Gender-specific effects in the treatment of acute schizophrenia with risperidone

Introduction: Gender-related effects play a role in antipsychotic treatment. We recently published a study demonstrating the efficacy of the atypical antipsychotic risperidone in the management of acute psychotic decompensations. We have now reanalysed the clinical data to assess the effects of gender on treatment and outcome. Methods: High-dose treatment with risperidone (6-8 mg/d) was administered to 23 male and 25 female acutely psychotic schizophrenic admissions. PANSS- and CGI-ratings were obtained for four weeks. Results: Males and females did not differ significantly in age, duration of treatment, dose of risperidone or clinical ratings. Females were treated with a significantly higher maximum dose of risperidone per kg bodyweight. Significantly more females (n = 14) than males (n = 8) discontinued the use of risperidone. Conclusion: Although the reasons for the lower drop-out rate in males are not clear, gender differences in the clinical presentation may have contributed. High-dose treatment with risperidone may be more beneficial in males for the treatment of acute schizophrenia.