/day, suggesting a dose-dependent side-effect. The bleeding side effect of risperidone might be caused by several mechanisms, including 5-hydroxytryptamine 2A receptor antagonism. Although bleeding associated with risperidone is rarely reported, clinicians should be aware of this side effect. PMID:27121433

  16. The evaluation of efficacy of subtenon triamcinolone injection combined with focal laser photocoagulation in diabetic macular edema

    Hüseyin Öksüz

    2012-06-01

    Full Text Available Objectives: The aim of this study was to investigate efficacyand safety of subtenon triamcinolone (ST in combinationwith focal laser photocoagulation in diabetic macularedema (DME.Materials and methods: Medical records of patients withDME, treated with 40 mg subtenon injection of triamcinoloneacetonid prior to focal laser photocoagulation wereretrospectively analyzed. Seventeen eyes of 17 patientswith DME were enrolled in the study. All patients underwenta comprehensive ophthalmological examinationbefore the treatment. Efficacy of the treatment after STinjection was evaluated by visual acuity and flouresceinangiography (FA. Follow-up visits were performed at 1st,3rd, 6th and 12th months. Repeated measures ANOVA wasused for statistical analysis.Results: The mean age was 61.5 ± 8.7 years and themean visual acuity in the study eyes was 0.22 ± 0.13 beforethe treatment, 0.39 ± 0.15 at 1st month, 0.36 ± 0.18at 3rd month, 0.33 ± 0.15 at 6th month and 0.34 ± 0.16 at12th month. The differences in the visual acuity before thetreatment and follow-up visits were significant (p ˂0.05.Visual acuity was increased in 13 (%76,4 patients, decreasedin 1 (%5,8 and unchanged in 3 (%17,6.Conclusion: Injection of 40 mg of triamsinolon via subtenonroute combined with focal laser photocoagulation isa safe and beneficial treatment in cases of DME

  17. 氯硝西泮对偏执型精神分裂症的辅助治疗作用%An efficacy study of risperidone combined with clonazepam injection in the treatment of paranoid schizophrenia

    王小全; 王晓峰; 周海晓

    2003-01-01

    目的:评价利培酮配合氯硝西泮注射液治疗偏执型精神分裂症的疗效.方法:对病程<3年的80例首次住院,选用利培酮治疗的偏执型精神分裂症患者,随机分为合用氯硝西泮(合用组)和未合用氯硝西泮(对照组)各40例,进行8周治疗.采用阳性症状与阴性症状量表(PANSS)评定疗效,副反应量表(TESS)评定不良反应.结果:合用组治疗2周后PANSS量表总分、阳性症状分、精神病理因子分及症状群中激活性、偏执、攻击性分值均显著下降;治疗4周末时利培酮剂量合用组显著低于对照组.结论:利培酮配合氯硝西泮注射液治疗偏执型精神分裂症可缩短疗程,改善其阳性症状及攻击行为.

  18. Olanzapine vs. Risperidone in Patients with First-Episode Schizophrenia and a Lifetime History of Cannabis Use Disorders: 16-Week Clinical and Substance Use outcomes

    Sevy, Serge; Robinson, Delbert G.; Sunday, Suzanne; Napolitano, Barbara; Miller, Rachel; McCormack, Joanne; Kane, John M.

    2011-01-01

    The purpose of this study is to compare the efficacy of olanzapine and risperidone for the acute treatment of first-episode schizophrenia patients with cannabis use disorders. This secondary analysis of a previously published study included forty-nine first-episode patients with a diagnosis of schizophrenia, schizophreniform disorder, or schizoaffective disorder and a co-occurring lifetime diagnosis of cannabis use disorders randomly assigned to treatment with either olanzapine (n=28) or risp...

  19. The efficacy and safety of urethral injection therapy for urinary incontinence in women: a systematic review

    Priscila Katsumi Matsuoka

    2016-02-01

    Full Text Available To evaluate the efficacy and safety of different bulking agents for treating urinary incontinence in women, a systematic review including only randomized controlled trials was performed. The subjects were women with urinary incontinence. The primary outcomes were clinical and urodynamic parameters. The results were presented as a weighted mean difference for non-continuous variables and as relative risk for continuous variables, both with 95% confidence intervals. Initially, 942 studies were identified. However, only fourteen eligible trials fulfilled the prerequisites. Altogether, the review included 1814 patients in trials of eight different types of bulking agents, and all studies were described and analyzed. The measured outcomes were evaluated using a large variety of instruments. The most common complications of the bulking agents were urinary retention and urinary tract infection. Additionally, there were certain major complications, such as one case of death after use of autologous fat. However, the lack of adequate studies, the heterogeneous populations studied, the wide variety of materials used and the lack of long-term follow-up limit guidance of practice. To determine which substance is the most suitable, there is a need for more randomized clinical trials that compare existing bulking agents based on standardized clinical outcomes.

  20. Paliperidone palmitate injection for the acute and maintenance treatment of schizophrenia in adults

    Kim S

    2012-07-01

    Full Text Available Shiyun Kim,1 Hugo Solari,2 Peter J Weiden,2 Jeffrey R Bishop11Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, 2Department of Psychiatry, University of Illinois at Chicago College of Medicine, Chicago, IL, USAPurpose: To review the use of paliperidone palmitate in treatment of patients with schizophrenia.Methods: Published clinical trial data for the development and utilization of paliperidone palmitate for the treatment of schizophrenia were assessed in this review. Four short-term, randomized, double-blind, placebo-controlled trials investigated the efficacy of paliperidone palmitate in acute exacerbation of schizophrenia. Paliperidone palmitate was also studied as a maintenance treatment to prevent or delay relapse in stable schizophrenia. In addition, paliperidone palmitate was compared to risperidone long-acting injection for noninferiority in three studies.Results: Paliperidone palmitate has been shown to be effective in reducing symptoms as measured by the Positive and Negative Syndrome Scale total scores in the four acute treatment studies. In the maintenance treatment studies, paliperidone palmitate was found to be more effective than placebo in preventing or delaying the time to first relapse in stable schizophrenia patients. In addition, paliperidone palmitate was shown to be noninferior to risperidone long-acting injection in two studies. It was shown to be reasonably well tolerated in all clinical trials. Acute treatment phase should be initiated with a dose of 234 mg on day one and 156 mg on day eight, followed by a recommended monthly maintenance dose of 39–234 mg based on efficacy and tolerability results from the clinical studies.Conclusion: Providing an optimal long-term treatment can be challenging. Paliperidone palmitate can be used as an acute treatment even in outpatient setting, and it has shown to be well tolerated by patients. Also, it does not require overlapping oral

  1. Dystonia with MPH/Risperidone Combined Therapy for ADHD

    J Gordon Millichap; Yee, Michelle M.

    2016-01-01

    Investigators from Child Neurology and Pediatrics, University of Texas Health Science Center, Houston, report extrapyramidal symptoms in a 13-year-old boy with a psychiatric history of schizophrenia, bipolar disorder, ADHD, and autism, responsive to combination risperidone, oxcarbazepine, and MPH.

  2. Dystonia with MPH/Risperidone Combined Therapy for ADHD.

    Millichap, J Gordon; Yee, Michelle M

    2016-01-01

    Investigators from Child Neurology and Pediatrics, University of Texas Health Science Center, Houston, report extrapyramidal symptoms in a 13-year-old boy with a psychiatric history of schizophrenia, bipolar disorder, ADHD, and autism, responsive to combination risperidone, oxcarbazepine, and MPH. PMID:27004141

  3. Serum concentrations of paliperidone versus risperidone and clinical effects

    Nazirizadeh, Yasmin; Vogel, Friederike; Bader, Wolfgang; Haen, Ekkehard; Pfuhlmann, Bruno; Gründer, Gerhard; Paulzen, Michael; Schwarz, Markus; Zernig, Gerald; Hiemke, Christoph

    2010-01-01

    Abstract Purpose The major aim of this multicenter retrospective analysis was to examine the relationship between paliperidone serum concentrations and clinical effects in patients treated with this new antipsychotic drug. Intra-individual variability in trough serum concentrations was also analyzed in patients under treatment with either the paliperidone-extended release (ER) formulation or the risperidone immediate-release formulation. ...

  4. DETERMINATION OF RISPERIDONE AND 9-HYDROXYRISPERIDONE IN THE SCHIZOPHRENICS’ URINE

    Sidelnikova, Larisa; Kartashov, Vladimir; Chernova, Larisa

    2015-01-01

    This research presents the testing possibility of risperidone and its main metabolite of 9-hydroxyrisperidone in the schizophrenics’ urine by isolation, purification, separation, identification and quantification of the studied substances using the methods of extraction, thin-layer chromatography (TLC) screening and UV spectrophotometry. Used methodology can be applied in chemical-toxicological analysis.

  5. Hyperprolactinemia in Thai children and adolescents with autism spectrum disorder treated with risperidone

    Hongkaew, Yaowaluck; Ngamsamut, Nattawat; Puangpetch, Apichaya; Vanwong, Natchaya; Srisawasdi, Pornpen; Chamnanphon, Montri; Chamkrachchangpada, Bhunnada; Tan-kam, Teerarat; Limsila, Penkhae; Sukasem, Chonlaphat

    2015-01-01

    Hyperprolactinemia is a common adverse effect observed in children with autism spectrum disorder (ASD) during pharmacotherapy with risperidone. The main aim of this study was to investigate important clinical factors influencing the prolactin response in risperidone-treated Thai ASD. A total of 147 children and adolescents (127 males and 20 females) aged 3–19 years with ASD received risperidone treatment (0.10–6.00 mg/day) for up to 158 weeks. Prolactin levels were measured by chemiluminescence immunoassay. The clinical data of patients collected from medical records – age, weight, height, body mass index, dose of risperidone, duration of treatment, and drug-use pattern – were recorded. Hyperprolactinemia was observed in 66 of 147 (44.90%) subjects. Median prolactin level at the high doses (24.00, interquartile range [IQR] 14.30–29.20) of risperidone was significantly found to be higher than at the recommended (16.20, IQR 10.65–22.30) and low (11.70, IQR 7.51–16.50) doses of risperidone. There was no relationship between prolactin levels and duration of risperidone treatment. Dose-dependence is identified as a main factor associated with hyperprolactinemia in Thai children and adolescents with ASD treated with risperidone. This study suggests that risperidone treatment causes prolactin elevations and the effects of risperidone on prolactin are probably dose-related in pediatric patients. PMID:25653528

  6. Long-acting injectable antipsychotics: focus on olanzapine pamoate

    JP Lindenmayer

    2010-05-01

    Full Text Available JP LindenmayerDepartment of Psychiatry, New York University School of Medicine, New York NY, USAAbstract: Medication non-adherence in patients with schizophrenia continues to be a significant problem and threatens successful treatment outcomes. Medication non-adherence is often associated with negative consequences, including symptom exacerbation, more frequent emergency room visits, re-hospitalizations and relapse. Long-acting injectable (LAI forms of antipsychotics allow for rapid identification of non-adherence, obviate the need for the patient to take the medication on a daily basis and increase adherence to some significant degree. Eli Lilly has developed a long-acting depot formulation of olanzapine, olanzapine pamoate, which has recently been approved by the FDA for the US market, and which will be reviewed here. Olanzapine LAI appears to be an effective antipsychotic at dosages of 210 mg every 2 weeks, 300 mg every 2 weeks and 405 mg every 4 weeks in patients with acute schizophrenia, and at 150 mg every 2 weeks, 300 mg every 2 weeks and at 405 mg every 4 weeks for the maintenance treatment of stable patients. Oral supplementation appears not to be needed, particularly not at the onset of treatment with the LAI as is necessary with risperidone LAI. Its efficacy is in general comparable to the efficacy seen with oral olanzapine at a corresponding dose. The side effect profile is also comparable to the side effects observed with oral olanzapine, including lower rates of extrapyramidal symptoms, prolactin elevation and cardiovascular side effects, but significant metabolic effects. The latter include significant weight gain, lipid abnormalities and glucose dysregulation. While the injection site adverse events are overall mild, the most significant serious adverse event is the post-injection delirium sedation syndrome (PDSS. While rare, this syndrome results from inadvertent intravascular injection of olanzapine LAI and can cause a range of

  7. Efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy: A prospective,randomized study

    Thawatchai Akaraviputh; Charay Leelouhapong; Varut Lohsiriwat; Somkiat Aroonpruksakul

    2009-01-01

    AIM: To determine the efficacy of perioperative parecoxib injection on postoperative pain relief after laparoscopic cholecystectomy.METHODS: A prospective, double-blind, randomized,placebo-controlled study was conducted on 70 patients who underwent elective laparoscopic cholecystectomy under general anesthesia at Siriraj Hospital, Bangkok,from January 2006 to December 2007. Patients were randomized to receive either 20 mg parecoxib infusion 30 min before induction of anesthesia and at 12 h after the first dose (treatment group), or normal saline infusion, in the same schedule, as a placebo (control group). The degree of the postoperative pain was assessed every 3 h in the first 24 h after surgery, and then every 12 h the following day, using a visual analog scale. The consumption of analgesics was also recorded.RESULTS: There were 40 patients in the treatment group, and 30 patients in the control group. The pain scores at each time point, and analgesic consumption did not differ between the two groups. However,there were fewer patients in the treatment group than placebo group who required opioid infusion within the first 24 h (60% vs 37%, P = 0.053).

  8. Efficacy of holmium laser urethrotomy and intralesional injection of Santosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase and N-acetyl cysteine) on the outcome of urethral strictures

    Kishore, Lalit; Sharma, Aditya Prakash; Garg, Nitin; Singh, Shrawan Kumar

    2015-01-01

    Introduction To study the efficacy of holmium laser urethrotomy with intralesional injection of Santosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase and N-acetyl cysteine) in the treatment of urethral strictures. Material and methods A total of 50 patients with symptomatic urethral stricture were evaluated by clinical history, physical examination, uroflowmetry and retrograde urethrogram preoperatively. All patients were treated with holmium laser urethrotomy, followed by injection of tetra-inject at the urethrotomy site. Tetra-inject was prepared by diluting acombination of 40 mg Triamcinolone, 2 mg Mitomycin, 3000 UHyaluronidase and 600 mg N-acetyl cysteine in 5–10 ml of saline, according to the stricture length. An indwelling 18 Fr silicone catheter was left in place for 7–10 days.All patients were followed-up for 6-18 months postoperatively by history, uroflowmetry, and if required, retrograde urethrogram and micturating urethrogram every 3 months. Results 41 (82%) patients had asuccessful outcome,whereas 9 (18%) had recurrences during a follow-up ranging from 6–18 months. In 3 cm lengthsthe success rates were 81.2% and 66.7% respectively. This modality, thus, has an encouraging success rate, especially in those with short segment urethral strictures (Holmium laser urethrotomy with intralesional injection ofSantosh PGI tetra-inject (Triamcinolone, Mitomycin C, Hyaluronidase, N-acetyl cysteine) is a safe and effective minimally-invasive therapeutic modality for short segment urethral strictures. PMID:26855803

  9. A brief review on the efficacy of different possible and nonpharmacological techniques in eliminating discomfort of local anesthesia injection during dental procedures

    Davoudi, Amin; Rismanchian, Mansour; Akhavan, Ali; Nosouhian, Saeid; Bajoghli, Farshad; Haghighat, Abbas; Arbabzadeh, Farahnaz; Samimi, Pouran; Fiez, Atiyeh; Shadmehr, Elham; Tabari, Kasra; Jahadi, Sanaz

    2016-01-01

    Dental anxiety and fear of needle injection is one of the most common problems encountered by dental practitioners, especially in the pediatric patient. In consequences, it might affect the patient's quality of life. Several methods are suggested to lower the discomfort of local anesthesia injection during dental procedures. Desensitization of injection site is one of the recommended strategies. Among chemical anesthetic topical agents that are effective but might have allergic side effects, using some nonpharmacological and safe techniques might be useful. This study aimed to overview the efficacy of using cooling techniques, mostly by ice or popsicles, warming or pH buffering of drug, and using modern devices to diminish the discomfort of local anesthesia injection during dental procedures. PMID:26957683

  10. Risperidone rechallenge for marked liver function test abnormalities in an autistic child.

    Copur, Mazlum; Erdogan, Ayten

    2011-09-01

    Risperidone have been reported to commonly lead to asymptomatic elevation of liver enzymes in adult population, and recently in children and adolescents. Results from controlled clinical trials, reports of spontaneous adverse events, and published studies/ case reports suggest that severe hepatotoxicity may be rare but can occur in the pediatric population. In the following case report, we describe a 5-year-old male patient diagnosed as autism with severe distruptive behavior. Substantial improvement was achieved with risperidone therapy. Increase in liver enzymes at the beginning of the risperidone treatment was successfully managed with multidisciplinary approach as the treatment was initially withdrawn, afterwards restarted and carefully continued. We demonstrated that risperidone may be cautiously rechallenged in selected pediatric patients who showed marked psychiatric improvement with risperidone on the face of liver enzymes elevation. Some important patents on risperidone delivery and their use for the treatment of autism are also outlined. PMID:21913889

  11. 18 month observational study on efficacy of intraarticular hyaluronic acid (Hylan G-F 20 injections under ultrasound guidance in hip osteoarthritis

    Cristiano Padalino

    2011-09-01

    Full Text Available Objective: To evaluate the efficacy and the tolerability of viscosupplementation (VS with hyaluronic acid (Hylan GF 20 in a cohort of 36 patients affected by hip osteoarthritis through a 18 months follow-up. Methods: Viscosupplementation was performed with an anteriorsagittal approach, under ultrasound guidance. 36 patients were administered hyaluronic acid intraarticularly in the hip, with a unique injection of Hylan G-F20, which could be repeated after at least 3 months. Treatment efficacy was assessed by functional index WOMAC, pain evaluation on a visual analogue scale and NSAID consumption. All such parameters were recorded at the time of the first injection and then 3, 6, 9, 12 and 18 months later. Results: Statistically significant reduction of all parameters was observed three months after the injection, and was still maintained at the timepoints 6, 9, 12 and 18 months. No local side effects have been observed, nor systemic complications. Conclusions: Our data show that viscosupplementation is a promising approach for hip osteoarthritis, providing beneficial effects in a long-tern follow up. Yet, the topic deserves further and wider studies, so to define the number of injections to administer and suggest a fit interval between subsequent injections.

