Switching to Long-Acting Injectable Effective in Schizophrenia Patients Previously on Oral Therapy
A study published in Psychopharmacology concludes that stable, non-acute but symptomatic patients taking oral antipsychotic monotherapy may experience clinically meaningful improvement in symptoms, functioning, and treatment satisfaction after direct switch to paliperidone palmitate once-monthly injection.
A team of researchers conducted a post-hoc analysis of a prospective, interventional, single-arm, international, multicenter, open-label, 6-month study to investigate the safety, tolerability, and treatment response of paliperidone palmitate once-monthly in symptomatic adults switched from previously unsuccessful monotherapy with common oral antipsychotics.
Study patients (n=472) were transitioned to paliperidone palmitate once-monthly from daily oral aripiprazole (n=46), olanzapine (n=87), paliperidone extended-release (n=104), quetiapine (n=44), or risperidone (n=191).
All patient groups demonstrated significant improvement in mean Positive and Negative Syndrome Scale total (P<0.0001) and Clinical Global Impression-Severity scores (P=0.0004 to P<0.0001). A ≥50% improvement in the Positive and Negative Syndrome Scale total score was seen in 21.7% of aripiprazole patients, 29.9% of olanzapine patients, 29.8% of paliperidone extended-release patients, 27.3% of quetiapine patients, and 37.2% of risperidone patients.
Significant improvements were also seen in the Personal and Social performance score, Mini International Classification of Functionality, Disability and Health Rating for Activity and Participation Disorders in Psychological Illnesses total scores, and Treatment Satisfaction Questionnaire for Medication Global Satisfaction score. The authors added that paliperidone palmitate once-monthly was well tolerated and no new safety signals were observed.
Data from the study were limited by the naturalistic study design; more studies are needed to confirm the findings.
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