In elderly schizophrenia patients remission is difficult to determine due to long disease duration, exposure to differing treatments, long-standing side-effects, non-adherence, cognitive decline and physical co-morbidity.

Retrospective chart review of elderly (60+ years) schizophrenia patients admitted to a university affiliated tertiary psychiatric center. Patients were experiencing an exacerbation at admission. Remission criteria were as defined by the APA’s “Remission in Schizophrenia Working Group”. Clinical status and improvement were quantified using the Clinical Global Impression scale.

During 2006 forty-eight elderly schizophrenia patients were admitted to our center. Of these, 25 patients were treated with long-acting risperidone (LAR), 18 women and 7 men, mean age 72 years (range: 62-81), mean disease duration 30.4 years (range:14-42) and mean number of previous hospitalizations 8.9 (range:1-21). Co-morbid physical illness was present in 12 patients (hypertension, diabetes, CHF and hypothyroidism). Of 25 patients treated with LAR, 19 (76%) continued uninterrupted treatment for 6 months or longer. In 6 patients treatment was discontinued due to insufficient response. All patient’s (N=25) clinical severity ratings with the CGI-S were in the range of 5 to 7 prior to treatment. Following 6 months of LAR treatment, mean dose 36.0 mg/2 weeks (range: 25-50), 18 patients were rated as “improved” or “very much improved” on the CGI-I scale. In 15/25 patients (60%) symptomatic remission was achieved.

LAR may be effective in achieving remission among elderly schizophrenia patients. Tolerability was high and adherence rates improved. The inherent bias in a retrospective analysis need temper our observations.