  12. Clinical result of intra-arterial lymphocyte injection therapy for treatment of lymphedema and the evaluation of the efficacy of the therapy. Quantitative analysis by an injection of {sup 111}In-labeled lymphocytes and by MR imaging

    Yoshizumi, Masanori; Kitagawa, Tetsuya; Hori, Takaki; Katoh, Itsuo; Harada, Masashi; Matsumoto, Takahiro; Nishitani, Hiromu [Tokushima Univ. (Japan). School of Medicine

    1995-11-01

    We have employed the intra-arterial lymphocytes injection therapy for treatment of lymphedema of the limbs with various causes. In the present study, we observed the clinical outcome of our therapy in 38 patients with lymphedema of the limbs. Results showed that the therapy was effective in 26 of 38 patients (68% of the total). Moreover, a marked efficacy was obtained in 13 of 38 patients (34% of the total). In the latest 5 patients, to evaluate the efficacy of our therapy, we examined the distribution of the {sup 111}In-oxine labeled lymphocytes injected into the proximal artery of the affected limb. The radioactivities of the affected limbs were apparently higher than that of the healthy limbs in effective cases. Moreover, MR imaging showed that the reduction of STIR ratio and T{sub 2} ratio well correlate with the results of clinical course. Thus, the efficacy of the lymphocyte injection therapy is able to be evaluated by radiolabeled lymphocytes and MR imaging. (author).

  13. A comparative study between risperidone and ritalin in the treatment of attention deficit hyperactivity disorder%利培酮治疗注意缺陷障碍对照观察

    兰利明; 薛漳

    2001-01-01

    目的:观察小剂量利培酮治疗注意缺陷障碍(ADHD) 的疗效和安全性。 方法:前瞻性研究,以利他林作为对照,采用 康纳多动症评定量表及不良反应症状量表(TESS)评定,观察4周。 结果:利培酮有效率为77%,利他林为78%;未见锥体外系副反应。 结论:利培酮与利他林的疗效相似,小剂量使用时安全有效。%Objective:To observe the efficacy and security of small doses risperidone in the treatment of attention deficit hyperactivity diso rder(ADHD). Method:Compared with ritalin group,the patients wer e treated with small doses risperidone for 4 weeks.Conner hyperactivety rating s cale (CHRS) and the treatment emergent symptom scale (TESS) were completed by th em. Results:The efficacy rate in risperidone group was 77%, a nd in ritalin group was 78%. No extrapyramidal side effect was found. C onclusion:It suggests that small doses risperidone is effective and safe in the treatment of ADHD, being similar to ritalin.

  14. Controlled clinical treatment of the domestic Ziprasidone and risperidone%国产齐拉西酮与维思通的临床对照治疗

    李永强; 冯金河

    2013-01-01

    Objective:comparison curative effect and untoward effect between Ziprasidone and risperidone. Methods:Sixty patients with schizophrenia were randomly divided into two groups: thirty patients were in Ziprasidone's group and the other thirty patients were in risperidone's group, after treatment for six weekends, used positive and negative symptom scale (PANSS) and treatment emergent symptoms scale (TESS) to evaluate the efficacy. Results: Ziprasidone and risperidone have equal therapy, but the incidence of adverse reaction and symptom severity of Ziprasidone was significantly lower than risperidone, especially, Ziprasidone has a small influence in mammotropic hormone and weight. Conclusion: Ziprasidone for schizophrenia have a good efficacy, few untoward effects and good compliance.%目的对比国产齐拉西酮与维思通的疗效和不良反应。方法对60例精神分裂症患者随机分为国产齐拉西酮组30例和维思通组30例,进行相应的药物治疗,疗程6周,采用PANSS量表和TESS副反应量表进行评价。结果国产齐拉西酮和维思通疗效相当,但国产齐拉西酮的不良反应发生率和症状严重程度显著低于维思通,特别对催乳素和体重的影响明显较小,同时具有良好的依从性。结论国产齐拉西酮治疗精神分裂症疗效确切,不良反应少,依从性好。

  15. Risperidone-induced Gingival Bleeding in a Pediatric Case: A Dose-dependent Side Effect

    Hergüner, Sabri; Özayhan, Hatice Yardım; Erdur, Emire Aybuke

    2016-01-01

    There are several case reports on risperidone-related bleeding; however, to our knowledge, there is no report about gingival bleeding associated with risperidone in the literature. We presented a case who experienced gingival bleeding when risperidone dose was increased to 0.5 mg/day, and subsided after decreasing the dose to 0.25 mg/day, suggesting a dose-dependent side-effect. The bleeding side effect of risperidone might be caused by several mechanisms, including 5-hydroxytryptamine 2A rec...

  16. Paliperidone palmitate injection for the acute and maintenance treatment of schizophrenia in adults

    Kim, Shiyun; Solari, Hugo; Weiden, Peter J; Bishop, Jeffrey R

    2012-01-01

    Purpose To review the use of paliperidone palmitate in treatment of patients with schizophrenia. Methods Published clinical trial data for the development and utilization of paliperidone palmitate for the treatment of schizophrenia were assessed in this review. Four short-term, randomized, double-blind, placebo-controlled trials investigated the efficacy of paliperidone palmitate in acute exacerbation of schizophrenia. Paliperidone palmitate was also studied as a maintenance treatment to prevent or delay relapse in stable schizophrenia. In addition, paliperidone palmitate was compared to risperidone long-acting injection for noninferiority in three studies. Results Paliperidone palmitate has been shown to be effective in reducing symptoms as measured by the Positive and Negative Syndrome Scale total scores in the four acute treatment studies. In the maintenance treatment studies, paliperidone palmitate was found to be more effective than placebo in preventing or delaying the time to first relapse in stable schizophrenia patients. In addition, paliperidone palmitate was shown to be noninferior to risperidone long-acting injection in two studies. It was shown to be reasonably well tolerated in all clinical trials. Acute treatment phase should be initiated with a dose of 234 mg on day one and 156 mg on day eight, followed by a recommended monthly maintenance dose of 39–234 mg based on efficacy and tolerability results from the clinical studies. Conclusion Providing an optimal long-term treatment can be challenging. Paliperidone palmitate can be used as an acute treatment even in outpatient setting, and it has shown to be well tolerated by patients. Also, it does not require overlapping oral antipsychotic supplementation while being initiated, and is dosed once per month. PMID:22879739

  17. Risperidone-Induced Nocturnal Enuresis Successfully Treated With Reboxetine.

    Mergui, Joseph; Jaworowski, Sol

    2016-01-01

    There are few reports in the literature and scarce research on the topic and the treatment of antipsychotic medication-induced urinary incontinence or nocturnal enuresis (NE) despite the significant frequency of these adverse effects.Treatment for antipsychotic medication-induced urinary incontinence has been reported in relation to clozapine with response to numerous pharmacological strategies such as ephedrine, oxybutynin, intranasal desmopressin, trihexyphenidyl, and amitriptyline.We report a case of NE induced by risperidone which has been successfully treated with reboxetine.To the best of our knowledge, this article is the first report of an atypical antipsychotic medication-induced NE treated with reboxetine.Reboxetine may be an effective treatment for risperidone-induced NE. Further research is required to confirm our finding and apply this treatment for NE caused by other neuroleptics. PMID:26992158

  18. Ultrasound-guided retro-calcaneal bursa corticosteroid injection for refractory Achilles tendinitis in patients with seronegative spondyloarthropathy: efficacy and follow-up study.

    Srivastava, Puja; Aggarwal, Amita

    2016-06-01

    Ultrasound (US)-guided corticosteroid injection has been shown to be safe and effective for varied causes of plantar fasciitis; however, its use for Achilles tendinitis is controversial. We studied the efficacy and changes in US findings at Achilles enthesitis after corticosteroid injection in patients with spondyloarthropathy (SpA). Patients with SpA with symptomatic Achilles enthesitis, refractory to 6 weeks of full-dose NSAIDs, were offered US-guided local corticosteroid injection. Injected entheses were examined by US (both B mode and power Doppler) at baseline and 6 weeks after injection. Standard OMERACT definitions were used to define enthesitis. Achilles tendon thickness >5.29 mm, 2 cm proximal to insertion in long axis, was considered thickened. Twenty-seven symptomatic Achilles tendons (in 18 patients) were injected with 20 mg methylprednisolone under US guidance baseline, and 6-week follow-up US features were compared. All patients reported improvement in pain (VAS) in the affected tendon after injection (p < 0.0001). Simultaneously, improvement in local inflammatory changes were noted, in the form of significant reduction in tendon thickness (p < 0.0001), vascularity (p < 0.0001), peritendinous oedema (p = 0.001), bursitis and bursal vascularity (p < 0.001 and < 0.0001, respectively). There was no change in bone erosions and enthesophyte. None of the patients had tendon rupture or other injection-related complications at 6 weeks of follow-up. US-guided local corticosteroid injection is an effective and safe modality for refractory Achilles enthesitis in patients with SpA and leads to reversion of acute changes at entheseal site. PMID:26894910

  19. Peripheral Edema Occurring during Treatment with Risperidone Combined with Citalopram

    Seyed Hamzeh Hosseini; Amirhossein Ahmadi

    2012-01-01

    An 80-year-old female presented with symptoms of depression, worthlessness, hopelessness, loss of energy, insomnia, impatience, and forgetfulness associated with persecutory delusion that had begun about one year before her visit. She was diagnosed with major depression with psychotic signs and began treatment with risperidone (2 mg/night) and citalopram (20 mg/day). After 20 days, she returned and reported partial improvement in her symptoms, although she had developed severe swelling of the...

  20. Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia

    Lin Chih-Hsun

    2012-01-01

    Full Text Available Abstract Idiopathic granulomatous mastitis (IGM is a rare inflammatory breast disease. The etiology and treatment options of IGM remain controversial. Previous case reports have suggested that hyperprolactinemia may be associated with IGM. In the present report, we describe the first case of IGM associated with risperidone-induced hyperprolactinemia. Virtual slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8120093785928228

  1. Idiopathic granulomatous mastitis associated with risperidone-induced hyperprolactinemia

    Lin Chih-Hsun; Hsu Chih-Wei; Tsao Tang-Yi; Chou Jason

    2012-01-01

    Abstract Idiopathic granulomatous mastitis (IGM) is a rare inflammatory breast disease. The etiology and treatment options of IGM remain controversial. Previous case reports have suggested that hyperprolactinemia may be associated with IGM. In the present report, we describe the first case of IGM associated with risperidone-induced hyperprolactinemia. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8120093785928228

  2. Adjunctive Aripiprazole Treatment for Risperidone-Induced Hyperprolactinemia: An 8-Week Randomized, Open-Label, Comparative Clinical Trial.

    Jingyuan Zhao

    Full Text Available The present study aimed to evaluate the efficacy and safety of adjunctive aripiprazole treatment in schizophrenia patients with risperidone-induced hyperprolactinemia.One hundred and thirteen patients who were receiving a stable dose of risperidone were randomly assigned to either adjunctive aripiprazole treatment (10 mg/day (aripiprazole group or no additional treatment (control group at a 1:1 ratio for 8 weeks. Schizophrenia symptoms were measured using the Positive and Negative Syndrome Scale (PANSS. Rating scales and safety assessments (RSESE, BARS, UKU were performed at baseline and at weeks 4 and 8. Serum levels of prolactin were determined at baseline and at weeks 2, 4, 6 and 8. Metabolic parameters were determined at baseline and again at weeks 4 and 8.One hundred and thirteen patients were enrolled in this study, and 107 patients completed the study (54 in the aripiprazole group, and 53 in the control group. PANSS-total scores in the aripiprazole group decreased significantly at week 4 (P = 0.003 and week 8 (P = 0.007 compared with the control group. PANSS-negative scores in the aripiprazole group also decreased significantly at week 4 (P = 0.005 and week 8 (P< 0.001 compared with the control group. Serum levels of prolactin in the aripiprazole group decreased significantly at week 2 (P< 0.001, week 4 (P< 0.001, week 6 (P< 0.001 and week 8 (P< 0.001 compared with the control group. There were no significant differences in changes of Fasting Plasma Glucose, Total cholesterol, Triglycerides and High Density Lipoprotein within each group at week 4 and 8 execpt low density lipoproteins. There was no significant difference in the incidence of adverse reactions between the two groups.Adjunctive aripiprazole treatment may be beneficial in reducing serum levels of prolactin and improving negative symptoms in schizophrenia patients with risperidone-induced hyperprolactinemia.chictr.org ChiCTR-IOR-15006278.

  3. Potential bias in testing for hyperprolactinemia and pituitary tumors in risperidone-treated patients: a claims-based study

    Wu Jasmanda; Mahmoud Ramy; Pandina Gahan; Gianfrancesco Frank D; Wang Ruey H

    2009-01-01

    Abstract Background A reporting association of risperidone with pituitary tumors has been observed. Because such tumors are highly prevalent, there may be other reasons why they were revealed in association with risperidone treatment. We assessed two potential explanations: disproportionately more prolactin assessment and head/brain imaging in risperidone-treated patients vs patients treated with other antipsychotics. Methods Treatment episodes with risperidone, clozapine, olanzapine, quetiap...

  4. Adjunctive treatment with aripiprazole for risperidone-induced hyperprolactinemia

    Ranjbar F

    2015-03-01

    Full Text Available Fatemeh Ranjbar,1 Homayoun Sadeghi-Bazargani,2,3 Parisa Niari Khams,1 Asghar Arfaie,1 Azim Salari,4 Mostafa Farahbakhsh1 1Clinical Psychiatry Research Center, Tabriz University of Medical Sciences, Tabriz, East Azerbaijan, Iran; 2Road Traffic Injury Research Center, Department of Statistics & Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran; 3World Health Organization Collaborating Center on Community Safety Promotion, Karolinska Institute, Stockholm, Sweden; 4Emam Khomeini Hospital, Naghadeh, West Azerbaijan, Iran Background: Antipsychotics have been used for more than 50 years in the treatment of schizophrenia and many other psychiatric disorders. Prolactin levels usually increase in patients treated with risperidone. Aripiprazole, which has a unique effect as an antipsychotic, is a D2 receptor partial agonist. It is an atypical antipsychotic with limited extrapyramidal symptoms. Since it acts as an antagonist in hyperdopaminergic conditions and as an agonist in hypodopaminergic conditions, it does not have adverse effects on serum prolactin levels. The present study aimed to investigate the effect of aripiprazole on risperidone-induced hyperprolactinemia. Methods: This before-and-after clinical trial was performed in 30 patients. Baseline prolactin levels were measured in all patients who were candidates for treatment with risperidone. In subjects with elevated serum prolactin, aripiprazole was added to their treatment. Serum prolactin levels were measured during the first week, second week, and monthly thereafter for at least 3 months or until prolactin levels became normal. The data were analyzed using Stata version 11 software. Survival analysis and McNemar’s test were also performed. Results: The mean age of the participants was 30.8 years. Prolactin levels normalized in 23 (77% participants during the study, and menstrual disturbances normalized in 25 (83.3%. Prolactin levels normalized in most patients between days 50

  5. Prolactin release in children treated with risperidone: impact and role of CYP2D6 metabolism.

    Troost, P.W.; Lahuis, B.E.; Hermans, M.H.; Buitelaar, J.K.; Engeland, H. van; Scahill, L.; Minderaa, R.B.; Hoekstra, P.J.

    2007-01-01

    OBJECTIVE: Little is known about the role of CYP2D6 polymorphism in risperidone-induced prolactin release in children. METHOD: Twenty-five children (aged 5-15 years) with pervasive developmental disorders were genotyped for CYP2D6 polymorphisms. Serum prolactin, risperidone, and 9-hydroxyrisperidone

  6. Comparison of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorder and attention deficit-hyperactivity disorder: A randomized clinical trial

    Parvin Safavi

    2016-01-01

    Full Text Available Although pharmacotherapy with atypical antipsychotics is common in child psychiatry, there has been little research on this issue. To compare the efficacy and safety of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorders comorbid with attention deficit-hyperactivity disorder (ADHD. Randomized clinical trial conducted in a university-affiliated child psychiatry clinic in southwest Iran. Forty 3-6-year-old children, diagnosed with oppositional defiant disorder comorbid with ADHD, were randomized to an 8-week trial of treatment with risperidone or aripiprazole (20 patients in each group. Assessment was performed by Conners′ rating scale-revised and clinical global impressions scale, before treatment, and at weeks 2, 4, and 8 of treatment. The data were analyzed by SPSS version 16. Mean scores between the two groups were compared by analysis of variance and independent and paired t-test. Mean scores of Conners rating scales were not different between two groups in any steps of evaluation. Both groups had significantly reduced scores in week 2 of treatment (P = 0.00, with no significant change in subsequent measurements. Rates of improvement, mean increase in weight (P = 0.894, and mean change in fasting blood sugar (P = 0.671 were not significantly different between two groups. Mean serum prolactin showed a significant increase in risperidone group (P = 0.00. Both risperidone and aripiprazole were equally effective in reducing symptoms of ADHD and oppositional defiant disorder, and relatively safe, but high rates of side effects suggest the cautious use of these drugs in children.

  7. Comparison of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorder and attention deficit-hyperactivity disorder: A randomized clinical trial.

