Optimal Dosing and Recommended Dose-Schedule with Risperidone

Kim, Chan Hyung; Lee, Hong Shick

Abstract

Although the establishment of appropriate dosage ranges and dose-up strategies for antipsychotic drugs has important ramifications for both short-term treatment and long-term therapeutic outcomes, difficulties in dosing persist. As a matter of fact, drug dosages utilized during controlled clinical trials are not always optimal for patients encountered in day-to-day practice. The original trials of risperidone, a novel antipsychotics, suggested that an initial target dose and dose-up schedule of 6 mg/day within 1week was appropriate, but these trials were necessarily conducted among patients who were chronically impaired, hospitalized, and often partly drug resistant. Relevant data relating to the dosage and dose-up schedule of risperidone identified through a lot of papers published in Korean and other country. On the basis of multicenter studies, naturalistic studies, phase 4 trials and many years of clinical experiences, the curre ntly recommended target dose and their schedule for risperidone treatment is 4-5 mg/day with less-rapid titration than previously recommended. Moreover, a lower dose than this and slower titration may be appropriate for elderly patients and first-episode patients.