Emerging treatments in the management of bipolar disorder – focus on risperidone long acting injection

Abstract

Bipolar disorder is a life-long psychiatric illness characterized by a high frequency of relapses and substantial societal costs. Almost half of the patients are prescribed second generation antipsychotics for treatment of manic states, or as the maintenance therapy. Risperidone long acting injection (RLAI) as a monotherapy or as adjunctive therapy to lithium or valproate for the maintenance treatment of bipolar I disorder was approved by Food and Drug Administration (FDA) in United States in May 2009. In this review we will consider the aspects of pharmacology, pharmacokinetics, metabolism, safety and tolerability, and clinical trials focusing on the efficacy of RLAI in bipolar disorder. The patients’ perspective and attitudes to long-acting injections will also be discussed.

Keywords:

• second generation
• antipsychotics
• patient attitudes
• lithium
• valproate
• monotherapy

Acknowledgment

The authors would like to thank Dr MX Patel for her helpful comments on the draft of this paper.

Disclosures

SAS has been reimbursed for the attendance at scientific conferences by Janssen-Cilag and Sanofi-Syntelabo. He also-has received speaker fees from AstraZeneca and Eli Lilly within the past 5 years.

WEH has received speaker fees from BMS, Eli Lilly, Janssen-Cilag and Lundbeck. He received research grants-from Servier, the French Association of Biological Psychiatry (AFPB) and Lundbeck, which are unrelated to the content of this manuscript.