    Safavi, Parvin; Hasanpour-Dehkordi, Ali; AmirAhmadi, Maryam

    2016-01-01

    Although pharmacotherapy with atypical antipsychotics is common in child psychiatry, there has been little research on this issue. To compare the efficacy and safety of risperidone and aripiprazole in the treatment of preschool children with disruptive behavior disorders comorbid with attention deficit-hyperactivity disorder (ADHD). Randomized clinical trial conducted in a university-affiliated child psychiatry clinic in southwest Iran. Forty 3-6-year-old children, diagnosed with oppositional defiant disorder comorbid with ADHD, were randomized to an 8-week trial of treatment with risperidone or aripiprazole (20 patients in each group). Assessment was performed by Conners' rating scale-revised and clinical global impressions scale, before treatment, and at weeks 2, 4, and 8 of treatment. The data were analyzed by SPSS version 16. Mean scores between the two groups were compared by analysis of variance and independent and paired t-test. Mean scores of Conners rating scales were not different between two groups in any steps of evaluation. Both groups had significantly reduced scores in week 2 of treatment (P = 0.00), with no significant change in subsequent measurements. Rates of improvement, mean increase in weight (P = 0.894), and mean change in fasting blood sugar (P = 0.671) were not significantly different between two groups. Mean serum prolactin showed a significant increase in risperidone group (P = 0.00). Both risperidone and aripiprazole were equally effective in reducing symptoms of ADHD and oppositional defiant disorder, and relatively safe, but high rates of side effects suggest the cautious use of these drugs in children. PMID:27144151

  8. Isolated sinus tachycardia following reinitiation of risperidone in a patient with suspected autonomic hypersensitivity

    Melanie J Grubisha

    2015-01-01

    Full Text Available The second generation antipsychotic risperidone is generally considered to have low cardiac adverse events, with an increased risk of ventricular arrhythmias being reported only rarely in literature. We report here the case of a patient with a significant history of alcohol dependence, yet with no previous cardiac history, who had previously tolerated risperidone well, but had experienced isolated sinus tachycardia in the post detox period, following the reinitiation of risperidone therapy. The Naranjo Adverse Drug Reaction (ADR probability scale rating for this being a medication adverse event (AE was 4, thus indicating that this  patient′s AE was associated with risperidone therapy. This case report will contribute to the limited evidence of adverse cardiac events associated with risperidone therapy, with particular emphasis on the susceptibility of patients in a state of autonomic hypersensitivity.

  9. Association of common genetic variants with risperidone adverse events in a Spanish schizophrenic population.

    Almoguera, B; Riveiro-Alvarez, R; Lopez-Castroman, J; Dorado, P; Vaquero-Lorenzo, C; Fernandez-Piqueras, J; Llerena, A; Abad-Santos, F; Baca-García, E; Dal-Ré, R; Ayuso, C

    2013-04-01

    Risperidone non-compliance is often high due to undesirable side effects, whose development is in part genetically determined. Studies with genetic variants involved in the pharmacokinetics and pharmacodynamics of risperidone have yielded inconsistent results. Thus, the aim of this study was to investigate the putative association of genetic markers with the occurrence of four frequently observed adverse events secondary to risperidone treatment: sleepiness, weight gain, extrapyramidal symptoms and sexual adverse events. A series of 111 schizophrenia inpatients were genotyped for genetic variants previously associated with or potentially involved in risperidone response. Presence of adverse events was the main variable and potential confounding factors were considered. Allele 16Gly of ADRB2 was significantly associated with a higher risk of sexual adverse events. There were other non-significant trends for DRD3 9Gly and SLC6A4 S alleles. Our results, although preliminary, provide new candidate variants of potential use in risperidone safety prediction. PMID:22212732

  10. Efficacy and safety of cross-linked hyaluronic acid single injection on osteoarthritis of the knee: a post-marketing phase IV study

    Bashaireh K

    2015-04-01

    Full Text Available Khaldoon Bashaireh,1 Ziad Naser,2 Khaled Al Hawadya,2 Sorour Sorour,2 Rami Nabeel Al-Khateeb3 1Department of Orthopedics Surgery, King Abdullah University Hospital, Jordan University of Science and Technology, Irbid, Jordan; 2Private Clinic, 3Elaf Medical Supplies Company, Amman, Jordan Purpose: The primary objective of this study was to evaluate the efficacy, safety, and duration of action of viscosupplementation with Crespine® Gel over a 9-month period.Materials and methods: The study was a post-marketing phase IV study. A total of 109 participants with osteoarthritis of the knee (grades 1–4 in the tibio–femoral compartment were recruited in Jordan. Data were collected from each participant during the baseline visit. Each participant received Crespine® Gel injection, and follow-up visits took place at 3 months, 6 months, and 9 months post-injection.Main outcome measure(s: An assessment of participants by phone was conducted at 1 month, 2 months, 4 months, 5 months, 7 months, and 8 months post-injection. Western Ontario and McMaster Universities Arthritis Index questionnaires were completed during each visit. A 72-hour visit questionnaire was used to assess the safety of the injection. Statistical analysis included a two-sided 95% confidence interval for the difference between pain scores across visits, and the percent change from baseline was calculated.Main results: The full analysis included 84 participants who gave their informed consent and finished the necessary baseline and follow-up visits needed to assess efficacy and safety. Peak improvement was noted at 5 months post-injection, when pain and physical performance scores had decreased to 2.60 and 9.90, respectively, and the stiffness score was 0.33. The peak improvement in stiffness was noted at 8 months post-injection, when the stiffness score had decreased to 0.32. Significant improvements were still apparent at 9 months post-injection, when the pain score was 3

  11. The Efficacy of Botulinum Toxin Type a Injection in the Hamstring and Calf Muscles With and Without Serial Foot Casting in Gait Improvement in Children With Cerebral Palsy

    Shamsodini A

    2011-11-01

    Full Text Available Background: The goal of this study was to compare the efficacy of botulinum toxin type A (BTX-A injection in the hamstring and calf muscles with and without ankle serial casting in the improvement of gait in children with cerebral palsy (CP.Methods : This double-blind prospective clinical trial was performed on 25, 2 to 8-year-old children with hemiplegic or diplegic CP in Tehran, Iran in 2010. The participants were chosen by simple randomized sampling and were matched for age, gross motor function classification system (GMFCS and type of CP and were randomly divided into two groups: children in the first group (13 only received BTX-A injection, but the second group (12 received BTX-A and serial foot casting starting one week after the injection.Results : Comparison of the gross motor function, right and left knee spasticities and passive ROM of both knees between the two groups before and 1, 3, 6 and 12 months after the injections were not statistically significant (P>0.1. Furthermore, comparison of the right and left ankle spasticities and passive ROM before the injections and in1 and 3-month follow-ups did not show a statistically significant difference (P>0.1, but the differences were significant in 6 and 12-month follow-ups (P<0.05.Conclusion: BTX-A injection with serial foot casting vs. BTX-A alone was more effective in decreasing spasticity and improving passive ROM in the ankle of children with CP, but such injections in the hamstrings were not useful in these regards.

  12. Comparison of Hemostatic Efficacy of Argon Plasma Coagulation with and without Distilled Water Injection in Treating High-Risk Bleeding Ulcers

    Yuan-Rung Li

    2014-01-01

    Full Text Available Background. Argon plasma coagulation (APC is useful to treat upper gastrointestinal bleeding, but its hemostatic efficacy has received little attention. Aims. This investigation attempted to determine whether additional endoscopic injection before APC could improve hemostatic efficacy in treating high-risk bleeding ulcers. Methods. From January 2007 to April 2011, adult patients with high-risk bleeding ulcers were included. This investigation compared APC plus distilled water injection (combined group to APC alone for treating high-risk bleeding ulcers. Outcomes were assessed based on initial hemostasis, surgery, blood transfusion, hospital stay, rebleeding, and mortality at 30 days posttreatment. Results. Totally 120 selected patients were analyzed. Initial hemostasis was accomplished in 59 patients treated with combined therapy and 57 patients treated with APC alone. No significant differences were noted between these groups in recurred bleeding, emergency surgery, 30-day mortality, hospital stay, or transfusion requirements. Comparing the combined end point of mortality plus the failure of initial hemostasis, rebleeding, and the need for surgery revealed an advantage for the combined group (P=0.040. Conclusions. Endoscopic therapy with APC plus distilled water injection was no more effective than APC alone in treating high-risk bleeding ulcers, whereas combined therapy was potentially superior for patients with poor overall outcomes.

  13. The Efficacy of Platelet Rich Plasma Combined with Steroid Injection in the Treatment of Resistant Lateral Epicondylitis

    Aktaş, Erdem; Yılmaz, Barış; Ataoğlu, Baybars; Arıkan, Murat; Toğral, Güray; İlikmen, Murat

    2014-01-01

    OBJECTIVE: To evaluate the impact of autologous platelet rich plasma (PRP) combined with steroid injection on hand grip strenght, pain and patient satisfaction in the treatment of lateral epicondylitis.METHODS: 84 patients, mean age 42.6 (23-62) years, diagnosed with unilateral resistant lateral epicondylitis was evaluated retrospectively. Group1 consisted of patients treated with local steroid injection (0,5ml Bethametasone+0.25 ml Prilokain) and PRP within 1 week interval to extensor carpi ...

  14. Efficacy of epidural steroid injection of patients with back pain dependant to lombar disc hernia; prospective, clinical study

    Şavluk, Ömer Faruk; Erbaş, Mesut

    2012-01-01

    It is aimed to evaluate of the effectiveness of the application of epidural steroid injection(ESE) in patients with lumbar disc herniation (LDH) in this study. Between November 2010- December 2011 patients applied Yahyalı State Hospital Algology Clinic withlow back pain for at least 3 months was evaluated in a prospective study. Application of the lumbar epidural steroid injection was planned for 150 patients. visual analogue scale (VAS) were used for scoring pain of patients. Besides, patien...

  15. Comparative safety, efficacy, and cycle control of Lunelle monthly contraceptive injection (medroxyprogesterone acetate and estradiol cypionate injectable suspension) and Ortho-Novum 7/7/7 oral contraceptive (norethindrone/ethinyl estradiol triphasic). Lunelle Study Group.

    Kaunitz, A M; Garceau, R J; Cromie, M A

    1999-10-01

    An open-label, nonrandomized, parallel, controlled study compared the efficacy, safety, and cycle control of a new monthly injectable contraceptive containing 25 mg of medroxyprogesterone acetate (MPA) and 5 mg of estradiol cypionate (E2C) (MPA/E2C) (Lunelle Monthly Contraceptive Injection) with that of a norethindrone 0.5, 0.75, 1.0 mg/0.035 mg ethinyl estradiol (NET/EE) triphasic oral contraceptive (Ortho-Novum 7/7/7). At study enrollment, women chose either the injections or the oral contraceptive. A higher proportion of women in the NET/EE group (65.1%) than in the MPA/E2C group (48.7%) had used hormonal contraception during the month before the study (p < 0.01). Overall, 55.5% (434/782) of MPA/E2C users and 67.6% (217/321) of NET/EE users completed the 60-week trial. One-year contraceptive efficacy (13 cycles of 28 days) for MPA/E2C and NET/EE was based on 8008 and 3434 woman-cycles of use, respectively. During the first year, one pregnancy occurred in an NET/EE user for a life table rate of 0.3; no pregnancies occurred in users of MPA/E2C. One additional pregnancy in the NET/EE group occurred during the 15th treatment cycle. After the first treatment cycle, women in both groups experienced regular menses, with an average cycle length of 28 days in MPA/E2C users and 27 days in NET/EE users. Although MPA/E2C users were more likely to experience bleeding irregularities, only 2.5% (19/775) cited metrorrhagia as a reason for discontinuing treatment. The adverse events reported in both treatment groups are consistent with those expected with the use of combined hormonal contraceptives. Overall, the results of this first Phase III US clinical trial of MPA/E2C confirm this method's high contraceptive efficacy and safety, as shown in previous studies by the World Health Organization. These results suggest that a monthly combination injectable would represent a welcome new contraceptive option for women in the US. PMID:10640164

  16. Effectiveness of Risperidone Augmentation in Obsessive-Compulsive Disorder: Experience From a Specialty Clinic in India.

    Hegde, Aditya; Kalyani, Bangalore G; Arumugham, Shyam Sundar; Narayanaswamy, Janardhanan C; Math, Suresh Bada; Reddy, Y C Janardhan

    2016-08-01

    Risperidone is the most widely used augmenting agent in the treatment of obsessive-compulsive disorder (OCD). However, a recent controlled study found risperidone to be no different from placebo, raising doubts about its effectiveness. In this context, we sought to examine the real-world effectiveness of risperidone from the large database of an OCD clinic in India. A total of 1314 consecutive patients who registered at the OCD clinic between 2004 and 2014 were evaluated with structured interviews and scales. Patients with OCD initiated on risperidone augmentation without concurrent cognitive behavior therapy and who were on stable and adequate doses of serotonin reuptake inhibitors for at least 12 preceding weeks were included for analysis. The primary outcome measure was all-cause discontinuation. Logistic regression was performed to identify the factors predicting improvement with risperidone augmentation. A total of 92 patients were eligible for analysis. Risperidone continued to be used in 23 patients (25%) at the time of last follow-up, and the remaining discontinued either because of ineffectiveness or intolerability. The fall in the Yale-Brown Obsessive-Compulsive Scale scores was significantly greater in patients who continued to take risperidone when compared with those who did not (41.6% vs 3.7%, t = 6.95, P Obsessive-Compulsive Scale scores. On regression analysis, no predictors of improvement with risperidone augmentation could be identified. The study demonstrated, in a real-world setting, that risperidone may be a useful augmenting agent in a proportion of patients with partial/poor response to serotonin reuptake inhibitors. PMID:27219093

  17. Efficacy and safety of alcohol sclerotherapy involving single-session multiple injections to treat simple renal cysts:a multicenter, prospective, randomized, controlled trial

    LI Yong-zhong; LI Ming-xing; WANG Tao; YANG Li-chuan; FENG Ping; GOU Zhong-ping; YUAN Jia-ying

    2013-01-01

    Background Alcohol has been used for treating simple renal cysts since 1981.Since then,various observational studies have examined the technique,but they differ significantly in the details of the procedures and efficacy measures used.This has made it difficult to assess the safety and efficacy of this technique.We carried out a randomized controlled trial to evaluate the efficacy and safety of ultrasound-guided alcohol sclerotherapy involving single-session multiple injections to treat simple renal cysts.Methods A total of 144 patients with simple renal cysts were randomly allocated to either the treatment group (ultrasound-guided percutaneous drainage and alcohol sclerotherapy with single-session multiple injections) or control group (ultrasound-guided simple percutaneous drainage).Follow-up CT scans of ablated cysts were collected 3 and 6 months after the procedure.The outcome was considered successful if cyst volume between baseline and 6 months decreased by at least 87.5%.Results Intention-to-treat analysis revealed an average volume reduction of 94.2% in the treatment group and 50.8% in the control group (P <0.0001).The percentage of patients achieving successful outcomes was 88.9% (95% CI 77.0%-100.0%) in the treatment group and 22.2% (95% CI 6.54%-37.9%) in the control group (P <0.0001).The corresponding results in the per-protocol analysis were an average volume reduction of 96.4% in the treatment group and 50.8% in the control group (P <0.0001).The percentage of patients achieving a successful outcome was 94.3% (95% CI 85.6%-100.0%) in the treatment group and 22.2% (95% CI 6.54%-37.9%) in the control group (P <0.0001).Conclusion Alcohol sclerotherapy involving single-session multiple injections is safe and efficacious in the treatment of renal cysts.(ChiCTR-TRC-10001114,http://www.chictr.org)

  18. Assessment on the Efficacy and Safety of Aidi Injection Combined with Vinorelbine and Cisplatin for Treatment of Advanced Nonsmall Cell Lung Cancer

    Zhao, Hua-Ye; Zhou, Hai-Yan; Wang, Yan-Ting; Chen, Wei; Qi, Shu-Ya; Cao, Jun-Ling; Li, Guo-Hui

    2016-01-01

    Background: The aim of this study was to assess the efficacy and safety of vinorelbine and cisplatin (NP chemotherapy) alone or in combination with Aidi injection for the treatment of advanced nonsmall cell lung cancer (NSCLC). Methods: Pertinent publications were identified in PubMed, EMBASE, Cochrane Library, CNKI, CQVIP, and Wanfang databases, up to December 8, 2015. After quality assessment of all included randomized controlled trials evaluating Aidi injection combined with NP chemotherapy for the treatment of advanced NSCLC, a meta-analysis was performed by Review Manager 5.2 and STATA 12.0 for statistical analyses. Results: Twelve studies including 509 and 503 cases in the experimental and control groups, respectively, were finally analyzed. The meta-analysis revealed that when cisplatin dose ranging from 20 to 40 mg/m2, combination of Aidi injection and NP chemotherapy was statistically different compared with NP chemotherapy alone in enhancing efficiency (relative risk [RR] = 1.24, 95% confidence interval [CI] [1.05–1.47], P = 0.010) and reducing the incidence of Grade II or above nausea and vomiting (RR = 0.49, 95% CI [0.30–0.80], P = 0.005). Meanwhile, with cisplatin ranging from 80 to 120 mg/m2, no significant differences in efficiency (RR = 1.11, 95% CI [0.87–1.42], P = 0.390) and Grade II or above nausea and vomiting (RR = 0.88, 95% CI [0.71–1.10], P = 0.260) were obtained. In addition, Aidi injection combined with NP chemotherapy was superior to NP chemotherapy alone in improving the quality of life, alleviating Grade II or above leukopenia and thrombocytopenia. Conclusions: Aidi injection combined with NP chemotherapy can enhance efficiency, improve the quality of life, and decrease adverse effects in patients with advanced NSCLC. PMID:26960377

  19. Assessment on the Efficacy and Safety of Aidi Injection Combined with Vinorelbine and Cisplatin for Treatment of Advanced Nonsmall Cell Lung Cancer

    Hua-Ye Zhao; Hai-Yan Zhou; Yan-Ting Wang; Wei Chen; Shu-Ya Qi; Jun-Ling Cao; Guo-Hui Li

    2016-01-01

    Background:The aim of this study was to assess the efficacy and safety of vinorelbine and cisplatin (NP chemotherapy) alone or in combination with Aidi injection for the treatment of advanced nonsmall cell lung cancer (NSCLC).Methods:Pertinent publications were identified in PubMed,EMBASE,Cochrane Library,CNKI,CQVIP,and Wanfang databases,up to December 8,2015.After quality assessment of all included randomized controlled trials evaluating Aidi injection combined with NP chemotherapy for the treatment of advanced NSCLC,a meta-analysis was performed by Review Manager 5.2 and STATA 12.0 for statistical analyses.Results:Twelve studies including 509 and 503 cases in the experimental and control groups,respectively,were finally analyzed.The meta-analysis revealed that when cisplatin dose ranging from 20 to 40 mg/m2,combination of Aidi injection and NP chemotherapy was statistically different compared with NP chemotherapy alone in enhancing efficiency (relative risk [RR] =1.24,95% confidence interval [CI] [1.05-1.47],P =0.010) and reducing the incidence of Grade Ⅱ or above nausea and vomiting (RR =0.49,95% CI [0.30-0.80],P =0.005).Meanwhile,with cisplatin ranging from 80 to 120 mg/m2,no significant differences in efficiency (RR =1.11,95% CI [0.87-1.42],P =0.390) and Grade Ⅱ or above nausea and vomiting (RR =0.88,95% CI [0.71-1.10],P =0.260) were obtained.In addition,Aidi injection combined with NP chemotherapy was superior to NP chemotherapy alone in improving the quality of life,alleviating Grade Ⅱ or above leukopenia and thrombocytopenia.Conclusions:Aidi injection combined with NP chemotherapy can enhance efficiency,improve the quality of life,and decrease adverse effects in patients with advanced NSCLC.

