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Schizophrenia Research and Treatment
Volume 2011 (2011), Article ID 631690, 10 pages
Research Article

Very Low-Dose Risperidone in First-Episode Psychosis: A Safe and Effective Way to Initiate Treatment

1Orygen Youth Health Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
2Lambeth Early Onset Service, Stockwell, London SW97AA, UK

Received 2 March 2010; Revised 21 September 2010; Accepted 6 December 2010

Academic Editor: R. A. Emsley

Copyright © 2011 Patrick D. McGorry et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Patients experiencing a first psychotic episode have high rates of extrapyramidal symptoms (EPSs) when treated with the doses of neuroleptics used in multiepisode or chronic schizophrenia. There is some evidence that lower doses may be equally, if not more, effective but less toxic in this population. Here, we report the results of a biphasic open label trial designed to assess the efficacy, safety, and tolerability of low-dose (2–4 mg/day) risperidone treatment in a group of 96 first-episode nonaffective psychosis patients. At the end of the trial, 62% of patients met the response criteria although approximately 80% had achieved a response at some time during the study. Reports of EPS remained low, and there were no dystonic reactions. We conclude that even at a dose of 2 mg/day, risperidone was highly effective in reducing acute symptomatology in a real world sample of young first-episode psychosis patients.