Abstract

Little data exists on the use of long-acting neuroleptics in patients with end stage renal disease (ESRD). In this case report we describe the use of long-acting risperidone in a single patient with schizoaffective disorder and ESRD admitted to the study center with an acute psychotic episode. The patient received long-acting risperidone with satisfactory control of symptoms. Day-7 plasma concentrations were obtained (LAI risperidone 100 mg with concurrent oral risperidone 4 mg nightly) and reflected adequate ongoing accumulation of risperidone and its active metabolite (risperidone: <5.0 ng/mL, 9-hydroxy-risperidone: 33.4 ng/mL). Long-acting antipsychotics can be considered in the treatment of schizophrenia in patients with severe organ dysfunction. Plasma concentrations should be obtained, and clinicians should monitor closely for potential toxicities.