  20. Endoscopic management of gastric variceal bleeding with cyanoacrylate glue injection: Safety and efficacy in a Canadian population

    Al-Ali, Jaber; Pawlowska, Monika; Coss, Alan; Svarta, Sigrid; Byrne, Michael; Enns, Robert

    2010-01-01

    BACKGROUND: Gastric variceal bleeding (GVB) is a major cause of morbidity and mortality among patients with portal hypertension. Endoscopic band ligation and standard sclerotherapy have been used but have significant limitations. Decompression through transjugular intrahepatic portosystemic shunt insertion has been shown to be effective. Gastric variceal injection therapy with a commercially available cyanoacrylate glue is less invasive than transjugular intrahepatic portosystemic shunt inser...

  1. Effect of paliperidone and risperidone on extracellular glutamate in the prefrontal cortex of rats exposed to prenatal immune activation or MK-801

    Roenker, Nicole L.; Gudelsky, Gary; Ahlbrand, Rebecca; Bronson, Stefanie L.; Kern, Joseph R.; Waterman, Heather; Richtand, Neil M.

    2011-01-01

    The NMDA glutamate hypofunction model of schizophrenia is based in part upon acute effects of NMDA receptor blockade in humans and rodents. Several laboratories have reported glutamate system abnormalities following prenatal exposure to immune challenge, a known environmental risk factor for schizophrenia. Here we report indices of NMDA glutamate receptor hypofunction following prenatal immune activation, as well as the effects of treatment during periadolescence with the atypical antipsychotic medications risperidone and paliperidone. Pregnant Sprague-Dawley rats were injected with polyinosinic:polycytidylic acid (poly I:C) or saline on gestational day 14. Male offspring were treated orally via drinking water with vehicle, risperidone (0.01 mg/kg/day), or paliperidone (0.01 mg/kg/day) between postnatal days 35 and 56 (periadolescence) and extracellular glutamate levels in the prefrontal cortex were determined by microdialysis at PD 56. Consistent with decreased NMDA receptor function, MK-801 – induced increases in extracellular glutamate concentration were markedly blunted following prenatal immune activation. Further suggesting NMDA receptor hypofunction, prefrontal cortex basal extracellular glutamate was significantly elevated (P<0.05) in offspring of Poly I:C treated dams. Pretreatment with low dose paliperidone or risperidone (0.01 mg/kg/day postnatal days 35–56) normalized prefrontal cortical basal extracellular glutamate (P<0.05 vs. poly I:C vehicle-treatment). Pretreatment with paliperidone and risperidone also prevented the acute MK-801-induced increase in extracellular glutamate. These observations demonstrate decreased NMDA receptor function and elevated extracellular glutamate, two key features of the NMDA glutamate receptor hypofunction model of schizophrenia, during periadolescence following prenatal immune activation. Treatment with the atypical antipsychotic medications paliperidone and risperidone normalized basal extracellular glutamate

  2. Double jeopardy--drug and sex risks among Russian women who inject drugs: initial feasibility and efficacy results of a small randomized controlled trial

    Wechsberg Wendee M

    2012-01-01

    Full Text Available Abstract Background With HIV prevalence estimated at 20% among female injecting drug users (IDUs in St. Petersburg, Russia, there is a critical need to address the HIV risks of this at-risk population. This study characterized HIV risks associated with injecting drug use and sex behaviors and assessed the initial feasibility and efficacy of an adapted Woman-Focused intervention, the Women's CoOp, relative to a Nutrition control to reduce HIV risk behaviors among female IDUs in an inpatient detoxification drug treatment setting. Method Women (N = 100 were randomized into one of two one-hour long intervention conditions--the Woman-Focused intervention (n = 51 or a time and attention-matched Nutrition control condition (n = 49. Results The results showed that 57% of the participants had been told that they were HIV-positive. At 3-month follow-up, both groups showed reduced levels of injecting frequency. However, participants in the Woman-Focused intervention reported, on average, a lower frequency of partner impairment at last sex act and a lower average number of unprotected vaginal sex acts with their main sex partner than the Nutrition condition. Conclusion The findings suggest that improvements in sexual risk reduction are possible for these at-risk women and that more comprehensive treatment is needed to address HIV and drug risks in this vulnerable population.

  3. A pilot study comparing the efficacy of radiofrequency and microwave diathermy in combination with intra-articular injection of hyaluronic acid in knee osteoarthritis

    Takahashi, Kenji; Hashimoto, Sanshiro; Kurosaki, Hiromasa; Kato, Kazuo; Majima, Tokifumi; Shindo, Yasuhiro; Watanabe, Hiroshi; Mochizuki, Yusuke; Takai, Shinro

    2016-01-01

    [Purpose] This study aimed to compare the efficacy of radiofrequency diathermy with that of microwave diathermy in combination with intra-articular injection of hyaluronic acid into the knee of patients with osteoarthritis (OA). [Subjects] A total of 17 patients with knee OA were enrolled. The participants were randomly divided into two groups: a radiofrequency diathermy group (RF group, 9 subjects), and a microwave diathermy group (MW group, 8 subjects). [Methods] Subjects received radiofrequency or microwave thermal therapy 3 times at 1-week intervals. Intra-articular injection of hyaluronic acid was administered 10 min before every thermal therapy session. The outcome was evaluated using the Japan Orthopaedic Association (JOA) and the Lequesne Index (LI) at baseline, at weeks 1 (1 week after the first thermal therapy) and 3 (1 week after the last thermal therapy). [Results] The JOA scale increased significantly after three sessions of thermal therapy in the RF group, while no significant increase was observed in the MW group. LI decreased significantly after 3 weeks in the RF group. In the MW group, there was no significant difference in LI between the two time points. [Conclusion] This study revealed that symptom relief in patients with knee OA was greater with radiofrequency diathermy than with microwave diathermy with concurrent use of hyaluronic acid injection, presumably due to the different heating characteristics of the two methods. PMID:27065540

  4. Anesthetic efficacy of the supplemental X-tip intraosseous injection using 4% articaine with 1:100,000 adrenaline in patients with irreversible pulpitis: An in vivo study

    Atool Chandra Bhuyan

    2014-01-01

    Full Text Available Introduction: Pain management remains the utmost important qualifying criteria in minimizing patient agony and establishing a strong dentist-patient rapport. Symptomatic irreversible pulpitis is a painful condition necessitating immediate attention and supplemental anesthetic techniques are often resorted to in addition to conventional inferior alveolar nerve block. Aim: The purpose of the study was to evaluate the anesthetic efficacy of X-tip intraosseous injection in patients with symptomatic irreversible pulpitis, in mandibular posterior teeth, using 4% Articaine with 1:100,000 adrenaline as local anesthetic, when the conventional inferior alveolar nerve block proved ineffective. Materials and Methods: X-tip system was used to administer 1.7 ml of 4% articaine with 1:100,000 adrenaline in 30 patients diagnosed with irreversible pulpitis of mandibular posterior teeth with moderate to severe pain on endodontic access after administration of an inferior alveolar nerve block. Results: The results of the study showed that 25 X-tip injections (83.33% were successful and 5 X-tip injections (16.66% were unsuccessful. Conclusion: When the inferior alveolar nerve block fails to provide adequate pulpal anesthesia, X-tip system using 4% articaine with 1:100,000 adrenaline was successful in achieving pulpal anesthesia in patients with irreversible pulpitis.

  5. Risperidone in Children and Adolescents with Conduct Disorder: A Single-Center, Open-Label Study

    Ercan, Eyüp Sabri; Kutlu, Ayşe; Çıkoğlu, Sibel; Veznedaroğlu, Baybars; Erermiş, Serpil; Varan, Azmi

    2003-01-01

    Background: Risperidone is one of the most commonly used atypical antipsychotic drugs in the treatment of children and adolescents. However, the data about its use in children and adolescents with conduct disorder (CD) are limited.

  6. Efficacy of caudal epidural injection of lidocaine, xylazine and xylazine plus hyaluronidase in reducing discomfort produced by electroejaculation in bulls

    PAGLIOSA, Ronaldo C.; DEROSSI, Rafael; COSTA, Deiler S.; FARIA, Fabio J.C.

    2015-01-01

    To test the hypothesis that epidural administration of lidocaine, xylazine or xylazine plus hyaluronidase provides reduced pain and stress during electroejaculation in bulls, eight 30-month-old Nellore bulls received saline solution (control), 2% lidocaine, 2% xylazine or 2% xylazine plus hyaluronidase injected into the first intercoccygeal (Co1–Co2) epidural space in randomized order. Heart rate, respiratory rate, mean arterial pressure, analgesia, animal behavior and motor blockade were eva...

  7. Dose-associated changes in safety and efficacy parameters observed in a 24-week maintenance trial of olanzapine long-acting injection in patients with schizophrenia

    Watson Susan B

    2011-02-01

    Full Text Available Abstract Background In a recently published 24-week maintenance study of olanzapine long-acting injection (LAI in schizophrenia (Kane et al., 2010, apparent dose-associated changes were noted in both efficacy and safety parameters. To help clinicians balance safety and efficacy when choosing a dose of olanzapine LAI, we further studied these changes. Methods Outpatients with schizophrenia who had maintained stability on open-label oral olanzapine for 4 to 8 weeks were randomly assigned to "low" (150 mg/2 weeks; N = 140, "medium" (405 mg/4 weeks; N = 318, or "high" (300 mg/2 weeks; N = 141 dosages of olanzapine LAI for 24 weeks. Potential relationships between dose and several safety or efficacy measures were examined via regression analysis, the Jonckheere-Terpstra test (continuous data, or the Cochran-Armitage test (categorical data. Results Safety parameters statistically significantly related to dose were mean weight change (low: +0.67 [SD = 4.38], medium: +0.89 [SD = 3.87], high: +1.70 [SD = 4.14] kg, p = .024; effect size [ES] = 0.264 high vs. low dose, mean change in prolactin (low: -5.61 [SD = 12.49], medium: -2.76 [SD = 19.02], high: +3.58 [SD = 33.78] μg/L, p = .001; ES = 0.410 high vs. low dose, fasting triglycerides change from normal at baseline to high (low: 3.2%, medium: 6.0%, high: 18.9%, p = .001; NNT = 7 high vs. low dose and fasting high-density lipoprotein cholesterol change from normal at baseline to low (low: 13.8%, medium: 19.6%, high: 30.7%, p = .019; NNT = 6 high vs. low dose. Efficacy measures significantly related to dose included Positive and Negative Syndrome Scale total score mean change (low: +2.66 [SD = 14.95], medium: -0.09 [SD = 13.47], high: -2.19 [SD = 13.11], p Conclusions Analyses of several safety and efficacy parameters revealed significant associations with dose of olanzapine LAI, with the highest dose generally showing greater efficacy as well as greater adverse changes in metabolic safety measures. When

  8. Hyperprolactinemia in Thai children and adolescents with autism spectrum disorder treated with risperidone

    Hongkaew Y

    2015-01-01

    Full Text Available Yaowaluck Hongkaew,1,2 Nattawat Ngamsamut,3 Apichaya Puangpetch,1,2 Natchaya Vanwong,1,2 Pornpen Srisawasdi,4 Montri Chamnanphon,1,2 Bhunnada Chamkrachchangpada,3 Teerarat Tan-kam,3 Penkhae Limsila,3 Chonlaphat Sukasem1,2 1Division of Pharmacogenomics and Personalized Medicine, Department of Pathology, Faculty of Medicine, 2Laboratory for Pharmacogenomics, Somdech Phra Debaratana Medical Center (SDMC, Ramathibodi Hospital, Mahidol University, 3Yuwaprasart Waithayopathum Child and Adolescent Psychiatric Hospital, Department of Mental Health Services, Ministry of Public Health, 4Division of Clinical Chemistry, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Abstract: Hyperprolactinemia is a common adverse effect observed in children with autism spectrum disorder (ASD during pharmacotherapy with risperidone. The main aim of this study was to investigate important clinical factors influencing the prolactin response in risperidone-treated Thai ASD. A total of 147 children and adolescents (127 males and 20 females aged 3–19 years with ASD received risperidone treatment (0.10–6.00 mg/day for up to 158 weeks. Prolactin levels were measured by chemiluminescence immunoassay. The clinical data of patients collected from medical records – age, weight, height, body mass index, dose of risperidone, duration of treatment, and drug-use pattern – were recorded. Hyperprolactinemia was observed in 66 of 147 (44.90% subjects. Median prolactin level at the high doses (24.00, interquartile range [IQR] 14.30–29.20 of risperidone was significantly found to be higher than at the recommended (16.20, IQR 10.65–22.30 and low (11.70, IQR 7.51–16.50 doses of risperidone. There was no relationship between prolactin levels and duration of risperidone treatment. Dose-dependence is identified as a main factor associated with hyperprolactinemia in Thai children and adolescents with ASD treated with

  9. The Canadian experience with risperidone for the treatment of schizophrenia: an overview.

    Iskedjian, M; Hux, M; Remington, G J

    1998-01-01

    OBJECTIVE: To summarize published data to date by Canadian authors and from Canadian sources on risperidone, a novel neuroleptic indicated in the management of schizophrenia and related psychotic disorders. It was introduced in Canada in 1993. DATA SOURCES: A MEDLINE search was performed using "risperidone" as a keyword. Three Canadian journals were also searched manually. STUDY SELECTION: Articles published between January 1991 and June 1996 by Canadian authors or involving Canadian patients...

  10. Antipsychotic discontinuation syndrome following risperidone withdrawal: a case report from rural India

    Sanivarapu, Sravanti L.; Krishnamurthy CN

    2014-01-01

    Risperidone is an atypical antipsychotic agent used primarily to treat schizophrenia. It is a dopamine antagonist with antiserotonergic, antihistaminergic and antiadrenergic properties. Antipsychotic discontinuation symptoms have been described in the literature following abrupt or rapid reduction in the dose. This unusual case demonstrates that sudden withdrawal of even a modest dose of risperidone may cause significant discontinuation symptoms in susceptible individuals. Hence, there is a n...

  11. Normalization of Risperidone-Induced Hyperprolactinemia with the Addition of Aripiprazole

    Shores, Larry E.

    2005-01-01

    The objective of this study was to monitor metabolic changes, including hyperprolactinemia, in adolescents medicated with atypical antipsychotics, especially when polypharmacy is involved. This study specifically followed risperidone-induced hyperprolactinemia in adolescents (14 male patients and 2 female patients) after aripiprazole was added to begin transitioning to another atypical antipsychotic. No other changes were made in the medication regimen. Risperidone was continued at the previo...

  12. A Comparison of Risperidone and Buspirone for Treatment of Behavior Disorders in Children with Phenylketonuria

    FAYYAZI, Afshin; Elham SALARI*; Ali KHAJEH; Abdi GAJARPOUR

    2014-01-01

    How to Cite This Article: Fayyazi A, Salari E, Khajeh A, Ghajarpour A. A Comparison of Risperidone and Buspirone for Treatment ofBehavior Disorders in Children with Phenylketonuria. Iran J Child Neurol. 2014 Autumn; 8(4):33-38.AbstractObjectiveMany patients with late-diagnosed phenylketonuria (PKU) suffer from severe behavior problems. This study compares the effects of buspirone and risperidone on reducing behavior disorders in these patients.Materials & MethodsIn this crossover clinical...

  13. In vitro-in vivo correlation of parenteral risperidone polymeric microspheres.

    Shen, Jie; Choi, Stephanie; Qu, Wen; Wang, Yan; Burgess, Diane J

    2015-11-28

    The objective of the present study was to determine whether an in vitro-in vivo correlation (IVIVC) can be established for polymeric microspheres that are equivalent in formulation composition but prepared with different manufacturing processes. Risperidone was chosen as a model therapeutic and poly(lactic-co-glycolic acid) (PLGA) with similar molecular weight as that used in the commercial product Risperdal® Consta® was used to prepare risperidone microspheres. Various manufacturing processes were investigated to produce the risperidone microspheres with similar drug loading (approx. 37%) but distinctly different physicochemical properties (e.g. porosity, particle size and particle size distribution). In vitro release of the risperidone microspheres was investigated using different release testing methods (such as sample-and-separate and USP apparatus 4). In vivo pharmacokinetic profiles of the risperidone microsphere formulations following intramuscular administration were determined using a rabbit model. Furthermore, the obtained pharmacokinetic profiles were deconvoluted using the Loo-Riegelman method and the calculated in vivo release was compared with the in vitro release of these microspheres. Level A IVIVCs were established and validated for the compositionally equivalent risperidone microspheres based on the in vitro release data obtained using USP apparatus 4. The developed IVIVCs demonstrated good predictability and were robust. These results showed that the developed USP apparatus 4 method was capable of discriminating PLGA microspheres that are equivalent in formulation composition but with manufacturing differences and predicting their in vivo performance in the investigated animal model. PMID:26423236

  14. Early onset of treatment effects with oral risperidone

    Naber Dieter

    2007-01-01

    Full Text Available Abstract Background The dogma of a delayed onset of antipsychotic treatment effects has been maintained over the past decades. However, recent studies have challenged this concept. We therefore performed an analysis of the onset of antipsychotic treatment effects in a sample of acutely decompensated patients with schizophrenia. Methods In this observational study, 48 inpatients with acutely decompensated schizophrenia were offered antipsychotic treatment with oral risperidone. PANSS-ratings were obtained on day 0, day 1, day 3, day 7 and day 14. Results Significant effects of treatment were already present on day 1 and continued throughout the study. The PANSS positive subscore and the PANSS total score improved significantly more than the PANSS negative subscore. Conclusion Our results are consistent with the growing number of studies suggesting an early onset of antipsychotic treatment effects. However, non-pharmacological effects of treatment also need to be taken into consideration.

