Serum concentrations of risperidone and 9-OH risperidone following intramuscular injection of long-acting risperidone compared with oral risperidone medication

Abstract Introduction: There are currently no guidelines for switching patients from oral risperidone to paliperidone palmitate (Invega Sustenna®). Furthermore, the paliperidone long-acting injectable (LAI) package insert does not recommend bridging with oral antipsychotics, which may result in inadequate serum concentrations in patients on ≥4 mg/d risperidone. Methods: This study evaluated the effects of suboptimal dosing and bridging in patients switched from oral risperidone to paliperidone LAI on hospitalization days, emergency department (ED)/mental health urgent care visits, and no-shows/cancellations to mental health appointments. Patients were categorized into optimal or suboptimal dosing based on their loading and maintenance paliperidone doses. Patients on risperidone ≥4 mg/d were categorized as bridged if they received risperidone for ≥7 days after the first paliperidone injection. Results: There were no significant differences in outcomes between optimally and suboptimally dosed patients. There were statistically significant reductions in hospitalization days in patients who were bridged compared with patients who were not bridged. There were statistically significant reductions in hospitalization days and ED/mental health urgent care visits after switching to paliperidone LAI. Discussion: The results of this study indicate that bridging patients who are on ≥4 mg/d risperidone, when converting to paliperidone LAI, is associated with reductions in hospitalization days. However, more research is required to determine the optimal dose and duration of the bridge. The results also indicate that switching patients from oral risperidone to paliperidone LAI, even if the dose is suboptimal, is associated with reductions in hospitalization days and ED/mental health urgent care visits.

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Effect of Long-Acting Thyroid Stimulator on Serum Concentration of Luteinizing Hormone in the Rat

Clinical Science ◽

10.1042/cs0480231 ◽

1975 ◽

Vol 48 (3) ◽

pp. 231-233

Author(s):

P. Dandona ◽

D. J. El Kabir ◽

F. Naftolin ◽

P. C. B. MacKinnon

Keyword(s):

Luteinizing Hormone ◽

Serum Concentration ◽

Pituitary Gland ◽

Immunoglobulin G ◽

Adrenocorticotrophic Hormone ◽

Serum Concentrations ◽

Serum Luteinizing Hormone ◽

Serum Lh ◽

Long Acting ◽

Dexamethasone Suppression

1. The effect of long-acting thyroid stimulator (LATS) on the serum luteinizing hormone (LH) levels of the rat in pro-oestrus has been studied. 2. The injection of three out of four LATS-containing immunoglobulin G fractions caused an increase in amounts of serum LH. 3. Adrenalectomy and dexamethasone suppression did not alter this response. 4. Injection of large doses of adrenocorticotrophic hormone did not produce any increase in serum concentrations of LH. 5. It is postulated that LATS may have a direct effect on the release of LH from the pituitary gland.

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Long acting injection versus oral risperidone in first-episode schizophrenia: Differential impact on white matter myelination trajectory

Schizophrenia Research ◽

10.1016/j.schres.2011.06.029 ◽

2011 ◽

Vol 132 (1) ◽

pp. 35-41 ◽

Cited By ~ 54

Author(s):

George Bartzokis ◽

Po H. Lu ◽

Chetan P. Amar ◽

Erika P. Raven ◽

Nicole R. Detore ◽

...

Keyword(s):

White Matter ◽

First Episode ◽

Differential Impact ◽

Oral Risperidone ◽

Long Acting ◽

First Episode Schizophrenia

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Tissue Damage Caused by the Intramuscular Injection of Long-Acting Penicillin

PEDIATRICS ◽

10.1542/peds.75.4.741 ◽

1985 ◽

Vol 75 (4) ◽

pp. 741-744

Author(s):

Harry Schanzer ◽

Julius H. Jacobson

Keyword(s):

