Paliperidone Palmitate Once-Monthly Injectable Treatment for Acute Exacerbations of Schizoaffective Disorder

Fu, Dong-Jing; Turkoz, Ibrahim; Simonson, Richard Bruce; Walling, David; Schooler, Nina R.; Lindenmayer, Jean-Pierre; Canuso, Carla M.; Alphs, Larry

doi:10.1097/jcp.0000000000000535

Cited by 9 publications

(6 citation statements)

References 32 publications

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“…Studies have revealed that paliperidone is effective in the treatment of schizoaffective disorder [ 49 , 50 ]. The once-monthly PLAI used to treat patients with acute exacerbation of schizoaffective disorder alleviated psychotic symptoms and manic and depressive symptoms [ 49 ]. Paliperidone has also been demonstrated to alleviate depressive symptoms in patients with schizophrenia [ 51 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes of paliperidone long-acting injection in patients with schizophrenia: a 1-year retrospective cohort study

2021

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Background Schizophrenia is a severe psychiatric disorder. Poor medical adherence increases relapse rate. Long-acting injection of antipsychotic agent is developed for improving medical adherence. In this study, we examined the effect of paliperidone long-acting injection (PLAI) treatment in patients with schizophrenia in a real-world setting. Methods In this retrospective cohort study, 467 patients with schizophrenia were enrolled, treated with risperidone PLAI or oral antipsychotics, and followed for 1 year. Concomitant medication, namely anticonvulsants, antidepressants, anxiolytics, sedatives or hypnotics, anticholinergics, and beta-blockers, were administered. Patients were classified into 2 groups: the LAI group (patients received LAI for treatment) and the NLAI group (patients taking only oral antipsychotics). The incidence of hospitalization, the length of hospitalization, and the incidence of emergency room visits were assessed. Results The LAI group had a higher incidence of psychiatric acute ward admission (NLAI group = 4.8%; LAI = 30.3%) and emergency room visits (NLAI group = 7.3%; LAI group = 36.0%) before enrolment. During the one-year follow-up, the incidence of acute ward admission and emergency room visit did not differ in the NLAI group (P = .586 and .241) compared with before enrolment, whereas both incidences were significantly decreased in the LAI group (P < .0001 in both of them). Conclusions PLAI reduces the incidence of admission and emergency room visits.

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Section: Discussionmentioning

confidence: 99%

Clinical outcomes of paliperidone long-acting injection in patients with schizophrenia: a 1-year retrospective cohort study

2021

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“…47,[49][50][51]53,55 The only study reporting the advantage of PP1M on oral antipsychotics showed several limitations, the main being a suboptimal statistical power due to the small sample size and the inclusion in the study cohort of both new and old PP1M users. 54 The main causes of drug discontinuation before the planned study end were adverse events 45,46,61,62,65 and ineffectiveness. 47,51,59,62,65,66 The two available long-term studies on PPM3 showed a rate of premature discontinuation similar to that shown by the active comparator (PP1M).…”

Section: Discussionmentioning

confidence: 99%

“…At the end of the double-blind phase of the study by Fu et al, there were small differences in the discontinuation rate between patients randomized to PP1M and those receiving PLA. 45,46 The most common reasons for discontinuation in the active group were withdrawal of consent and onset of adverse events.…”

Section: Ari-lai and Ari-lxlmentioning

confidence: 99%

Discontinuation rates during long‐term, second‐generation antipsychotic long‐acting injection treatment: A systematic review

Gentile

2019

Psychiatry Clin Neurosci

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Aim The aim of this review was to analyze the discontinuation rates during long‐term treatment with second‐generation antipsychotic long‐acting injection (SGA‐LAI) in adults with either schizophrenia spectrum or bipolar disorders. Methods A systematic search (PubMed, Scopus, and the Cochrane Library) of studies published in English (1 January 2001–12 October 2018) identified 1214 abstracts, which were analyzed independently by the author and two colleagues. Studies were retrieved and reviewed if they reported primary data on the discontinuation rate before the study end during treatment lasting ≥36 weeks. Data were extracted from 51 articles meeting the inclusion criteria. Results In all head‐to‐head comparisons, and studies on patients with schizophrenia spectrum or bipolar disorders, the discontinuation rate before the study end in patients treated with SGA‐LAI was, at best, similar to that recorded in patients treated with first‐generation antipsychotics in either oral or LAI formulations or with oral SGA. In particular, in most of the SGA‐LAI long‐term studies, the rate of premature dropout was higher than 50%. Conclusion Reviewed data suggest that SGA‐LAI show no clear superiority over less expensive drugs (including first‐generation antipsychotic LAI and oral antipsychotic formulations) in reducing the risk of premature antipsychotic discontinuation. Thus, alternative strategies should be considered to improve medication persistence and lower discontinuation rates in patients with severe psychiatric disorders. Planning tailored, individualized, and integrated approaches (including frequent clinical evaluations, and behavioral or other flexible techniques adaptable to different settings and patients) may be an effective intervention for improving patient adherence in long‐term pharmacological treatment regimens.

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“…The injectable form seems to be safer than oral paliperidone, given that it has lower rates of spontaneously reported EPS, lower rates of antiparkinsonian medications use, and a more considerable improvement on EPS scales [2]. Nevertheless, EPS remain a common treatment-emergent adverse effect in patients receiving PP regardless of the injection's dosage, reaching an incidence of 8.5% in various open-label studies [9,10]. In a very recent 18-months cohort study, 31.3% of patients receiving the LAI PP developed EPS, akathisia (13.4%) and parkinsonism (16%) being the most common [11].…”

Section: Discussionmentioning

confidence: 99%

A Case of Extrapyramidal Symptoms Secondary to Long-Acting Injectable Paliperidone Palmitate

Talih

2019

ANN

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Paliperidone Palmitate Once-Monthly Injectable Treatment for Acute Exacerbations of Schizoaffective Disorder

Abstract: Supplemental digital contents are available in the text.

Cited by 9 publications

References 32 publications

Clinical outcomes of paliperidone long-acting injection in patients with schizophrenia: a 1-year retrospective cohort study

Clinical outcomes of paliperidone long-acting injection in patients with schizophrenia: a 1-year retrospective cohort study

Discontinuation rates during long‐term, second‐generation antipsychotic long‐acting injection treatment: A systematic review

A Case of Extrapyramidal Symptoms Secondary to Long-Acting Injectable Paliperidone Palmitate

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