  15. Pharmacogenetics of Risperidone and Cardiovascular Risk in Children and Adolescents

    Amilton Dos Santos-Júnior

    2016-01-01

    Full Text Available Objective. To identify the frequency of obesity and metabolic complications in child and adolescent users of risperidone. Potential associations with clinical parameters and SNPs of the HTR2C, DRD2, LEP, LEPR, MC4R, and CYP2D6 genes were analyzed. Methods. Samples from 120 risperidone users (8–20 years old were collected and SNPs were analyzed, alongside assessment of chronological and bone ages, prescribed and weight-adjusted doses, use of other psychotropic drugs, waist circumference, BMI z-scores, blood pressure, HOMA-IR index, fasting levels of serum glucose, insulin, cholesterol, triglycerides, transaminases, and leptin. Results. Thirty-two (26.7% patients were overweight and 5 (4.2% obese. Hypertension was recorded in 8 patients (6.7%, metabolic syndrome in 6 (5%, and increased waist circumference in 20 (16.7%. The HOMA-IR was high for 22 patients (18.3%, while total cholesterol and triglycerides were high in 20 (16.7% and 41 (34.2% patients, respectively. SNP associations were found for LEP, HTR2C, and CYP2D6 with BMI; CYP2D6 with blood pressure, ALT, and HOMA-IR; HTR2C and LEPR with leptin levels; MC4R and DRD2 with HOMA-IR; HTR2C with WC; and LEP with ALT. Conclusions. Although not higher than in the general pediatric population, a high frequency of patients was overweight/obese, with abnormalities in metabolic parameters and some pharmacogenetic associations.

  16. Adjunctive Aripiprazole Treatment for Risperidone-Induced Hyperprolactinemia: An 8-Week Randomized, Open-Label, Comparative Clinical Trial

    Zhao, Jingyuan; Song, Xueqin; Ai, Xiaoqing; Gu, Xiaojing; Huang, Guangbiao; Li, Xue; Pang, Lijuan; Ding, Minli; Ding, Shuang; Lv, Luxian

    2015-01-01

    Objective The present study aimed to evaluate the efficacy and safety of adjunctive aripiprazole treatment in schizophrenia patients with risperidone-induced hyperprolactinemia. Methods One hundred and thirteen patients who were receiving a stable dose of risperidone were randomly assigned to either adjunctive aripiprazole treatment (10 mg/day) (aripiprazole group) or no additional treatment (control group) at a 1:1 ratio for 8 weeks. Schizophrenia symptoms were measured using the Positive and Negative Syndrome Scale (PANSS). Rating scales and safety assessments (RSESE, BARS, UKU) were performed at baseline and at weeks 4 and 8. Serum levels of prolactin were determined at baseline and at weeks 2, 4, 6 and 8. Metabolic parameters were determined at baseline and again at weeks 4 and 8. Results One hundred and thirteen patients were enrolled in this study, and 107 patients completed the study (54 in the aripiprazole group, and 53 in the control group). PANSS-total scores in the aripiprazole group decreased significantly at week 4 (P = 0.003) and week 8 (P = 0.007) compared with the control group. PANSS-negative scores in the aripiprazole group also decreased significantly at week 4 (P = 0.005) and week 8 (P< 0.001) compared with the control group. Serum levels of prolactin in the aripiprazole group decreased significantly at week 2 (P< 0.001), week 4 (P< 0.001), week 6 (P< 0.001) and week 8 (P< 0.001) compared with the control group. There were no significant differences in changes of Fasting Plasma Glucose, Total cholesterol, Triglycerides and High Density Lipoprotein within each group at week 4 and 8 execpt low density lipoproteins. There was no significant difference in the incidence of adverse reactions between the two groups. Conclusions Adjunctive aripiprazole treatment may be beneficial in reducing serum levels of prolactin and improving negative symptoms in schizophrenia patients with risperidone-induced hyperprolactinemia. Trial Registration chictr.org Chi

  17. COMPARATIVE STUDY OF EFFICACY OF LOCAL STEROID INJECTION AND EXTRACORPOREAL SHOCKWAVE THERAPY IN THE TREATMENT OF PLANTAR FASCITIS

    Rajan

    2014-04-01

    Full Text Available INTRODUCTION: Plantar fasciitis is a common condition causing misery to lot of patients. The etiology and treatment of plantar fasciitis are poorly understood. The results from such treatments vary considerably, and there is no consensus of opinion on the best method. MATERIAL AND METHODS: We conducted a controlled trial in our institute to compare the results of local steroid injections & the use of Extra-corporeal shock wave therapy (ESWT for managing plantar fasciitis. 200 patients with 240 painful heels were evaluated. All patients with moderate to severe heel pain who had already taken ten days of unsatisfactory treatment with oral NSAIDS were divided in two main groups. Group A of 100 patients received 1000 impulses of shock waves in three sessions at weekly interval. In Group B of 100 patients up to three local injections of 40 mg methyl prednisone mixed with 1 ml. of 2% lignocaine were given at biweekly interval. Pain assessment was done using VAS scale and the results were evaluated at six weeks, three months and six months after the completion of the therapy. CONCLUSIONS: There was a significant difference between two groups of patients being treated. The group B patients had significantly greater improvement in pain scale and early return to daily activities

  18. Identification and quantification of the antipsychotics risperidone, aripiprazole, pipamperone and their major metabolites in plasma using ultra-high performance liquid chromatography-mass spectrometry.

    Wijma, Rixt A; van der Nagel, Bart C H; Dierckx, Bram; Dieleman, Gwen C; Touw, Daan J; van Gelder, Teun; Koch, Birgit C P

    2016-06-01

    The antipsychotics risperidone, aripiprazole and pipamperone are frequently prescribed for the treatment in children with autism. The aim of this study was to validate an ultra-high performance liquid chromatography-mass spectrometry method for the quantification of these antipsychotics in plasma. An ultra-high performance liquid chromatography-mass spectrometry assay was developed for the determination of the drugs and metabolites. Gradient elution was performed on a reversed-phase column with a mobile phase consisting of ammonium acetate, formic acid in methanol or in Milli-Q ultrapure water at a flow rate of 0.5 mL/min. The method was validated according to the US Food and Drug Administration guidelines. The analytes were found to be stable enough after reconstitution and injection of only 5 μL improved the accuracy and precision in combination with the internal standard. Calibration curves of all five analytes were linear. All analytes were stable for at least 72 h in the autosampler and the high quality control of 9-OH-risperidone was stable for 48 h. The method allows quantification of all analytes. The advantage of this method is the combination of a minimal injection volume, a short run-time, an easy sample preparation method and the ability to quantify all analytes in one run. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26447610

  19. A literature review on the efficacy and safety of botulinum toxin: An injection in post-stroke spasticity

    Majid Ghasemi

    2013-01-01

    Full Text Available Background: A variety of techniques for the management of spasticity have been suggested, including positioning, cryotherapy, splinting and casting, biofeedback, electrical stimulation, and medical management by pharmacological agents, Botulinum toxin A (BTA is now the pharmacological treatment of choice in focal spasticity. BTA by blocking acetylcholine release at neuromuscular junctions accounts for its therapeutic action to relieve spasticity. Methods: A computerized search of Pub Med was carried out to find the latest result about efficacy of BTA in management of post stroke spasticity. Result: Among 84 articles were found, frothy of them included in this review and divided to lower and upper extremity. Conclusions: BTA is a treatment choice in reducing tone and managing post stroke spasticity .

  20. Comparison of efficacy of lignocaine anesthesia of vocal cords by spray as you go through a bronchoscope with lignocaine injection through the cricothyroid membrane

    To assess and compare the efficacy of lignocaine anesthesia of vocal cords by spray as you go through a bronchoscope with lignocaine injection through the cricothyroid membrane. Study Design: Quasi experimental study. Place and Duration of Study:This study was done in Combined Military Hospital Peshawar form May 2009 to June 2010. Material and method: Thirty patients in each group were given local anesthesia to the vocal cords. With lignocaine either via intratracheal instillation through the cricothyroid membrane or through a fibreoptic bronchoscope spray as you go. A cough score was calculated by recording the number of coughs as the bronchoscope was advanced through the cords into the trachea. A twenty point unpleasantness score was marked by the patient 2 hours after the procedure. Result: Cough score and unpleasantness score was compared among the two groups using SPSS version 19. Median unpleasantness score was 6 (Inter quartile range (IQR) 4-8) whereas median cough score was 2(IQR 0-3). The difference was statistically significant among the two groups for both cough and unpleasant scores (p< 0.001 and p< 0.001 respectively). Conclusion: Intratracheal injection of lignocaine is more comfortable for the patient. It induces much less cough and irritability to the patient than the spray as you go technique. (author)

  1. A randomized, crossover comparison of herbal medicine and bromocriptine against risperidone-induced hyperprolactinemia in patients with schizophrenia.

    Yuan, Hai-Ning; Wang, Chuan-Yue; Sze, Cho Wing; Tong, Yao; Tan, Qing-Rong; Feng, Xiu-Jie; Liu, Rui-Mei; Zhang, Ji-Zhi; Zhang, Yan-Bo; Zhang, Zhang-Jin

    2008-06-01

    Hyperprolactinemia is a common adverse effect that occurs as a result of antipsychotic therapies, which often results in discontinuation. Empirical evidence has shown that some herbal medicines have suppressive effects on prolactin (PRL) hyperactivities. This study was designed to compare the herbal preparation called Peony-Glycyrrhiza Decoction (PGD) with bromocriptine (BMT), a dopamine agonist widely used for PRL-secreting disorders, in the treatment of risperidone-induced hyperprolactinemia. Twenty schizophrenic women who were under risperidone maintenance treatment, diagnosed with hyperprolactinemia (serum PRL levels >50 mug/L), and currently experiencing oligomenorrhea or amenorrhea were selected for the study. Subjects were randomized to additional treatment with PGD (45 g/d) followed by BMT (5 mg/d) or BMT followed by PGD at the same doses for 4 weeks each, with an interval of 4-week washout period between 2 treatment sessions. The severity of psychotic symptoms, adverse events, serum PRL, estradiol, testosterone, and progesterone levels were examined at baseline and end point. Peony-Glycyrrhiza Decoction treatment produced a significant baseline-end point decrease in serum PRL levels, without exacerbating psychosis and changing other hormones, and the decreased amplitudes were similar to those of BMT (24% vs 21%-38%). Moreover, there was a significantly greater proportion of patients during PGD treatment than BMT treatment showing improvements on adverse effects associated with hyperprolactinemia (56% vs 17%, P = 0.037). These results suggest that the herbal therapy can yield additional benefits while having comparable efficacy in treating antipsychotic-induced hyperprolactinemia in individuals with schizophrenia. PMID:18480682

  2. Efficacy of a single intramuscular injection of porcine FSH in hyaluronan prior to ovum pick-up in Holstein cattle.

    Vieira, L M; Rodrigues, C A; Netto, A Castro; Guerreiro, B M; Silveira, C R A; Freitas, B G; Bragança, L G M; Marques, K N G; Sá Filho, M F; Bó, G A; Mapletoft, R J; Baruselli, P S

    2016-03-15

    Plasma FSH profiles, in vitro embryo production (IVP) after ovum pickup (OPU), and establishment of pregnancy with IVP embryos were compared in untreated Holstein oocyte donors and those superstimulated with multiple injections or a single intramuscular (IM) injection of porcine FSH (pFSH) in hyaluronan (HA). Plasma FSH profiles were determined in 23 heifers randomly allocated to one of four groups. Controls received no treatment, whereas the F200 group received 200 mg of pFSH in four doses, 12 hours apart. The F200HA and F300HA groups received 200- or 300-mg pFSH in 5 mL or 7.5 mL, respectively of a 0.5% HA solution by a single IM injection. Plasma FSH levels were determined before the first pFSH treatment and every 6 hours over 96 hours. All data were analyzed by orthogonal contrasts. Circulating FSH area under curve (AUC) in pFSH-treated animals was greater than that in the control group (P = 0.02). Although the AUC did not differ among FSH-treated groups (P = 0.56), the total period with elevated plasma FSH was greater in the F200 group than in the HA groups (P FSH (P = 0.17). The IVP was performed in 90 nonlactating Holstein cows randomly allocated to one of the four treatment groups as in the first experiment. A greater proportion of medium-sized (6-10 mm) follicles was observed in cows receiving pFSH, regardless of the treatment group (P oocyte complexes (COCs) retrieved (P = 0.01) and matured (P = 0.02), cleavage rates (P = 0.002), and blastocysts produced per OPU session (P = 0.06) were greater in cows receiving pFSH, regardless of the treatment group. Cows in the F200HA group had a greater recovery rate (P = 0.009), number of COCs cultured (P = 0.04), and blastocysts produced per OPU session (P = 0.06) than cows in the F300HA group. Similar pregnancy rates were observed 50 to 60 days after transferring IVP embryos from donors in the different treatment groups (P > 0.05). In conclusion, a single IM injection of pFSH combined in 0.5% HA resulted in similar

  3. Second-generation long-acting injectable antipsychotics in schizophrenia: patient functioning and quality of life

    Montemagni C

    2016-04-01

    Full Text Available Cristiana Montemagni,1,2 Tiziana Frieri,1,2 Paola Rocca1,2 1Department of Neuroscience, Unit of Psychiatry, University of Turin, 2Department of Mental Health, Azienda Sanitaria Locale (ASL Torino 1 (TO1, Azienda Ospedaliero-Universitaria (AOU Città della Salute e della Scienza di Torino, Turin, Italy Abstract: Long-acting injectable antipsychotics (LAIs were developed to make treatment easier, improve adherence, and/or signal the clinician when nonadherence occurs. Second-generation antipsychotic LAIs (SGA-LAIs combine the advantages of SGA with a long-acting formulation. The purpose of this review is to evaluate the available literature concerning the impact of SGA-LAIs on patient functioning and quality of life (QOL. Although several studies regarding schizophrenia patients’ functioning and QOL have been performed, the quantity of available data still varies greatly depending on the SGA-LAI under investigation. After reviewing the literature, it seems that SGA-LAIs are effective in ameliorating patient functioning and/or QOL of patients with schizophrenia, as compared with placebo. However, while methodological design controversy exists regarding the superiority of risperidone LAI versus oral antipsychotics, the significant amount of evidence in recently published research demonstrates the beneficial influence of risperidone LAI on patient functioning and QOL in stable patients and no benefit over oral treatment in unstable patients. However, the status of the research on SGA-LAIs is lacking in several aspects that may help physicians in choosing the correct drug therapy. Meaningful differences have been observed between SGA-LAIs in the onset of their clinical efficacy and in the relationships between symptoms and functioning scores. Moreover, head-to-head studies comparing the effects of SGA-LAIs on classical measures of psychopathology and functioning are available mainly on risperidone LAI, while those comparing olanzapine LAI with other

  4. A Randomized Open Label Comparison of the Effects ofRisperidone and Haloperidol on Sexual Function

    S. Jaber Mousavi

    2009-12-01

    Full Text Available "n Objective: "nSexual dysfunction in patients who take antipsychotics causes adecline in their quality of life and medication acceptance. Considering the restrictions in cross sectional design of many earlier researches, we used a clinical trial aimed at assessing sexual dysfunction by substituting Risperidone, an atypical antipsychotic drug, with Haloperidol, a typical one . "n "n "nMethod: This clinical trial was conducted on 51 patients who had been using Risperidone with a minimum dose of 2 mg/daily for at least 2 months. The patients were randomly divided into 2 groups. The first group continued taking Risperidone, whereas the second group was given Haloperidol. Sexual function prior to and after the drug substitution was assessed using a sexual questionnaire designed to assess four stages of sexual function . "nResults: Compared to those who changed their medication to Haloperidol, the patients who remained on Risperidone therapy suffered from more sexual dysfunction, especially in their tendency towards having sexual activities (P= 0.01, post menstrual sexual activity (P= 0.002, and reaching orgasm in their sexual activities (P= 0.04; however in the Haloperidol group, no significant difference was observed before and after the change in medication . "nConclusion: Although Risperidone and Haloperidol can both disturb patients'sexual function, the side effects of Risperidone are stronger. Hence toprevent the decline of medication acceptance or irregular consumption by patients which may lead to possible relapse, substitution of Risperidone withanother drug with fewer side effects on sexual activities is definitely to the advantage of the patients .