New Zealand ◽

Femoral Artery ◽

Normal Saline ◽

Tissue Damage ◽

Intramuscular Injection ◽

Penicillin G ◽

Left Femoral Artery ◽

New Zealand White Rabbits ◽

Long Acting ◽

The Right

In order to elucidate whether tissue damage produced on occasion by intramuscular injection of longacting penicillin is due to accidental intra-arterial injection or vasospasm, two types of experiments were carried out in rabbits. In the first set of experiments, six New Zealand White rabbits were given intra-arterial injections of 0.4 mL of a mixture containing 300,000 U of penicillin G benzathine and 300,000 units of penicillin procaine per milliliter (Bicillin C-R) into the left femoral artery and 0.4 mL of normal saline into the right femoral artery as autocontrol. In a second set of experiments, 0.4 mL of the same penicillin preparation was injected in the space surrounding the left femoral artery in five New Zealand rabbits, and 0.4 mL of normal saline was injected in a similar fashion around the right femotal artery as control. The legs of the rabbits that received the intra-arterial injection of penicillin invariably developed ischemic manifestations. None of the legs of rabbits given intra-arterial injections of normal saline had pathologic manifestations. None of the rabbits that received the periarterial penicillin preparation or normal saline developed abnormalities. These results strongly suggest that the tissue damage produced by penicillin is secondary to the intra-arterial administration of the drug.

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Health service utilization and medical costs among patients with schizophrenia receiving long-acting injectable risperidone versus oral risperidone

International Clinical Psychopharmacology ◽

10.1097/yic.0000000000000213 ◽

2018 ◽

Vol 33 (4) ◽

pp. 204-212 ◽

Cited By ~ 1

Author(s):

Szu-Jui Fan ◽

Ning Lu ◽

Hui-Chih Chang ◽

Chao-Hsiun Tang ◽

Kuo-Cherh Huang

Keyword(s):

Health Service ◽

Service Utilization ◽

Health Service Utilization ◽

Medical Costs ◽

Oral Risperidone ◽

Long Acting

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Effects of Continuing Oral Risperidone vs. Switching from Risperidone to Risperidone Long-Acting Injection on Cognitive Function in Stable Schizophrenia Patients: A Pilot Study

Frontiers in Psychiatry ◽

10.3389/fpsyt.2018.00074 ◽

2018 ◽

Vol 9 ◽

Cited By ~ 4

Author(s):

Hikaru Hori ◽

Asuka Katsuki ◽

Kiyokazu Atake ◽

Reiji Yoshimura

Keyword(s):

Cognitive Function ◽

Pilot Study ◽

Oral Risperidone ◽

Long Acting

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Atypical antipsychotic switching versus atypical antipsychotic combination in schizoaffective disorder – A clinical case

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1985 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S536-S536 ◽

Cited By ~ 1

Author(s):

A. Ballesteros ◽

B. Cortés ◽

A. Petcu ◽

L. Montes ◽

W. Jaimes ◽

...

Keyword(s):

Atypical Antipsychotic ◽

Schizoaffective Disorder ◽

Drug Combination ◽

Clinical Case ◽

Standard Dose ◽

Clinical Relapse ◽

Upper Limbs ◽

Oral Risperidone ◽

Long Acting

IntroductionRecent studies suggest that aripiprazole (ARP) shows a better profile in terms of mental state and extrapyramidal symptoms (EPS) in psychosis. However, other studies consider that a combination of atypical antipsychotics (AAP) may also be an option for some refractory patients. We present a case of a schizoaffective disorder, manic type (SAFM) (F25.0, ICD-10 criteria) that improved in terms of EPS adverse effects after switching from long-term fluphenazine (LTF) to Long-acting injectable aripiprazole (LAIA) but showed relapse symptoms.ObjectiveWe present a clinical case of SAFM that improved clinically in our outpatient clinic after 1 month of bi-therapy with low doses of oral risperidone and standard dose of LAIA. We study oral AAP-LAIA drug combination utility in this clinical setting.AimsTo study “oral AAP-LAIA combo” benefits in refractory SAFM cases.MethodsOur patient is a 68-year-old female diagnosed of SAFM clinically stable with a combination of lithium and LTF. She presented severe cogwheel stiffness in the upper limbs and postural tremor. We switched from long-term fluphenazine to LAIA and 4 weeks later, she showed discrete cogwheel stiffness but also persecutory delusions and dysphoria.ResultsWe maintained LAIA (400 mg/28 days) and lithium (800 mg/day) doses and added-on risperidone 1 mg/day. She presented clinical relapse 1 month later. She kept her better EPS tolerance as she only had discrete cogwheel in upper limbs only by using attention distraction techniques.ConclusionsOral risperidone-LAIA drug combination appears as an effective and well-tolerated treatment in refractory SAFM cases.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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