Dear Doctor

The National Institute for Clinical Excellence guidelines for the treatment and management of schizophrenia have been published.1

According to the NICE guidelines, when promoting recovery, relapse prevention is the main aim of the treatment and management of schizophrenia.

Up to 82% of all patients with schizophrenia relapse in the first five years.2 Each relapse reduces the potential for recovery. People who suffer relapses often can be caught in a vicious cycle between acute episodes and periods of being well.

So it should come as no surprise that the NICE guidelines state "The main aim here is to prevent relapse and help keep a person stable enough to live as normal a life as possible."1

Importantly, Risperdal effectively breaks the cycle of schizophrenia and carries a low risk of relapse.3 The incidence of relapse with oral Risperdal has been shown to be significantly lower than haloperidol.3

New Risperdal Consta, a long-acting formulation of Risperdal, provides continuous protection against relapse. And confers a very low risk of relapse. One-year re-hospitalization rates being just 17.6%.4* (Rates for conventional agents range from 30-50% and for other atypicals they range from 20-30%.5)

NICE believes patients experiencing unacceptable side effects should be switched to another treatment.

The guidelines recommend that "…oral atypical antipsychotic drugs should be considered as treatment options for individuals currently receiving conventional antipsychotic drugs who, despite adequate symptom control, are experiencing unacceptable side effects..."1 Risperdal does not over-sedate patients and has a favourable side effect profile compared with conventional neuroleptics.6

I hope this highlights some key points about the NICE guidelines and how they relate to some of the properties.

Yours faithfully

Lynette Heathfield-Elliott
Risperdal Product Manager
Janssen-Cilag Ltd

*Weighted mean between outpatients at 1-year hospitalisation rate of 16% and inpatients rehospitalisation rate of 25%.

 

References

  1. Schizophrenia: Core interventions in the treatment and management of schizophrenia in primary and secondary care. NICE guideline, 2002. [Full text]
  2. Robinson D et al. Predictors of Relapse Following Response From a First Episode of Schizophrenia or Schizoaffective Disorder Arch Gen Psychiatry 1999: 56: 241-7 [Abstract]
  3. Adapted from Csernansky JG et al. A Comparison of Risperidone and Haloperidol for the Prevention of Relapse in Patients with Schizophrenia N Engl J Med 2002: 346: 16-22 [ Abstract] [Full text]
  4. Chue P, Devos E Value in Health 2002 Vol 2
  5. Llorca PM, Devos E. Abstract presented at CINP 2002
  6. Currier GW, Simpson GM. Risperidone liquid concentrate and oral lorazepam versus intramuscular haloperidol and intramuscular lorazepam for treatment of psychotic agitation. J Clin Psychiatry 2001: 62: 153-7 [Abstract]