  5. Risperidone in children with autism: randomized, placebo-controlled, double-blind study.

    Nagaraj, Ravishankar; Singhi, Pratibha; Malhi, Prahbhjot

    2006-06-01

    Some open-label studies suggest that risperidone can be useful in the treatment of certain target symptoms in children with autism. We aimed to study whether the use of risperidone in comparison with placebo improved functioning in children with autism with regard to behavior (aggressiveness, hyperactivity, irritability), social and emotional responsiveness, and communication skills. We conducted a randomized, double-blind, placebo-controlled trial with 40 consecutive children with autism, whose ages ranged from 2 to 9 years, who were receiving either risperidone or placebo given orally at a dose of 1 mg/day for 6 months. Autism symptoms were monitored periodically. The outcome variables were total scores on the Childhood Autism Rating Scale (CARS) and the Children's Global Assessment Scale (CGAS) after 6 months. Of the 40 children enrolled, 39 completed the trial over a period of 18 months; 19 received risperidone, and 20 received placebo. In the risperidone group, 12 of 19 children showed improvement in the total Childhood Autism Rating Scale score and 17 of 19 children in the Children's Global Assessment Scale score compared with 0 of 20 children for the Childhood Autism Rating Scale score and 2 of 20 children for the Children's Global Assessment Scale score in the placebo group (P social responsiveness and nonverbal communication and reduced the symptoms of hyperactivity and aggression. Risperidone was associated with increased appetite and a mild weight gain, mild sedation in 20%, and transient dyskinesias in three children. Risperidone improved global functioning and social responsiveness while reducing hyperactivity and aggression in children with autism and was well tolerated. PMID:16948927

  6. Potential bias in testing for hyperprolactinemia and pituitary tumors in risperidone-treated patients: a claims-based study

    Wu Jasmanda

    2009-02-01

    Full Text Available Abstract Background A reporting association of risperidone with pituitary tumors has been observed. Because such tumors are highly prevalent, there may be other reasons why they were revealed in association with risperidone treatment. We assessed two potential explanations: disproportionately more prolactin assessment and head/brain imaging in risperidone-treated patients vs patients treated with other antipsychotics. Methods Treatment episodes with risperidone, clozapine, olanzapine, quetiapine, ziprasidone, aripiprazole, haloperidol, perphenazine and 'other typical' antipsychotics were identified in two databases (large commercial, Medicaid. Comparisons used proportional hazards regression to determine whether prolactin testing was disproportionate with risperidone, regardless of prior potentially prolactin-related adverse events (PPAEs. Logistic regression determined whether magnetic resonance imaging (MRI/computed tomography (CT were disproportionate in risperidone-treated patients vs other patients, regardless of hyperprolactinemia or PPAEs. In each regression, the 'other typical' antipsychotic category served as the comparator. Regression models controlled for age, gender, and other factors. Results Altogether, 197,926 treatment episodes were analyzed (63,878 risperidone. Among patients with or without preceding PPAEs, risperidone treatment was associated with a significantly greater likelihood of prolactin assessment (hazard ratio (HR 1.34, 95% confidence interval (CI = 1.09 to 1.66, p = 0.007. Among patients with hyperprolactinemia or PPAEs, those treated with risperidone (odds ratio (OR 1.66, 95% CI 1.23 to 2.23, p = 0.001 or ziprasidone (OR 1.66, 95% CI 1.06 to 2.62, p = 0.028 had a higher likelihood of MRI/CT. Conclusion Risperidone-treated patients are more likely to undergo prolactin assessment regardless of prior PPAEs, and more likely to undergo MRI/CT in association with hyperprolactinemia or PPAEs. Thus, a predisposition for

  7. Efficacy of caudal epidural injection of lidocaine, xylazine and xylazine plus hyaluronidase in reducing discomfort produced by electroejaculation in bulls.

    Pagliosa, Ronaldo C; Derossi, Rafael; Costa, Deiler S; Faria, Fabio J C

    2015-11-01

    To test the hypothesis that epidural administration of lidocaine, xylazine or xylazine plus hyaluronidase provides reduced pain and stress during electroejaculation in bulls, eight 30-month-old Nellore bulls received saline solution (control), 2% lidocaine, 2% xylazine or 2% xylazine plus hyaluronidase injected into the first intercoccygeal (Co1-Co2) epidural space in randomized order. Heart rate, respiratory rate, mean arterial pressure, analgesia, animal behavior and motor blockade were evaluated before treatment and at predetermined intervals during and after treatment. Pain and stress were scored subjectively, and semen quality was evaluated. The onset of anesthetic action was significantly faster with lidocaine (3.0 ± 1.2 min) than with xylazine or xylazine plus hyaluronidase (8.9 ± 1.5 and 5.5 ± 2.6 min, P=0.021 and P=0.012, respectively), and the onset of anesthesia with xylazine plus hyaluronidase was significantly faster than that with xylazine alone (P=0.032). Treatment with xylazine or xylazine plus hyaluronidase resulted in less discomfort than treatment with lidocaine, as indicated by animal behavior. Changes in heart rate, respiratory rate and arterial pressure were within acceptable limits. Penile protrusion and semen emission occurred in all animals during all four treatments. Our results suggest that xylazine plus hyaluronidase reduced discomfort during electroejaculation more effectively than xylazine or lidocaine alone. Further experiments are necessary to determine whether electroejaculation with xylazine plus hyaluronidase is feasible for obtaining semen from Nellore bulls unaccustomed to being handled or restrained. PMID:26097016

  8. A Placebo-Controlled Study of Raloxifene Added to Risperidone in Men with Chronic Schizophrenia.

    Mohammad-Reza Khodaie-Ardakani

    2015-06-01

    Full Text Available Selective estrogen receptor modulators (SERMs such as raloxifene have already shown beneficial effects on negative, positive and general psychopathology symptoms in postmenopausal women with schizophrenia. The purpose of the present investigation was to assess the efficacy of raloxifene as an adjuvant agent in the treatment of men with chronic schizophrenia in an 8-week double-blind and placebo-controlled trial. In a randomized, double-blind and placebo-controlled study, forty-six male patients diagnosed with schizophrenia (DSM-IV-TR, were randomized to either raloxifene (120 mg/day or placebo in addition to risperidone (6 mg/day for eight weeks. The assessment was performed using the positive and negative symptom scale (PANSS at baseline, and at weeks 2, 4, 6 and 8. Extrapyramidal symptom rating scale (ESRS at baseline, weeks 1, 2, 4, 6, 8 and Hamilton depression rating scale (HDRS at baseline and week 8 were also used to assess extrapyramidal symptoms and depression simultaneously. Forty-two patients completed the trial. The raloxifene group showed significantly greater improvement on the negative subscale (P<0.001, the general psychopathology subscale (P=0.002 and total PANSS score (P<0.001 in comparison to the placebo group at the endpoint. There was no significant difference in the reduction of positive symptoms score between the two group (P=0.525. Extrapyramidal symptom rating scale and Hamilton depression rating scale and frequency of other adverse effects were comparable between two groups.This study indicates raloxifene as a potential adjunctive treatment strategy for chronic schizophrenia in men.

  9. Risperidone and NAP protect cognition and normalize gene expression in a schizophrenia mouse model.

    Vaisburd, Sinaya; Shemer, Zeev; Yeheskel, Adva; Giladi, Eliezer; Gozes, Illana

    2015-01-01

    Mutated disrupted in schizophrenia 1 (DISC1), a microtubule regulating protein, leads to schizophrenia and other psychiatric illnesses. It is hypothesized that microtubule stabilization may provide neuroprotection in schizophrenia. The NAP (NAPVSIPQ) sequence of activity-dependent neuroprotective protein (ADNP) contains the SxIP motif, microtubule end binding (EB) protein target, which is critical for microtubule dynamics leading to synaptic plasticity and neuroprotection. Bioinformatics prediction for FDA approved drugs mimicking SxIP-like motif which displace NAP-EB binding identified Risperidone. Risperidone or NAP effectively ameliorated object recognition deficits in the mutated DISC1 mouse model. NAP but not Risperidone, reduced anxiety in the mutated mice. Doxycycline, which blocked the expression of the mutated DISC1, did not reverse the phenotype. Transcripts of Forkhead-BOX P2 (Foxp2), a gene regulating DISC1 and associated with human ability to acquire a spoken language, were increased in the hippocampus of the DISC1 mutated mice and were significantly lowered after treatment with NAP, Risperidone, or the combination of both. Thus, the combination of NAP and standard of care Risperidone in humans may protect against language disturbances associated with negative and cognitive impairments in schizophrenia. PMID:26553741

  10. Risperidone – Solid-state characterization and pharmaceutical compatibility using thermal and non-thermal techniques

    Daniel, Josiane Souza Pereira; Veronez, Isabela Pianna; Rodrigues, Larissa Lopes [Laboratório de Análise e Caracterização de Fármacos – LACFar, Instituto de Química, Universidade Federal de Alfenas, Alfenas, Minas Gerais (Brazil); Trevisan, Marcello G. [Laboratório de Análise e Caracterização de Fármacos – LACFar, Instituto de Química, Universidade Federal de Alfenas, Alfenas, Minas Gerais (Brazil); National Institute of Bioanalytics Science and Technology – INCTBio, Institute of Chemistry – UNICAMP, 13084-653, Campinas, São Paulo (Brazil); Garcia, Jerusa Simone, E-mail: jerusa.garcia@unifal-mg.edu.br [Laboratório de Análise e Caracterização de Fármacos – LACFar, Instituto de Química, Universidade Federal de Alfenas, Alfenas, Minas Gerais (Brazil)

    2013-09-20

    Highlights: • DSC was used to characterize Risperidone and study its compatibility with excipients. • FT-IR associated with PCA was used to complement DSC data. • LC analyzes confirmed the DSC and FT-IR/PCA results. • Risperidone was incompatible with three among five excipients evaluated. - Abstract: A full solid-state characterization of risperidone was conducted using differential scanning calorimetry (DSC), thermogravimetry (TG), powder X-ray diffraction (PXRD), Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM) to examine its physicochemical properties and polymorphism. The primary aim of this work was to study the compatibility of risperidone with pharmaceutical excipients using DSC to obtain and compare the curves of the active pharmaceutical ingredient (API) and the excipients with their 1:1 (w/w) binary mixtures. These same binary mixtures were turned to room temperature and analyzed by FT-IR combined with principal component analysis (PCA) to evaluate solid-state incompatibilities. The chemical incompatibilities of these samples were verified using a stability-indicating liquid chromatography (LC) method to assay for the API and evaluate the formation of degradation products. All of these methods showed incompatibilities between risperidone and the excipients magnesium stearate, lactose and cellulose microcrystalline.

  11. Risperidone – Solid-state characterization and pharmaceutical compatibility using thermal and non-thermal techniques

    Highlights: • DSC was used to characterize Risperidone and study its compatibility with excipients. • FT-IR associated with PCA was used to complement DSC data. • LC analyzes confirmed the DSC and FT-IR/PCA results. • Risperidone was incompatible with three among five excipients evaluated. - Abstract: A full solid-state characterization of risperidone was conducted using differential scanning calorimetry (DSC), thermogravimetry (TG), powder X-ray diffraction (PXRD), Fourier transform infrared spectroscopy (FT-IR) and scanning electron microscopy (SEM) to examine its physicochemical properties and polymorphism. The primary aim of this work was to study the compatibility of risperidone with pharmaceutical excipients using DSC to obtain and compare the curves of the active pharmaceutical ingredient (API) and the excipients with their 1:1 (w/w) binary mixtures. These same binary mixtures were turned to room temperature and analyzed by FT-IR combined with principal component analysis (PCA) to evaluate solid-state incompatibilities. The chemical incompatibilities of these samples were verified using a stability-indicating liquid chromatography (LC) method to assay for the API and evaluate the formation of degradation products. All of these methods showed incompatibilities between risperidone and the excipients magnesium stearate, lactose and cellulose microcrystalline

  12. Desipramine enhances the ability of risperidone to decrease alcohol intake in the Syrian golden hamster.

    Gulick, Danielle; Chau, David T; Khokhar, Jibran Y; Dawson, Ree; Green, Alan I

    2014-08-30

    The atypical antipsychotic clozapine reduces alcohol drinking in patients with schizophrenia. We have proposed that clozapine׳s ability to decrease alcohol drinking relates to its weak blockade of the dopamine D2 receptor and potent blockade of the norepinephrine α-2 receptor, as well as its ability to elevate plasma and brain norepinephrine. Another atypical antipsychotic, risperidone, which is a potent blocker of both the dopamine D2 receptor and norepinephrine α-2 receptor, does not decrease alcohol drinking. In this study, we used the Syrian golden hamster to test whether the ability of risperidone to reduce alcohol drinking would be enhanced if it was used in combination with the norepinephrine reuptake inhibitor desipramine. Hamsters were given free access to water and alcohol (15% v/v) until they reached a steady drinking baseline. They were then treated daily with each drug or drug combination for 20 days. Risperidone (0.2mg/kg) only transiently decreased alcohol drinking. However, 5.0mg/kg, and possibly 1.0mg/kg, desipramine added to 0.2mg/kg risperidone appeared to produce a more substantial and relatively sustained effect than risperidone alone. Data from this study provide leads toward the development of new treatments for patients with schizophrenia and alcoholism, and also for those with alcoholism alone. PMID:24836200

  13. Optimization and in vivo toxicity evaluation of G4.5 PAMAM dendrimer-risperidone complexes.

    Maria Jimena Prieto

    Full Text Available Risperidone is an approved antipsychotic drug belonging to the chemical class of benzisoxazole. This drug has low solubility in aqueous medium and poor bioavailability due to extensive first-pass metabolism and high protein binding (>90%. Since new strategies to improve efficient treatments are needed, we studied the efficiency of anionic G4.5 PAMAM dendrimers as nanocarriers for this therapeutic drug. To this end, we explored dendrimer-risperidone complexation dependence on solvent concentration, pH and molar relationship. The best dendrimer-risperidone incorporation (46 risperidone molecules per dendrimer was achieved with a mixture of chloroform:methanol 50∶50 v/v solution pH 3. In addition, to explore the possible effects of this complex, in vivo studies were carried out in the zebrafish model. Changes in the development of dopaminergic neurons and motoneurons were studied using tyrosine hydroxylase and calretinin, respectively. Physiological changes were studied through histological sections stained with hematoxylin-eosin to observe possible morphological brain changes. The most significant changes were observed when larvae were treated with free risperidone, and no changes were observed when larvae were treated with the complex.

  14. A Risperidone-Induced Prolactinoma Resolved when a Woman with Schizoaffective Disorder Switched to Ziprasidone: A Case Report

    Arcari, Gail T.; Mendes, Asante K.; Sothern, Robert B.

    2012-01-01

    Antipsychotic drug therapy, e.g., risperidone, can be associated with endocrine abnormalities, including an increase in serum prolactin level (sPrl) due to a drug-induced benign pituitary tumor (prolactinoma). A few case reports have noted a resolution of hyperprolactinemia and prolactinoma after cessation of risperidone treatment. We report a similar finding for a woman with schizoaffective disorder, manic type.

  15. Risperidone-induced weight gain and reduced locomotor activity in juvenile female rats: The role of histaminergic and NPY pathways.

    Lian, Jiamei; De Santis, Michael; He, Meng; Deng, Chao

    2015-01-01

    Second generation antipsychotic drugs (SGAs) such as risperidone are increasingly prescribed (mostly for off-label use) to children and adolescents for treating various mental disorders. SGAs cause serious weight gain/obesity and other metabolic side-effects. This study aimed to establish an animal model of risperidone-induced weight gain in female juvenile rats, and to investigate the effects of risperidone on the expression of hypothalamic histaminergic H1 receptors (H1R) and neuropeptides, and their association with weight gain. Female Sprague Dawley rats were treated orally with risperidone (0.3mg/kg, 3 times/day) or vehicle (control) starting from postnatal day (PD) 23 (±1 day) for 3 weeks (a period corresponding to the childhood-adolescent period in humans). In the female juvenile rats, risperidone treatment increased food intake and body weight gain, which started to appear after 12 days' treatment. Risperidone also significantly decreased the locomotor activity of the female rats. Consistently, risperidone significantly elevated mRNA expression of hypothalamic H1R, neuropeptide Y (NPY), and agouti-related peptide (AgRP) compared to controls, and H1R and NPY levels were correlated with risperidone enhanced weight gain and food intake in the female juvenile rats. However, risperidone did not affect hypothalamic proopiomelanocortin (POMC) and cocaine- and amphetamine-regulated transcript (CART) mRNA expression. Therefore, these results suggested that risperidone elevated appetite and body weight gain in juveniles via regulation of the hypothalamic H1R, NPY and AgRP pathways, as well as by reducing activity. PMID:25782398

  16. Once-monthly paliperidone injection for the treatment of schizophrenia

    Delia Bishara

    2010-01-01

    Delia BisharaPharmacy Department, South London and Maudsley NHS Foundation Trust, London, United KingdomAbstract: Paliperidone palmitate is a new long-acting antipsychotic injection for the treatment of acute and maintenance therapy in schizophrenia. Paliperidone (9-hydroxyrisperidone) is the major active metabolite of risperidone and acts at dopamine D2 and serotonin 5HT2A receptors. As with other atypical antipsychotics, it exhibits a high 5HT2A:D2 affinity ratio. It also has binding activi...

  17. CYP2D6 poor metabolizer status might be associated with better response to risperidone treatment.

    Almoguera, Berta; Riveiro-Alvarez, Rosa; Lopez-Castroman, Jorge; Dorado, Pedro; Vaquero-Lorenzo, Concepción; Fernandez-Piqueras, José; Llerena, Adrián; Abad-Santos, Francisco; Baca-García, Enrique; Dal-Ré, Rafael; Ayuso, Carmen

    2013-11-01

    The variability in the antipsychotic response is, to some extent, genetically determined. Several studies have attempted to establish a role for genetic variation in genes coding pharmacokinetic and pharmacodynamic targets, but to date, no definite genetic predictive marker has been identified. We aimed to explore the putative role of 19 genetic variants and risperidone clinical improvement in 76 White schizophrenic inpatients, measured as change in Positive and Negative Syndrome Scale (PANSS). CYP2D6 poor metabolism was significantly associated with greater clinical improvement in total PANSS and a trend was also found for MDR1 3435C>T to higher total PANSS scores in 3435T carriers. This study suggests the importance that genetic variability on pharmacokinetic factors may have in risperidone response and gives evidence for the need for further investigation in order to establish the actual predictive value and clinical utility that CYP2D6 genotyping might have in risperidone therapy management. PMID:24026091

  18. Therapeutic Efficacy and Safety of Percutaneous Ethanol Injection with or without Combined Radiofrequency Ablation for Hepatocellular Carcinomas in High Risk Locations

    Cha, Dong Ik; Lee, Min Woo; Rhim, Hyunchul; Choi, Dongil; Kim, Young-sun; Lim, Hyo K. [Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710 (Korea, Republic of)

    2013-07-01

    To evaluate the therapeutic efficacy and safety of percutaneous ethanol injection (PEI) alone and combined with radiofrequency ablation (RFA) for hepatocellular carcinomas (HCCs) in high risk locations. We performed PEI for HCCs in RFA-high risk locations, either alone or in combination with RFA. There were 20 HCCs (1.7 ± 0.9 cm) in 20 patients (PEI group: n = 12; PEI + RFA group: n = 8). We evaluated technical success, local tumor progression and complications in both groups. Technical success was achieved in all HCCs in both groups. During follow-up, local tumor progression was found in 41.7% (5/12) in the PEI group, whereas 12.5% (1/8) for the PEI + RFA group (p = 0.32). Bile duct dilatation was the most common complication, especially when the tumors were in periportal locations; 55% (5/9) in the PEI group and 50% (2/4) in the PEI + RFA group (p = 1.00). One patient in the PEI group developed severe biliary stricture and upstream dilatation that resulted in atrophy of the left hepatic lobe. One patient treated with PEI + RFA developed cholangitis and an abscess. Combined PEI and RFA treatment has a tendency to be more effective than PEI alone for managing HCCs in high risk locations, although the difference is not statistically significant. Even though PEI is generally accepted as a safe procedure, it may cause major biliary complications for managing HCCs adjacent to the portal vein.

