Titre du document / Document title

Oral risperidone plus oral lorazepam versus standard care with intramuscular conventional neuroleptics in the initial phase of treating individuals with acute psychosis

Auteur(s) / Author(s)

LEJEUNE Joseph ⁽¹⁾ ; LARMO Ilkka ⁽²⁾ ; CHRZANOWSKI Wlodzimierz ⁽³⁾ ; WITTE Roel ⁽⁴⁾ ; KARAVATOS Athanasios ⁽⁵⁾ ; SCHREINER Andreas ⁽⁶⁾ ; LEX Alice ⁽⁷⁾ ; MEDORI Rossella ⁽⁷⁾ ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

⁽¹⁾ CHR Citadelle, Liege, BELGIQUE
⁽²⁾ Central Mental Health Unit, Auroran Hospital, Helsinki, FINLANDE
⁽³⁾ Psychiatric Clinic of Medical Academy Bialystok, Choroszcs, POLOGNE
⁽⁴⁾ Meander MC, Amersfoort, PAYS-BAS
⁽⁵⁾ University Psychiatric Clinic, University of Thessaloniki, Papageorgiou General Hospital, Thessaloniki, GRECE
⁽⁶⁾ Medical and Scientific Affairs, Janzeen-Cilag, Neuss, ALLEMAGNE
⁽⁷⁾ Medical Affairs EMEA, Janssen-Cilag EMEA, Neuss, ALLEMAGNE

Résumé / Abstract

Although atypical antipsychotics are now considered first line treatments for schizophrenia, intramuscular (i.m.) conventional neuroleptics are often still considered necessary in emergency treatment of acute psychoses. This European, multicentre, open-label, active-controlled trial compared oral risperidone plus oral lorazepam to standard care with i.m. conventional neuroleptics with or without lorazepam in the emergency treatment of acutely psychotic patients. Patients were allowed to choose either oral risperidone (a single dose of 2 mg and 2.0-2.5 mg lorazepam; 121 patients) or standard i.m. treatment (conventional neuroleptic with or without lorazepam; 105 patients). No additional treatment was allowed for 2 h. Primary outcome was the percentage of patients with treatment success (asleep or at least much improved on Clinical Global Impression-global improvement scale) 2 h after treatment initiation. Baseline characteristics were similar in both treatment groups. Oral risperidone plus oral lorazepam was more successful at 2 h (66.9%) and significantly non-inferior compared to standard i.m. care (54.3%; P=0.0003), and the incidence of extrapyramidal symptoms (EPS) was lower (1.7%) compared to standard i.m. care (9.5%). In acutely psychotic patients requiring emergency treatment, oral risperidone/oral lorazepam was at least as effective as i.m. conventional neuroleptic treatment with or without lorazepam. Oral risperidone plus lorazepam rapidly reduces symptoms, including aggression, and causes fewer EPS.

Revue / Journal Title

International clinical psychopharmacology   ISSN 0268-1315 

Source / Source

2004, vol. 19, n^o5, pp. 259-269 [11 page(s) (article)] (21 ref.)

Langue / Language

Anglais

Editeur / Publisher

Lippincott Williams & Wilkins, Hagerstown, MD, ETATS-UNIS  (1986) (Revue)

Mots-clés anglais / English Keywords

Benzodiazepine derivatives ; Serotonine receptor ; Dopamine receptor ; Serotonin antagonist ; Dopamine antagonist ; Sedative ; Hypnotic ; Psychotropic ; Schizophrenia ; Psychosis ; Acute ; Treatment ; Intramuscular administration ; Tranquillizer ; Lorazepam ; Neuroleptic ; Risperidone ; Oral administration ; Chemotherapy ; Human ; Comparative study ;

Mots-clés français / French Keywords

Benzodiazépine dérivé ; Récepteur sérotoninergique ; Récepteur dopaminergique ; Antagoniste sérotonine ; Antagoniste dopamine ; Sédatif ; Hypnotique ; Psychotrope ; Schizophrénie ; Psychose ; Aigu ; Traitement ; Voie intramusculaire ; Tranquillisant ; Lorazépam ; Neuroleptique ; Rispéridone ; Voie orale ; Chimiothérapie ; Homme ; Etude comparative ;

Mots-clés espagnols / Spanish Keywords

Benzodiazepina derivado ; Receptor serotoninérgico ; Receptor dopaminérgico ; Antagonista serotonina ; Antagonista dopamina ; Sedante ; Hipnótico ; Psicotropo ; Esquizofrenia ; Psicosis ; Agudo ; Tratamiento ; Vía intramuscular ; Tranquilizante ; Lorazepam ; Neuroléptico ; Risperidona ; Vía oral ; Quimioterapia ; Hombre ; Estudio comparativo ;

Mots-clés d'auteur / Author Keywords

Acute psychotic episode ; acute schizophrenia ; conventional neuroleptic ; intramuscular ; oral risperidone ;

Localisation / Location

INIST-CNRS, Cote INIST : 21187, 35400011393023.0010