Risperidone for Individuals with Refractory Schizophrenia

Background: Risperidone has been shown to be as effective as other atypical antipsychotic medications in the treatment of psychotic symptoms, but its effectiveness in refractory psychotic symptoms is unclear. Objective: In this paper, we aim to review the available evidence related to the use of risperidone in refractory schizophrenia. Methods: English language articles ranging from 1985 to 2009 (inclusive) were retrieved from Pubmed in December 2009 using the search terms ‘schizophrenia’, ‘refractory’, ‘resistant’, ‘risperidone’, ‘atypical’, ‘combination’ and ‘antipsychotic’. Results: The available literature is conflicting on the use of risperidone as an augmentation of clozapine or of other antipsychotics and methodological problems make drawing firm conclusions difficult. Studies using Risperidone Long Acting Injection have included both individuals with recent-onset schizophrenia and those with refractory schizophrenia, which makes it difficult to interpret its effectiveness specifically for those with refractory schizophrenia. Risperidone may reduce potentially disabling cognitive symptoms of schizophrenia, but these effects do not differ significantly from that of other typical and atypical antipsychotic medications. Conclusion: Further and more rigorous research is required on risperidone for refractory schizophrenia.