  19. Comparison the effectiveness of aripiprazole and risperidone for the treatment of acute bipolar mania

    Amir Akhavan Rezayat

    2014-01-01

    Full Text Available Background: Second-generation antipsychotics, approved for the treatment of mania, are associated with adverse effects such as weight gain and metabolic disorders. Aripiprazole, a recently introduced second-generation antipsychotic, are thought to account for its low propensity for weight gain, metabolic disturbances and sedation. The purpose of this study was to investigate the effect of risperidone versus aripiprazole in the treatment of acute mania. Materials and Methods: Fifty patients with acute episodes of mania were enrolled in this study, and they were randomly assigned into a risperidone group of 24 cases and an aripiprazole group of 26 cases. In group A, aripiprazole with a dose of 5-30 mg/day and in group B, risperidone with a dose of 2-8 mg/day was given to patients. The average dose of aripiprazole was 27 mg/day, and the average dose of risperidone was 6 mg/day. The effects of each drug for the treatment of acute mania were assessed on the 1 st day of admission and on days 2, 4, 6, 8 and at weeks 2, 4 and 6 after therapy using the young mania rating scale (YMRS and at the baseline and on weeks 3 and 6 after admission using the clinical global impression (CGI scale. Results: The mean age of the group of risperidone was 34 ± 8.6 years and in a group of aripiprazole it was 34 ± 9.1 years (P = 0.83. Comparison of YMRS scores over the period of 6 weeks revealed a statistically significant difference in both groups (P < 0.0001.There was also a statistically significant difference in YMRS scores between risperidone and aripiprazole at day 8 (P = 0.026 and weeks 2 (P = 0.035 and 4 (P = 0.042. There was also a statistically significant difference in CGI-Severity scale score at weeks 3 (P = 0.003 and 6 (P = 0.000 and in CGI-Improvement scale score at weeks 3 (P = 0.005 and 6 (P = 0.002. The most common side-effect observed in both groups was headache (0%15/4 in aripiprazole vs. %16/7 in risperidone Conclusion: Aripiprazole that is readily

  20. Antipsychotic discontinuation syndrome following risperidone withdrawal: a case report from rural India

    Sravanti L. Sanivarapu

    2014-02-01

    Full Text Available Risperidone is an atypical antipsychotic agent used primarily to treat schizophrenia. It is a dopamine antagonist with antiserotonergic, antihistaminergic and antiadrenergic properties. Antipsychotic discontinuation symptoms have been described in the literature following abrupt or rapid reduction in the dose. This unusual case demonstrates that sudden withdrawal of even a modest dose of risperidone may cause significant discontinuation symptoms in susceptible individuals. Hence, there is a need for caution while taking a patient off antipsychotic medications in view of the vulnerable subgroup. [Int J Basic Clin Pharmacol 2014; 3(1.000: 233-234

  1. Risperidone-induced weight gain is mediated through shifts in the gut microbiome and suppression of energy expenditure

    Sarah M. Bahr

    2015-11-01

    Full Text Available Risperidone is a second-generation antipsychotic that causes weight gain. We hypothesized that risperidone-induced shifts in the gut microbiome are mechanistically involved in its metabolic consequences. Wild-type female C57BL/6J mice treated with risperidone (80 μg/day exhibited significant excess weight gain, due to reduced energy expenditure, which correlated with an altered gut microbiome. Fecal transplant from risperidone-treated mice caused a 16% reduction in total resting metabolic rate in naïve recipients, attributable to suppression of non-aerobic metabolism. Risperidone inhibited growth of cultured fecal bacteria grown anaerobically more than those grown aerobically. Finally, transplant of the fecal phage fraction from risperidone-treated mice was sufficient to cause excess weight gain in naïve recipients, again through reduced energy expenditure. Collectively, these data highlight a major role for the gut microbiome in weight gain following chronic use of risperidone, and specifically implicates the modulation of non-aerobic resting metabolism in this mechanism.

  2. Publication bias in antipsychotic trials: an analysis of efficacy comparing the published literature to the US Food and Drug Administration database.

    Erick H Turner

    Full Text Available BACKGROUND: Publication bias compromises the validity of evidence-based medicine, yet a growing body of research shows that this problem is widespread. Efficacy data from drug regulatory agencies, e.g., the US Food and Drug Administration (FDA, can serve as a benchmark or control against which data in journal articles can be checked. Thus one may determine whether publication bias is present and quantify the extent to which it inflates apparent drug efficacy. METHODS AND FINDINGS: FDA Drug Approval Packages for eight second-generation antipsychotics-aripiprazole, iloperidone, olanzapine, paliperidone, quetiapine, risperidone, risperidone long-acting injection (risperidone LAI, and ziprasidone--were used to identify a cohort of 24 FDA-registered premarketing trials. The results of these trials according to the FDA were compared with the results conveyed in corresponding journal articles. The relationship between study outcome and publication status was examined, and effect sizes derived from the two data sources were compared. Among the 24 FDA-registered trials, four (17% were unpublished. Of these, three failed to show that the study drug had a statistical advantage over placebo, and one showed the study drug was statistically inferior to the active comparator. Among the 20 published trials, the five that were not positive, according to the FDA, showed some evidence of outcome reporting bias. However, the association between trial outcome and publication status did not reach statistical significance. Further, the apparent increase in the effect size point estimate due to publication bias was modest (8% and not statistically significant. On the other hand, the effect size for unpublished trials (0.23, 95% confidence interval 0.07 to 0.39 was less than half that for the published trials (0.47, 95% confidence interval 0.40 to 0.54, a difference that was significant. CONCLUSIONS: The magnitude of publication bias found for antipsychotics was less

  3. A pharmaco-economic analysis of patients with schizophrenia switching to generic risperidone involving a possible compliance loss

    Möller Hans-Jürgen

    2009-02-01

    Full Text Available Abstract Background As schizophrenia patients are typically suspicious of, or are hostile to changes they may be reluctant to accept generic substitution, possibly affecting compliance. This may counteract drug costs savings due to less symptom control and increased hospitalization risk. Although compliance losses following generic substitution have not been quantified so far, one can estimate the possible health-economic consequences. The current study aims to do so by considering the case of risperidone in Germany. Methods An existing DES model was adapted to compare staying on branded risperidone with generic substitution. Differences include the probability of non-compliance and medication costs. Incremental probability of non-compliance after generic substitution was varied between 2.5% and 10%, while generic medication costs were assumed to be 40% lower. Effect of medication price was assessed as well as the effect of applying compliance losses to all treatment settings. The probability of staying on branded risperidone being cost-effective was calculated for various outcomes of a hypothetical study that would investigate non-compliance following generic substitution of risperidone. Results If the incremental probability of non-compliance after generic substitution is 2.5%, 5.0%, 7.5% and 10% respectively, incremental effects of staying on branded risperidone are 0.004, 0.007, 0.011 and 0.015 Quality Adjusted Life Years (QALYs. Incremental costs are €757, €343, -€123 and -€554 respectively. Benefits of staying on branded risperidone include improved symptom control and fewer hospitalizations. If generic substitution results in a 5.2% higher probability of non-compliance, the model predicts staying on branded risperidone to be cost-effective (NICE threshold of ₤30,000 per QALY gained. Compliance losses of more than 6.9% makes branded risperidone the dominant alternative. Results are sensitive to the locations at which compliance

  4. Priapism associated with risperidone: a case report, literature review and review of the South London and Maudsley hospital patients’ database

    Paklet, Lise; Olajide, Dele

    2013-01-01

    Priapism is a urological emergency defined as persistent penile erection that is unrelated to sexual stimulation and typically involving only the corporal cavernosa. It can occur as a rare side effect of antipsychotic medications and is mediated via their α-adrenergic antagonist effect. In this paper we describe a case of priapism in a patient started on risperidone and sodium valproate. We also review the South London and Maudsley Case Register Interactive Search database to assess how many other cases of priapism were reported in patients taking risperidone. We add this information to a literature review of cases of priapism associated with risperidone. PMID:23983987

  5. Emerging treatments in the management of bipolar disorder – focus on risperidone long acting injection

    Wissam El-Hage; Surguladze, Simon A.

    2010-01-01

    Wissam El-Hage1, Simon A Surguladze21Inserm U930 ERL CNRS 3106, Université François Rabelais and Clinique Psychiatrique Universitaire, CHRU de Tours, Tours, France; 2Institute of Psychiatry, King’s College London, UKAbstract: Bipolar disorder is a life-long psychiatric illness characterized by a high frequency of relapses and substantial societal costs. Almost half of the patients are prescribed second generation antipsychotics for treatment of manic states, or...

  6. Efficacy and safety of second-generation antipsychotic long-acting injections (SGA LAIs) in maintenance treatment of bipolar disorder: protocol for a systematic review and meta-analysis

    Prajapati, Asta R; Wilson, Jonathan; Maidment, Ian D

    2016-01-01

    Introduction Bipolar disorder requires long-term treatment but non-adherence is a common problem. Antipsychotic long-acting injections (LAIs) have been suggested to improve adherence but none are licensed in the UK for bipolar. However, the use of second-generation antipsychotics (SGA) LAIs in bipolar is not uncommon albeit there is a lack of systematic review in this area. This study aims to systematically review safety and efficacy of SGA LAIs in the maintenance treatment of bipolar disorde...

  7. Risperidone treatment for ADHD in children and adolescents with bipolar disorder

    Joseph Biederman

    2008-03-01

    Full Text Available Joseph Biederman, Paul Hammerness, Robert Doyle, Gagan Joshi, Megan Aleardi, Eric MickPediatric Psychopharmacology Research Department, Massachusetts General Hospital, Boston, MA, USAObjective: Children and adolescents with bipolar disorder are also at high risk of having comorbid attention-deficit hyperactivity disorder (ADHD. The objective of this study was to estimate improvement in ADHD symptoms in children with bipolar disorder.Methods: This was an open-label, study of risperidone monotherapy for the treatment of pediatric bipolar disorder. Thirty-one children and adolescents 4–15 years of age (7.2 ± 2.8 years of both sexes (71%, N = 22 male with pediatric bipolar disorder (YMRS score = 32.9 ± 8.8 and ADHD (ADHD-RS score = 37.9 ± 8.9 were included in these analyses.Results: Improvement in ADHD symptoms was contingent on improvement in manic symptoms. Although both hyperactive/impulsive (−7.5 ± 5.5.6, p < 0.05 and inattentive (−6.8 ± 5.0, p < 0.05 ADHD symptoms were significantly improved with risperidone, improvement was modest, and only 29% of subjects (N = 6 showed a 30% reduction in ADHD rating scale scores and had a CGI-I ≤ 2.Conclusions: These results suggest that that treatment with risperidone is associated with tangible but generally modest improvement of symptoms of ADHD in children with bipolar disorder.Keywords: ADHD, bipolar disorder, children, risperidone

  8. Sexual dysfunction and hormonal changes in first episode psychosis patients on olanzapine or risperidone

    M. van Bruggen; T. van Amelsvoort; L. Wouters; P. Dingemans; L. de Haan; D. Linszen

    2009-01-01

    Atypical antipsychotics interfere with central and peripheral neurotransmitter systems and with hormonal production. In this study we compared the effect of olanzapine and risperidone on hormonal state and sexual function (by using the Questionnaire for Sexual Dysfunction, QSD) in 40 patients with a

  9. Dystonia in an Adolescent on Risperidone Following the Discontinuation of Methylphenidate: A Case Report

    Guler, Gulen; Yildirim, Veli; Kutuk, Meryem Ozlem; Fevziye TOROS

    2015-01-01

    Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder with common comorbidities that include oppositional defiant disorder, conduct disorder, anxiety disorder, and affective disorders. Because of these comorbidities, drug combination treatments and drug-drug interactions are becoming increasingly more frequent. The present case report describes an acute dystonic reaction following the abrupt discontinuation of methylphenidate from a drug regimen with risperidone. Th...

  10. Sustained release of risperidone from biodegradable microspheres prepared by in-situ suspension-evaporation process.

    An, Taekun; Choi, Juhyuen; Kim, Aram; Lee, Jin Ho; Nam, Yoonjin; Park, Junsung; Sun, Bo Kyung; Suh, Hearan; Kim, Cherng-Ju; Hwang, Sung-Joo

    2016-04-30

    Risperidone-loaded poly (d,l-lactide-co-glycolide) (PLGA) microspheres were prepared with a suspension-evaporation process with an aqueous suspension containing an in situ-formed aluminum hydroxide inorganic gel (SEP-AL process) and evaluated for encapsulation efficiency, particle size, surface morphology, glass transition temperature, in vitro drug release profile, and in vivo behavior. The SEP-AL microspheres were compared with conventional oil-in-water (O/W) emulsion solvent evaporation method using polyvinylalcohol (PVA) as an emulsifier (CP-PVA process). The microspheres were spherical in shape. DSC measurements showed that risperidone crystallinity was greatly reduced due to the homogeneous distribution of risperidone in PLGA microspheres. In vitro drug release profile from the microspheres showed a sigmoidal pattern of negligible initial burst up to 24h and minimal release (time-lag) for 7days. After the lag phase, slow release took a place up to 25days and then rapid release occurred sharply for 1 week. In vivo rat pharmacokinetic profile from the microspheres showed very low blood concentration level at the initial phase (up to 24h) followed by the latent phase up to 21days. At the 3rd week, main phase started and the blood concentration of the drug increased up to the 5th week, and then gradually decreased. The risperidone-loaded PLGA microspheres produced by SEP-AL process showed excellent controlled release characteristics for the effective treatment of schizophrenia patients. PMID:26899975

  11. Switching to quetiapine for risperidone-induced amenorrhea: Report of two cases

    P K Pardal

    2010-01-01

    Full Text Available Almost all the antipsychotics can cause hyperprolactinemia-related side-effects like amenorrhea. Quetiapine has been reported to have minimal propensity to cause hyperprolactinemia. We report here two cases of risperidone-induced amenorrhea, who resumed their normal cycle on switching over the medication to quetiapine.

  12. Switching to quetiapine for risperidone-induced amenorrhea: Report of two cases

    Pardal, P. K.; Raaj Konwar; Jyoti Prakash

    2010-01-01

    Almost all the antipsychotics can cause hyperprolactinemia-related side-effects like amenorrhea. Quetiapine has been reported to have minimal propensity to cause hyperprolactinemia. We report here two cases of risperidone-induced amenorrhea, who resumed their normal cycle on switching over the medication to quetiapine.

  13. Risperidone in Children and Adolescents with Conduct Disorder: A Single-Center, Open-Label Study

    Ercan, Eyüp Sabri; Kutlu, Ayşe; Çıkoğlu, Sibel; Veznedaroğlu, Baybars; Erermiş, Serpil; Varan, Azmi

    2003-01-01

    Background: Risperidone is one of the most commonly used atypical antipsychotic drugs in the treatment of children and adolescents. However, the data about its use in children and adolescents with conduct disorder (CD) are limited. Objective: The aim of this study was to investigate the effectiveness and tolerability of risperidone in controlling major symptoms of CD in children and adolescents diagnosed with attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), and severe CD. Methods: Children and adolescents were eligible for this single-center, open-label study if they met the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for ADHD and ODD and also were diagnosed with severe CD. The patients were treated with risperidone in an open-label fashion for 8 weeks, starting at a daily dosage of 0.25 mg or 0.5 mg (depending on their body weight) in 2 divided doses. Results: The study population comprised 21 children and adolescents (17 boys, 4 girls) with a mean (SD) age of 10.8 (3.6) years. The mean (SD) dosage of risperidone at the end of 8 weeks of treatment was 1.27 (0.42) mg/d (range, 0.75–2.0 mg/d). On the basis of the global improvement subscale of the Clinical Global Impression scale, 16 of 20 patients (80%) were classified as responders. Significant improvements were observed after risperidone treatment in the inattention, hyperactivity/impulsivity, ODD, and CD subscales of the Turgay DSM-IV–Based Child and Adolescent Behavior Disorders Screening and Rating Scale (parent and teacher forms). No severe adverse events were reported. Conclusions: The results of this study are consistent with previous findings and suggest that risperidone may be an effective and well-tolerated atypical antipsychotic drug for the treatment of children and adolescents with CD. However, further studies, particularly placebo-controlled and double-blinded, are needed to better define the clinical use

  14. Quality of Life and Hormonal, Biochemical, and Anthropometric Profile Between Olanzapine and Risperidone Users.

    de Araújo, Aurigena Antunes; Ribeiro, Susana Barbosa; Dos Santos, Ana Cely Souza; Lemos, Telma Maria Araújo Moura; Medeiros, Caroline Addison Xavier; Guerra, Gerlane Coelho Bernardo; de Araújo Júnior, Raimundo Fernandes; Serrano-Blanco, Antoni; Rubio-Valera, Maria

    2016-06-01

    This cross-sectional study compared quality of life and side effects in 108 users of olanzapine or risperidone suffering schizophrenia and being attended at psychiatric ambulatory services in Rio Grande do Norte, Brazil. Economic, socio-demographic, anthropometric, biochemical, and hormonal variables were compared. The EuroQoL Five-Dimension Scale (EQ-5D) was used to evaluate quality of life, and side effects were assessed using the Udvalg for Kliniske Undersøgelser (UKU) Side Effect Rating Scale and the Simpson-Angus Scale. Data were analysed using the χ(2) test and Student's t test, with a significance level of 5 %.The household incomes of approximately 80 % of patients were <2.0 minimum wages ($678). Anthropometric variables (waist circumference, hip circumference, weight, waist-to-hip ratio) and systolic and diastolic blood pressure were noted among male olanzapine users (all p < 0.05). EQ-5D scores showed that olanzapine use significantly impacted self-help ability (p < 0.001). Risperidone users had a mean quality-adjusted life year value of 1. Mean total Simpson-Angus Scale scores was 0.38 for olanzapine users and 0.11 for risperidone users (p < 0.02). Significant differences in UKU were observed for the following items: asthenia/lassitude/fatigue (higher among olanzapine users, p = 0.02), dystonia (higher among olanzapine users, p = 0.01), tremors (higher among olanzapine users, p = 0.03), gynecomastia (higher among risperidone users, p < 0.02), and ejaculatory dysfunction (higher among risperidone users, p < 0.02). Olanzapine users had impaired quality of life, which can be explained in part by adverse motor, biochemical, and hormonal effects characteristic of metabolic syndrome. PMID:26220635

  15. Trabecular bone loss after administration of the second-generation antipsychotic risperidone is independent of weight gain.

