Effectiveness of Two Long-Acting Injectable Antipsychotics Compared
the MPR take:
For adults with schizophrenia or schizoaffective disorder, newer long-acting injectable antipsychotic medications may not be more effective than older ones in preventing psychiatric hospitalization and other efficacy failures. Published in JAMA, this multisite, double-blind randomized clinical trial of 311 adult patients diagnosed with schizophrenia or schizoaffective disorder and who were at risk of relapse were given either intramuscular injections of 25–200mg of haloperidol decanoate or 39–234mg of paliperidone palmitate every month for ≤24 months. No statistically significant difference was seen in efficacy failure rates between the two (33.8% vs. 32.4% respectively) but patients taking paliperidone palmitate were more likely to gain weight and experience increases in serum prolactin; haloperidol decanoate was linked to an increase in akathisia. Despite these findings, the authors state that there could still be clinically meaningful advantages for patients taking paliperidone palmitate.
Objective: To compare the effectiveness of the second-generation long-acting injectable antipsychotic paliperidone palmitate with the older long-acting injectable antipsychotic haloperidol decanoate. Design, Setting, and Participants: Multisite, double-blind, randomized clinical trial conducted from March 2011 to July 2013 at 22 US clinical research sites.
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