Risperidone injection - questions for those with experience

Does it beat the pill? Is it a consistent mood both morning and night? I like having a release at night personally. What are the pros and cons? As I understand it, there are additional risks to health from injection, but I thought injection would be nice because if I were ever faced with a situation where I was away from home and did not have access to my pills, my ass would be covered. I also wouldn’t have to worry about taking it at the same time every night.

Which brings me to another question. My meds help me sleep. Is it harder to get to sleep with injection, or do you feel more drowsy all the time?


March 3,
2011 — Long-acting, injectable risperidone, the first second-generation
antipsychotic available in the United States in this formulation, is no
better than oral antipsychotics for the treatment of unstable
schizophrenia, a new study published in the March 3 issue of the New England Journal of Medicine suggests.In
a randomized study of more than 300 Veterans Affairs (VA) patients,
investigators found injectable risperidone did not significantly
decrease hospitalization rates or improve symptoms, social function, or
quality of life compared with those treated with “clinicians’ choice” of
oral antipsychotics. The risperidone-treated group also reported more
adverse effects.The researchers note that this treatment has not
been tested before in a long-term randomized trial involving this
particular patient population.“Other studies have looked at this
but not in unstable patients, which most doctors would think would most
benefit from this,” lead study author Robert Rosenheck, MD, professor of
psychiatry at Yale School of Medicine in New Haven, Connecticut, and
senior investigator at the New England Mental Illness, Research
Education, and Clinical Center at VA Connecticut Healthcare System in
West Haven, told Medscape Medical News. “However, like its
predecessors, our study failed to find any benefit. This is a drug that
current evidence does not support as being better than available oral
medications,” added Dr. Rosenheck.In addition, he said that he
was surprised to find that patients receiving the long-acting injectable
medication had more adverse effects.“This suggests that patients
on oral medications adjust their dosage to avoid side effects, but when
patients who receive injections begin to get side effects, they can’t
reduce their dosage. This treatment also did not lead to patients
staying on their medications for any longer period of time. I think
those are 2 unexpected but important findings in regards to injectables
overall.” Mixed Findings According to investigators
hopes were high that an injectable antipsychotic would improve
treatment adherence, which is known to be notoriously poor among
patients with schizophrenia who take oral agents.Although
previous placebo-controlled trials suggest injectable risperidone is
efficacious, results from studies comparing it to oral medications have
been mixed.“Before-and-after studies have shown tolerability in
switching from oral to long-acting injectable risperidone, with improved
symptoms and reduced hospital use, [but] these studies involved
clinically stable patients and lacked randomized control groups,” the
researchers write.To assess the drug’s efficacy in patients with
unstable disease, investigators enrolled 369 patients older than 18
years with unstable schizophrenia or schizoaffective disorder. All
patients were currently hospitalized (40%), had been hospitalized within
the previous 2 years (55%), or were at imminent risk for
hospitalization (5%).Participants
were randomly assigned to receive 25 to 50 mg of long-acting injectable
risperidone intramuscularly every 2 weeks for the first month and then
monthly thereafter (n = 187; 92% male; 47% white; mean age, 50.6 years)
or to continue receiving their regularly prescribed oral antipsychotic
medications (control group; n = 182; 90.7% male; 43% white; mean age,
51.3 years).All patients were assessed every 3 months through blinded videoconference interviews and followed up for up to 2 years.

So it looks like it may be worse on side effects, and based on memory from reading drugs.com there is greater risk to health as well. Too bad, because it would be cool to just be able to get a 1 month injection. That I suppose would make me feel more normal and self contained. It would make me feel more prepared for the unexpected as well, such as emergency scenarios.

I will be more eager for injection if ITI-007 pans out. Now that would be a potential drug I wouldn’t have to worry about injections with.