The use of concurrent long-acting injectable antipsychotic therapy with paliperidone palmitate and aripiprazole monohydrate in a patient with schizophrenia

Evernden, Christopher; Giang, Irene; Anderson, Mariah

doi:10.9740/mhc.2021.09.305

Cited by 2 publications

(3 citation statements)

References 21 publications

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“…(1) Twelve case reports (Burke and Lincoln, 2006;Grover, Sharan and Gupta, 2006;Ahuja and Lloyd, 2007;Kantrowitz et al, 2007;Kapusta et al, 2007;Kuo and Hwu, 2008;Leo et al, 2008;Adan-Manes and Garcia-Parajua, 2009;Lecamwasam and Alexander, 2011;Huang and Chang, 2012;Noorani et al, 2016;Evernden et al, 2021); (2) Five case series (DeQuardo, 2004;Ramaswamy et al, 2004;Lea et al, 2007;Raja, 2007;Li et al, 2019); (3) One double-blind, placebo-controlled RCT ; ( 4) Two open-label clinical trials (Wang et al, 2013;Gupta et al, 2021); (5) One animal study (Sonnenschein et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

“…Twelve case reports (Burke and Lincoln, 2006; Grover, Sharan and Gupta, 2006; Ahuja and Lloyd, 2007; Kantrowitz et al , 2007; Kapusta et al , 2007; Kuo and Hwu, 2008; Leo et al , 2008; Adan-Manes and Garcia-Parajua, 2009; Lecamwasam and Alexander, 2011; Huang and Chang, 2012; Noorani et al , 2016; Evernden et al , 2021);…”

Section: Resultsmentioning

confidence: 99%

“…In the one case of clinical worsening in which haloperidol was added to the ongoing aripiprazole therapy, no worsening of psychotic symptoms was reported but QTc prolongation (Leo et al , 2008). On the other hand, two patients experienced an improvement in psychotic symptoms following the addition of a strong FDA on previous stable aripiprazole therapy (Kuo and Hwu, 2008; Evernden et al , 2021). Therefore, adding aripiprazole on top of a strong FDA would appear to be a riskier strategy than adding a strong FDA on a previously ongoing aripiprazole therapy.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The dilemma of polypharmacy in psychosis: is it worth combining partial and full dopamine modulation?

Lippi

Fanelli

Fabbri

et al. 2022

International Clinical Psychopharmacology

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Antipsychotic polypharmacy in psychotic disorders is widespread despite international guidelines favoring monotherapy. Previous evidence indicates the utility of low-dose partial dopamine agonist (PDAs) add-ons to mitigate antipsychotic-induced metabolic adverse effects or hyperprolactinemia. However, clinicians are often concerned about using PDAs combined with high-potency, full dopaminergic antagonists (FDAs) due to the risk of psychosis relapse. We, therefore, conducted a literature review to find studies investigating the effects of combined treatment with PDAs (i.e. aripiprazole, cariprazine and brexpiprazole) and FDAs having a strong D2 receptor binding affinity. Twenty studies examining the combination aripiprazole – high-potency FDAs were included, while no study was available on combinations with cariprazine or brexpiprazole. Studies reporting clinical improvement suggested that this may require a relatively long time (~11 weeks), while studies that found symptom worsening observed this happening in a shorter timeframe (~3 weeks). Patients with longer illness duration who received add-on aripiprazole on ongoing FDA monotherapy may be at greater risk for symptomatologic worsening. Especially in these cases, close clinical monitoring is therefore recommended during the first few weeks of combined treatment. These indications may be beneficial to psychiatrists who consider using this treatment strategy. Well-powered randomized clinical trials are needed to derive more solid clinical recommendations.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The dilemma of polypharmacy in psychosis: is it worth combining partial and full dopamine modulation?

Lippi

Fanelli

Fabbri

et al. 2022

International Clinical Psychopharmacology

View full text Add to dashboard Cite

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Breakthrough Psychosis and Long-Acting Injectable Antipsychotics

Joo¹,

Lee²,

Jeong³

et al. 2023

Korean J Schizophr Res

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“Breakthrough” of psychosis despite good compliance of antipsychotics medication for a long time is a major obstacle to the treatment of schizophrenia, whether the mechanism is caused by dopamine hypersensitivity or insufficient dose of antipsychotics. Researchers advocating “Dopamine Supersensitivity Psychosis” (DSP) emphasize to avoid excessive inhibition of dopamine 2 receptors from the beginning of treatment. On the other hand, researchers advocating “Breakthrough psychosis on Antipsychotic Maintenance Medication” (BAMM) in which psychosis recurs due to insufficient medication despite continuous administration of antipsychotics without non-adherence argue that dose of antipsychotics should be increased to enhance therapeutic effect. In patients using long-acting antipsychotics injection (LAI), non-compliance can be ruled out. We believe that in treating non-affective psychosis, it is necessary to continuously maintain the lowest dose possible using the optimal dose considering the side effects of second-generation antipsychotics and the cycle and stage of psychosis, and the optimal formulation such as LAI.

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The use of concurrent long-acting injectable antipsychotic therapy with paliperidone palmitate and aripiprazole monohydrate in a patient with schizophrenia

Cited by 2 publications

References 21 publications

The dilemma of polypharmacy in psychosis: is it worth combining partial and full dopamine modulation?

The dilemma of polypharmacy in psychosis: is it worth combining partial and full dopamine modulation?

Breakthrough Psychosis and Long-Acting Injectable Antipsychotics

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