Three case-reports on the use of risperidone in the long-term treatment of bipolar disorder

Background

The treatment of bipolar disorder is often complex, and patients suffer from serious adverse events due to treatment with mood stabilizers and especially lithium. Also, many of them are refractory to this treatment alone

Material and Methods

The current study is a report of 3 cases of female bipolar patients. All three patients were partial responders to lithium therapy alone, and unresponsive to other therapies (anticonvulsants, antidepressants, typical antipsychotics, various combinations). They had suffered from a number of manic and depressed episodes which were at least 1–2 of each kind annually.

Results

All manifested complete remission of symptoms after combination therapy with litium (plasma levels above 0.8 mEq/lt) plus 1–3 mg of risperidone daily. The two of them are still free of symptomatology during the maintainance period for 16 and 17 months respectively. The third patient, after several months during which she was free of symptomatology discontinued lithium against the psychiatrist's advise and received only 3 mg of Risperidone daily. For the next 18 months (until now) the patient is under risperiodone monotherapy and free of symptomatology.

Discussion

The follow-up period of the current study is the longest reported in the literature. The results support the usefulness of risperidone as monotherapy or in combination with mood stabilizers in bipolar disorder.