Oct. 17, 2006
UI Researchers Aim To Reduce Schizophrenia Relapse
Even when using medications to manage schizophrenia, people with the disease face a nearly one-in-three chance of having a relapse within a two-year period.
However, University of Iowa researchers recently received a five-year, $1.1 million grant from the National Institute of Mental Health to study whether a certain newer medication might, without serious side effects, reduce the chance of relapse, compared to other drugs. The UI is one of eight sites participating in the nationwide study.
Relapse in schizophrenia can lead to serious consequences, said Del Miller, M.D., principal investigator for the UI site and professor of psychiatry in the UI Roy J. and Lucille A. Carver College of Medicine.
"People with schizophrenia who relapse can lose their jobs or be evicted from their homes," Miller said. "The support of family and other people becomes very trying for all involved. The risk of suicide also increases significantly for people with schizophrenia during a relapse."
"Medications for schizophrenia have come a long way in the past 30 years, but we continually need to improve treatment options," he added.
The new study will be the first to compare the effectiveness in preventing relapse of long-acting, injectable risperidone to newer oral antipsychotic medications.
The Clinical Antipsychotic Trials of Interventions Effectiveness study published in 2005, which included the UI, showed that the oral antipsychotics are effective in some ways. However, that study did not examine how well the oral antipsychotics prevent relapse, nor did it make any comparisons to long-lasting drugs, Miller said.
Long-acting, injectable medications are taken once every two weeks, rather than daily, as is the case with oral drugs, and thus could contribute to increased patient compliance, Miller said. In addition, with the injectable form, drug levels in the blood stay at a nearly constant level over the two-week period. In contrast, with oral medications taken daily, drug levels in the blood fluctuate over the course of a day.
"Whether these aspects of the long-lasting injectable medication risperidone can help prevent relapse may be shown by the study or additional research based on the study," Miller said.
Long-acting injectable risperidone became available in the United States in 2003 and is the first long-acting medication in the newer class of medications for schizophrenia.
Two older antipsychotic medications available in a long-lasting injectable form are rather effective in preventing relapse. However, these older drugs cause serious side-effects, including movement disorders such as rigidity and tremor, and so are rarely used.
"We're interested to see whether the newer long-lasting, injectable drug can prevent relapse but without the negative side effects," Miller said.
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