    Motyl, Katherine J; Dick-de-Paula, Ingrid; Maloney, Ann E; Lotinun, Sutada; Bornstein, Sheila; de Paula, Francisco J A; Baron, Roland; Houseknecht, Karen L; Rosen, Clifford J

    2012-02-01

    Second generation antipsychotics (SGAs) have been linked to metabolic and bone disorders in clinical studies, but the mechanisms of these side effects remain unclear. Additionally, no studies have examined whether SGAs cause bone loss in mice. Using in vivo and in vitro modeling we examined the effects of risperidone, the most commonly prescribed SGA, on bone in C57BL6/J (B6) mice. Mice were treated with risperidone orally by food supplementation at a dose of 1.25 mg/kg daily for 5 and 8 weeks, starting at 3.5 weeks of age. Risperidone reduced trabecular BV/TV, trabecular number and percent cortical area. Trabecular histomorphometry demonstrated increased resorption parameters, with no change in osteoblast number or function. Risperidone also altered adipose tissue distribution such that white adipose tissue mass was reduced and liver had significantly higher lipid infiltration. Next, in order to tightly control risperidone exposure, we administered risperidone by chronic subcutaneous infusion with osmotic minipumps (0.5 mg/kg daily for 4 weeks) in 7 week old female B6 mice. Similar trabecular and cortical bone differences were observed compared to the orally treated groups (reduced trabecular BV/TV, and connectivity density, and reduced percent cortical area) with no change in body mass, percent body fat, glucose tolerance or insulin sensitivity. Unlike in orally treated mice, risperidone infusion reduced bone formation parameters (serum P1NP, MAR and BFR/BV). Resorption parameters were elevated, but this increase did not reach statistical significance. To determine if risperidone could directly affect bone cells, primary bone marrow cells were cultured with osteoclast or osteoblast differentiation media. Risperidone was added to culture medium in clinically relevant doses of 0, 2.5 or 25 ng/ml. The number of osteoclasts was significantly increased by addition in vitro of risperidone while osteoblast differentiation was not altered. These studies indicate that

  16. Polypharmacy in the management of patients with schizophrenia on risperidone in a tertiary-care hospital in Malaysia

    Jacob, SA; Ibrahim, MI Mohamed; Mohammed, F.

    2013-01-01

    The present study was conducted primarily to determine the occurrence of polypharmacy in patients with schizophrenia on risperidone. The secondary aim was to ascertain the incidence of inappropriate prescribing with anticholinergics. A retrospective review of the medical records of all patients who were being followed up at the out-patient clinic of a tertiary-care hospital in Malaysia was conducted. Only patients who were being prescribed risperidone between 1 June 2008 and 31 December 2008 ...

  17. Use of a Direct Observational Measure in a Trial of Risperidone and Parent Training in Children with Pervasive Developmental Disorders

    HANDEN, BENJAMIN L.; JOHNSON, CYNTHIA R.; Butter, Eric M.; LECAVALIER, LUC; SCAHILL, LAWRENCE; Aman, Michael G; McDougle, Christopher J.; Arnold, L. Eugene; Swiezy, Naomi B.; Sukhodolsky, Denis G.; Mulick, James A.; White, Susan W.; Bearss, Karen; Hollway, Jill A.; Stigler, Kimberly A.

    2012-01-01

    A Structured Observational Analog Procedure (SOAP), an analogue measure of parent-child interactions, was used to assess treatment outcome in children with Autism Spectrum Disorder and serious behavior problems. It served as a secondary outcome measure in a 24-week, randomized trial of risperidone (MED; N=49) versus risperidone plus parent training (COMB; n=75) (ages 4–13 years). At 24-weeks, there was 28 % reduction in child inappropriate behavior during a Demand Condition (p=.0002) and 12 %...

  18. 穴位注射配合牵引治疗神经根型颈椎病疗效观察%Observations on the Efficacy of Acupuncture Point Injection plus Traction in Treating Cervical Spondylotic Radiculopathy

    汪崇淼; 吴耀持; 张峻峰; 黄承飞

    2012-01-01

    目的 观察穴位注射配合牵引治疗神经根型颈椎病的临床疗效.方法 将122例神经根型颈椎病患者随机分为3组,观察组42例,进行穴位注射配合牵引治疗;穴位注射组40例,进行穴位注射治疗;牵引组40例进行牵引治疗.治疗结束比较3组间疗效差异.结果 观察组总有效率为92.9%,穴位注射组总有效率为72.5%,牵引组总有效率为75.0%,观察组总有效率与穴位注射组、牵引组比较差异均有统计学意义(P<0.05),穴位注射组与牵引组比较差异无统计学意义(P>0.05).结论 穴位注射配合牵引治疗神经根型颈椎病总有效率优于单纯穴位注射及单纯牵引治疗.%Objective To investigate the clinical efficacy of acupuncture point injection plus traction in treating cervical spondylotic radiculopathy. Method One hundred and twenty-two patients with cervical spondylotic radiculopathy were randomly allocated to three groups. The observation group of 42 patients received acupuncture point injection plus traction. The acupuncture point injection group of 40 patients and the traction group of 40 patients received corresponding treatments. The therapeutic effects were compared between the three groups after treatment. Result The total efficacy rate was 92.9% in the observation group, 72.5% in the acupuncture point injection group and 75.0% in the traction group; there was a statistically significant difference between the observation group and the acupuncture point injection group or the traction group (P 0.05). Conclusion The total efficacy rate of acupuncture point injection plus traction for cervical spondylotic radiculopathy is higher than that of acupuncture point injection alone and that of traction alone.

  19. 酮咯酸氨丁三醇穴位注射治疗肾绞痛的疗效观察%Efficacy of ketorolac tromethamine acupuncture point injection in the treatment of renal colic

    代蓉; 杨鼎君

    2014-01-01

    Objective To evaluate the efficacy of ketorolac tromethamine with acupuncture point injection in the treatment of renal colic. Methods 176 patients with renal colic were randomly and equally divided into two groups,The control group was administrated with ketorolac tromethamine 30 mg with intramuscular injection. The treatment group was administrated with acupuncture point injection(bilateral Sanyinjiao and kidney shu points). The total effective rate, analgesic onset time and complete pain relief time were analyzed and compared between the two groups. Results The efficacy of the treatment group was better than that of the control group, the difference was statistically significant(P<0.05). Conclusion The efficacy of ketorolac tromethamine with acupuncture point injection is significantly improved and this approach was worthy of clinical.%目的:观察酮咯酸氨丁三醇穴位注射治疗肾绞痛的疗效。方法将176例肾绞痛患者随机分为治疗组和对照组,每组88例,均使用酮咯酸氨丁三醇30 mg,对照组采用肌肉注射,治疗组采用穴位注射(双侧三阴交和肾腧穴),对比2组疗效(包括总有效率、止痛起效时间、疼痛完全缓解时间)。结果治疗组疗效优于对照组,差异具有统计学意义(P<0.05)。结论将酮咯酸氨丁三醇用药途径由肌肉注射改为穴位注射后,可显著提高疗效,值得临床推广。

  20. 针刀配合痛点注射治疗肱骨外上髁炎疗效观察%Efficacy Observation on Acupotomology Combined with Trigger Point Injection for External Humeral Epicondylitis

    姜丰山; 朱佩仪; 曾幸丽; 郭振宇; 卢利国

    2015-01-01

    目的:探讨针刀配合痛点注射治疗肱骨外上髁炎的疗效。方法:将105例肱骨外上髁炎患者随机分为三组:治疗组(35例)采用针刀配合痛点注射治疗,对照I组(35例)单纯采用针刀治疗,对照II组(35例)单纯采用痛点注射治疗,观察三组临床疗效。结果:治疗组总有效率高于对照I组、对照II组(P0.05)。结论:针刀配合痛点注射疗法能有效提高肱骨外上髁炎的临床疗效,安全有效,值得临床推广应用。%Objective:To investigate the efficacy of acupotomology combined with trigger point injection for external humeral epicondylitis. Meth-ods:105 cases of patients with external humeral epicondylitis were randomly divided into 3 groups:the treatment group (35 cases) treated by acu-potomology combined with trigger point injection, the control group I (35 cases) only by acupotomology, and control group II (35 cases) only by trig-ger point injection. observed the efficacy of 3 groups. Results:The total effective rate of treatment group was higher than that of control group I and control group II (P0.05). Conclusion:The treatment of acupotomology combined with trigger point injection ca n effictively improve the efficacy of external humeral epicon-dylitis, and its safety and effiective makes it worthy of promotion and application.

  1. Onset of efficacy with acute long-acting injectable paliperidone palmitate treatment in markedly to severely ill patients with schizophrenia: post hoc analysis of a randomized, double-blind clinical trial

    Ma Yi-Wen

    2011-04-01

    Full Text Available Abstract Background This post hoc analysis (trial registration: ClinicalTrials.gov NCT00590577 assessed onset of efficacy and tolerability of acute treatment with once-monthly paliperidone palmitate (PP, a long-acting atypical antipsychotic initiated by day 1 and day 8 injections, in a markedly to severely ill schizophrenia population. Methods Subjects entering the 13-week, double-blind trial were randomized to PP (39, 156, or 234 mg [25, 100, and 150 mg eq of paliperidone, respectively] or placebo. This subgroup analysis included those with a baseline Clinical Global Impressions-Severity (CGI-S score indicating marked to severe illness. PP subjects received a 234-mg day 1 injection (deltoid, followed by their assigned dose on day 8 and monthly thereafter (deltoid or gluteal. Thus, data for PP groups were pooled for days 4 and 8. Measures included Positive and Negative Syndrome Scale (PANSS, CGI-S, Personal and Social Performance (PSP, and adverse events (AEs. Analysis of covariance (ANCOVA and last-observation-carried-forward (LOCF methodologies, without multiplicity adjustments, were used to assess changes in continuous measures. Onset of efficacy was defined as the first time point a treatment group showed significant PANSS improvement (assessed days 4, 8, 22, 36, 64, and 92 versus placebo, which was maintained through end point. Results A total of 312 subjects met inclusion criterion for this subgroup analysis. After the day 1 injection, mean PANSS total scores improved significantly with PP (all received 234 mg versus placebo at day 4 (P = 0.012 and day 8 (P = 0.007. After the day 8 injection, a significant PANSS improvement persisted at all subsequent time points in the 234-mg group versus placebo (P P P P Conclusions In this markedly to severely ill population, acute treatment with 234 mg PP improved psychotic symptoms compared with placebo by day 4. After subsequent injections, observed improvements are suggestive of a dose

  2. Short- and long-term efficacy of intra-articular injections with betamethasone as part of a treat-to-target strategy in early rheumatoid arthritis

    Hetland, Merete Lund; Østergaard, Mikkel; Ejbjerg, Bo;

    2012-01-01

    M-RF and C-reactive protein were not.CONCLUSION: In early RA, intra-articular injections of betamethasone in small and large peripheral joints resulted in rapid, effective and longlasting inflammatory control. The cumulative dose of betamethasone was low, and the injections were well tolerated....

  3. Efficacy and safety of atypical antipsychotic drug treatment for dementia: a systematic review and meta-analysis

    Tan, Lin; Tan, Lan; Wang, Hui-Fu; Wang, Jun; Tan, Chen-Chen; Tan, Meng-Shan; Meng, Xiang-Fei; Wang, Chong; Yu, Jin-Tai

    2015-01-01

    Introduction A wide variety of atypical antipsychotic drugs (risperidone, olanzapine, quetiapine, aripiprazole, ziprasidone and clozapine) are widely used in the management of neuropsychiatric symptoms, which are commonly seen in dementia, but results from randomised controlled trials (RCTs) on the efficacy and safety of these agents are conflicting. We aimed to quantify the efficacy and safety of atypical antipsychotic drugs on neuropsychiatric symptoms in dementia patients. Methods PubMed, ...

  4. Comparison between risperidone, an atypical antipsychotic agent and haloperidol, a conventional agent used to treat schizophrenia

    An observational and comparative study was conducted to compare the functional outcome between the patients treated with conventional antipsychotic agent haloperidol and typical antipsychotic agent, Risperidone (Risperidal). A total of 32 patients were included in the study with established schizophrenia according to (DSM iv). The data was processed on SSPE 10th version. The primary outcome measure was the improvement of negative symptoms of schizophrenia and secondary outcome measure was to observe the superiority of the atypical drug Risperid one over conventional agent haloperidol regarding side effects. Patients were assessed at baseline, 2nd and 8th week, using four tools of assessment. For treatment group receiving haloperidol mean was 47.2+-11.50 at 8th week and for Risperidone treatment group mean was 43+-14.68. The P values for all the parameters in the Clozapine group were significant as compared to haloperidol. (author)

  5. Non-destructive quantitative analysis of risperidone in film-coated tablets.

    Orkoula, M G; Kontoyannis, C G

    2008-07-15

    A simple, non-destructive, methodology based on FT-Raman spectroscopy was developed for the quantitative analysis of risperidone in commercially available film-coated tablets. A simple linear regression model was constructed based on standard tablets, prepared using the same manufacturing process as the commercially available. The tablets contained 0.27, 0.54, 1.08, 1.62, 2.16, 3.24 and 4.32 wt% risperidone. The most prominent Raman vibration of the active pharmaceutical ingredient at 1533 cm(-1), recorded using a home-made rotating system, was plotted against concentration. The model was tested on commercial film-coated tablets. The results were compared against those obtained by application of HPLC on the same samples. PMID:18359600

  6. Comparison the effectiveness of aripiprazole and risperidone for the treatment of acute bipolar mania

    Amir Akhavan Rezayat; Paria Hebrani; Fatemeh Behdani; Mohamad Salaran; Majid Nabizadeh Marvast

    2014-01-01

    Background: Second-generation antipsychotics, approved for the treatment of mania, are associated with adverse effects such as weight gain and metabolic disorders. Aripiprazole, a recently introduced second-generation antipsychotic, are thought to account for its low propensity for weight gain, metabolic disturbances and sedation. The purpose of this study was to investigate the effect of risperidone versus aripiprazole in the treatment of acute mania. Materials and Methods: Fifty patients wi...

  7. Risperidone treatment for ADHD in children and adolescents with bipolar disorder

    Joseph Biederman; Paul Hammerness; Robert Doyle; Gagan Joshi; Megan Aleardi; Eric Mick

    2008-01-01

    Joseph Biederman, Paul Hammerness, Robert Doyle, Gagan Joshi, Megan Aleardi, Eric MickPediatric Psychopharmacology Research Department, Massachusetts General Hospital, Boston, MA, USAObjective: Children and adolescents with bipolar disorder are also at high risk of having comorbid attention-deficit hyperactivity disorder (ADHD). The objective of this study was to estimate improvement in ADHD symptoms in children with bipolar disorder.Methods: This was an open-label, study of risperidone monot...

  8. Review of risperidone for the treatment of pediatric and adolescent bipolar disorder and schizophrenia

    Bishop, Jeffrey R.; Pavuluri, Mani N.

    2008-01-01

    Jeffrey R Bishop1,2, Mani N Pavuluri21Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA; 2Department of Psychiatry, Pediatric Mood Disorders Program and Center for Cognitive Medicine, University of Illinois at Chicago College of Medicine, Chicago, IL, USAAbstract: Risperidone is a commonly used medication for the treatment of bipolar disorder and schizophrenia in children and adolescents. It has been studied as a monotherapy treatment in ...

  9. Risperidone Versus Methylphenidate in Treatment of Preschool Children With Attention-Deficit Hyperactivity Disorder

    Arabgol, Fariba; Panaghi, Leily; Nikzad, Vahid

    2015-01-01

    Background: Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric diagnosis among preschool children. Objectives: The aim of this study was to examine the Risperidone treatment compared to Methylphenidate (MPH) in preschool children with ADHD. Patients and Methods: Thirty three outpatient preschool children, aged 3-6 years, diagnosed with ADHD (The diagnosis of ADHD was established by two child and adolescent psychiatrists according to the DSM-IV-TR criteria), participated i...

  10. CHALLENGE WITH ATYPICAL ANTIPSYCHOTIC DRUGS IN RISPERIDONE INDUCED NEUROLEPTIC MALIGNANT SYNDROME: A CASE REPORT

    Mendhekar, D.N.; Jiloha, R.C.; M M Mehndiratta; War, L.

    2002-01-01

    There are several reports available on neuroleptic malignant syndrome (NMS) associated with risperidone but when a more stringent criterion is applied there are only a few. Report on challenge and rechallenge with various atypical antipsychotic drugs in re-emergence of post NMS psychosis is scanty. Our aim of presenting this is to highlight the differential response of various atypical antipsychotic drugs in the treatment of post NMS psychosis. This paper reports a young male with mild mental...