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Article Abstract

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Background: Risperidone is an”atypical” antipsychotic with strong binding affinityfor dopamine-2 and serotonin-2 receptors. Risperidone is oftenused to treat hospitalized patients who have acute psychoticdecompensation, and the therapeutic target dose commonly used is2 to 6 mg/day. The most common clinical practice is to titratethe dose of risperidone to the target therapeutic dose overseveral days. This study investigated the safety and tolerabilityof a rapid oral-loading regimen for risperidone developed toachieve therapeutic doses of this antipsychotic within 24 hours.

Method: Rapid-loaded risperidone was initiatedwith 1 mg. Subsequent doses were increased by 1 mg every 6 to 8hours up to 3 mg. Dose increases were contingent on tolerance oflast administered dose.

Results: Of a sample of 11 consecutiveinpatients admitted to an acute psychiatric facility who weretreated with this protocol, 7 tolerated the most rapid titration,achieving a standing dose of 3 mg b.i.d. in 16 hours. Threerequired a slightly slower titration and achieved this targetdose in 24 hours. One patient could not tolerate the 3-mg dosebut tolerated a standing regimen of 2 mg t.i.d. No patientexperienced serious extrapyramidal side effects, sedation, or anyother adverse event during the rapid titration, and in no casedid risperidone have to be discontinued.

Conclusion: These results suggest thataggressive dosing of risperidone is well tolerated in mostpsychiatric inpatients. ‘ ‹’ ‹’ ‹