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Original papers: Carol Paton and Chike Okocha Risperidone long-acting injection: the first 50 patients Psychiatr Bull 2004; 28: 12-14 [Abstract] [Full text] [PDF]

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Letter to the Editor, Psychiatric Bulletin

ROBERT LASSER, JOHN KANE, THE ZUCKER HILLSIDE HOSPITAL, EDWARD CRUMBLEY, JANSSEN MEDICAL AFFAIRS   (5 April 2004)

Letter to the Editor, Psychiatric Bulletin 5 April 2004
ROBERT LASSER, PHYSICIAN JANSSEN MEDICAL AFFAIRS, JOHN KANE, THE ZUCKER HILLSIDE HOSPITAL, EDWARD CRUMBLEY, JANSSEN MEDICAL AFFAIRS Send letter to journal: Re: Letter to the Editor, Psychiatric Bulletin RLASSER{at}JANUS.JNJ.COM ROBERT LASSER, et al.	Letter to the Editor, Psychiatric Bulletin Paton C & Okocha C. (2004) Risperidone long-acting injection: the first 50 patients. 28, 2-24. Dear Editor, We were pleased to read of the positive experience with long-acting risperidone by Paton & Okocha. The abstract, however, appeared inconsistent with the data describing generally positive patient outcomes. From the abstract alone, the findings with long-acting risperidone sound more negative than they actually were. Specifically, the authors studied a difficult-to-treat population (42 of 50 patients with histories of non-compliance or unacceptable EPS). Even in this population, a majority (54%) had at least minimal improvement, with 40% (20 of 50 patients) being seen as 'much or very much improved'. This is impressive considering the population examined, but the authors do not mention this context when drawing their conclusions. Further, one might view a 40% attrition rate to be a positive outcome given that patients were selected largely on the basis of noncompliance. Comparison to a published one-year trial1 may not be entirely appropriate as patients in the latter were selected on the basis of clinical stability, not noncompliance, and most were switched from oral atypical, not depot, antipsychotics. We agree with Paton & Okocha about the need for additional information regarding long-acting risperidone, including mention that at least six months of therapy are needed before assessing outcome. However, we interpret their findings as supportive of the potential for further improvements among more severely ill or difficult to treat patients, complimenting the 'average' patients studied by Fleischhacker et al.1 Hopefully, readers will consider the full report before reaching conclusions about the potential impact of long-acting risperidone for their particular patients. John M. Kane, MD, The Zucker Hillside Hospital, Glen Oaks, NY Robert Lasser, MD, Janssen Medical Affairs, LLC, Titusville, NJ Edward Crumbley, MS, Janssen Medical Affairs, LLC, Titusville, NJ References 1. FLEISCHHACKER W.W., EERDEKENS M, KARCHER K, et al. (2003) Treatment of schizophrenia with long-acting injectable risperidone: a 12- month open-label trial of the first long-acting second-generation antipsychotic. Journal of Clinical Psychiatry, 64, 10, 1250-1257.