December 31 2008
AGITATED NURSING HOME PATIENTS: NEW AGENT CALLED SAFE ALTERNATIVE
Tagged Under : Risperdal
WHAT’S NEW
For your elderly nursing home patients who are agitated, a recently approved antipsychotic agent may be an alternative to traditional antipsychotics, according to Ned H. Cassem, MD. Risperidone (Risperdal) has received FDA approval for the treatment of schizophrenia and other psychotic disorders.
“It’s a great help for us, because it helps people to settle down without the bad side effects that have troubled us up to now,” said Dr. Cassem.
He said risperidone’s main advantage, when given at low doses, is its relatively low incidence of parkinsonian side effects and tardive dyskinesia, common adverse effects of conventional antipsychotics. Until now, the only drug to offer this advantage was clozapine, which carried the risk of agranulocytosis, according to Dr. Cassem. Because this is not a significant risk with risperidone, weekly white blood cell monitoring is not required.
Risperidone is the first drug in a new chemical class called ben-zisoxazole derivatives. Although its exact mechanism for inducing fewer extrapyramidal side effects is unknown, the drug’s clinical benefits appear to derive from blockade of both serotonin and dopamine receptors.
For agitation, Dr. Cassem recommends a daily dose of 0.5 to 1 mg given at bedtime, not to exceed 10 mg/d.
Dr. Cassem is associate professor, Harvard Medical School, and chief of psychiatry, Massachusetts General Hospital, Boston.
Source: American College of Physicians 75th Annual Session, Miami Beach, FL
