Drug offers hope for schizophrenia
Injections reduce side effects
Results often `quite impressive'
Aug. 6, 2004. 06:17 AM
ELAINE CAREY
MEDICAL REPORTER
Eighteen months ago, Ralph Cooper started hearing voices and became convinced neighbours were spying on him.Diagnosed with schizophrenia, the 26-year-old Edmonton man began taking a daily pill to control it.
But the medication left him with facial twitches and a swelled tongue that made it difficult to speak. He couldn't work because of his condition.
Now, a year after beginning treatment with a newer-generation anti-psychotic medication that is injected every two weeks, Cooper is studying electronic engineering technology and working at a warehouse part-time to pay for his studies.
"It's been a 100 per cent turnaround for me," Cooper said of the drug, Risperdal Consta (risperidone), which has just been approved by Health Canada and which he received during a trial of the drug in Edmonton.
"I have no side effects at all. It's been a huge breakthrough."
While injectable schizophrenia drugs have been available for a decade, they had side effects, including movement disorders and muscle fibrosis or scarring. They also didn't treat some of the symptoms, such as apathy or the inability to express thoughts or keep to a schedule, said Dr. Jorge Soni, deputy clinical director of the general psychiatry program at Toronto's Centre for Addiction and Mental Health.
But Risperdal Consta produced none of the common side effects and patients commonly reported "their mind was much clearer," said Soni, who has been treating patients with it since January.
"The younger patients we started on it had really quite impressive results."
While there is no cure for schizophrenia, it can be managed in most patients with appropriate treatment.
However, some patients don't take their medication, either because they don't believe they're ill or because of the side effects, Soni said. They may then relapse into a psychotic state requiring hospitalization and, the more often a patient is hospitalized, the more difficult it is to treat them and the longer it takes, he said.
A worldwide one-year study of 615 patients who took the new long-acting injection found it cut patients' days in hospital by 64 per cent, or 21 days per year each.
The treatment will be especially beneficial for patients who have trouble taking medication, such as the homeless, Soni said.
"We treat lots of people who are homeless, living in shelters and don't have any health services at all," he said. "That is a very large group that could benefit a lot from this."
But a long-acting medication that has few side effects will help people with all types of schizophrenia, said Dr. Pierre Chue, an associate professor of psychiatry at the University of Alberta, who conducted the worldwide study. None of those involved in the drug trial were funded by its manufacturer, Janssen-Ortho Inc.
The side effects of the new drug were less than 5 per cent, "which is really very low by schizophrenia standards," Chue said. "Because it is injected, we can get by with a lower dose than a pill."
About 300,000 Canadians have schizophrenia and they occupy more than 30,000 hospital bed-days every year, the second highest number of all mental illness hospitalizations, according to Statistics Canada.
The direct and indirect costs of the disease total more than $4 billion annually, according to Health Canada.