The Canadian experience with risperidone for the treatment of schizophrenia: an overview

Objective: To summarize published data to date by Canadian authors and from Canadian sources on risperidone, a novel neuroleptic indicated in the management of schizophrenia and related psychotic disorders. It was introduced in Canada in 1993. Data sources: A MEDLINE search was performed using "risperidone" as a keyword. Three Canadian journals were also searched manually. Study selection: Articles published between January 1991 and June 1996 by Canadian authors or involving Canadian patients. Data extraction: Retrieved articles were categorized according to data on efficacy; safety, resource use/economics and other miscellaneous aspects. Articles were abstracted and summarized. Some non-Canadian sources were used for comparison. Data synthesis: The initial Canadian multicentre trial found risperidone (6 mg daily) to be superior to haloperidol (20 mg daily) in reducing positive and negative symptoms, with fewer extrapyramidal side effects (EPS). Various case reports have extended both the clinical use and safety profile of risperidone, while neuro-imaging studies have tried to clarify its mechanism of action. Economic studies suggest substantial cost benefits due to prevention of hospitalization as well as improvement in quality of life. Conclusions: Canadian research has contributed considerably to the current knowledge regarding risperidone. Future studies, both controlled and naturalistic, will need to focus on comparisons with the various new compounds now available.