Practical guidelines on the use of paliperidone palmitate in schizophrenia

Newton, Richard, Hustig, Harry, Lakshmana, Raju, Lee, Joseph, Motamarri, Balaji, Norrie, Peter, Parker, Robert and Schreiner, Andreas (2012) Practical guidelines on the use of paliperidone palmitate in schizophrenia. Current Medical Research and Opinion, 28 4: 559-567. doi:10.1185/03007995.2012.665362


Author Newton, Richard
Hustig, Harry
Lakshmana, Raju
Lee, Joseph
Motamarri, Balaji
Norrie, Peter
Parker, Robert
Schreiner, Andreas
Title Practical guidelines on the use of paliperidone palmitate in schizophrenia
Journal name Current Medical Research and Opinion   Check publisher's open access policy
ISSN 0300-7995
1473-4877
Publication date 2012-04
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1185/03007995.2012.665362
Volume 28
Issue 4
Start page 559
End page 567
Total pages 9
Place of publication London, United Kingdom
Publisher Informa Healthcare
Collection year 2013
Language eng
Formatted abstract
Objective:
Paliperidone palmitate is an atypical long-acting injectable (LAI) antipsychotic that has been approved for
use in the US, EU, Australia and numerous other countries for acute and maintenance therapy of
schizophrenia.

LAI antipsychotics are often viewed as a ‘last-resort’ treatment for difficult-to-treat patients, however this
article considers their role more broadly in the management of partial or non-adherence in schizophrenia.

Method:

A search of MedLine, CTR and PsychInfo was conducted to identify relevant publications and clinical trials
(search term ‘paliperidone palmitate’, up to December 2010). The findings were discussed in a number of
teleconferences and the manuscript was finalized with a face-to-face meeting of the authors group.

Main findings:

Relapse prevention in schizophrenia requires a comprehensive approach to treatment, which includes
antipsychotic medication and psychosocial measures as well as family and/or carer involvement. Good
symptom control and the interconnected issue of treatment adherence are arguably the most crucial factors
for success. Carer and patient feedback should be carefully considered. Negotiation about commencing LAI
therapy done early in course of disease is easier than many clinicians believe, although it is not often
attempted in practice. Paliperidone palmitate is useful in both the acute and maintenance phases of
treatment.

Commentary:

A case-based approach is presented to suggest various opportunities where use of paliperidone palmitate
could be considered within the disease course of schizophrenia.

Conclusions:

Paliperidone palmitate offers some advantages in terms of tolerability, simplicity of treatment initiation and
long duration between injections. The consensus of the authors is that rather than reserving paliperidone
palmitate for use in difficult-to-treat or refractory patients, it could be used to promote adherence and
prevent relapse earlier in the course of the illness.
Keyword Long-acting injectable antipsychotic
Paliperidone palmitate
Acting injectable risperidone
Antipsychotic medication
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2013 Collection
School of Medicine Publications
 
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