scholarly journals Dosing strategies for switching from oral risperidone to paliperidone palmitate: Effects on clinical outcomes

2017 ◽  
Vol 7 (3) ◽  
pp. 95-100 ◽  
Author(s):  
Stephanie L. Hsia ◽  
Susan G. Leckband ◽  
Sanjai Rao ◽  
Elizabeth Jackson ◽  
Jonathan P. Lacro
Keyword(s):  
Mental Health ◽  
Emergency Department ◽  
Package Insert ◽  
Optimal Dose ◽  
Urgent Care ◽  
Paliperidone Palmitate ◽  
Serum Concentrations ◽  
Oral Risperidone ◽  
Dosing Strategies ◽  
Long Acting

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.

Incident infection during the first year of treatment – A comparison of clozapine and paliperidone palmitate long-acting injection

2022 ◽  
pp. 026988112110589
Author(s):  
Shubhra Mace ◽  
Olubanke Dzahini ◽  
Victoria Cornelius ◽  
Hadar Langerman ◽  
Ebenezer Oloyede ◽  
...  
Keyword(s):  
Mental Health ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Paliperidone Palmitate ◽  
First Year ◽  
Risk Of Infection ◽  
Long Acting ◽  
First Time ◽  
Health Trust ◽  
Incident Infection

Background: To examine the risk of infection in patients prescribed clozapine compared with patients prescribed paliperidone palmitate long-acting injection (PPLAI). Method: A retrospective, 1-year, cohort study conducted on events occurring in eligible patients beginning treatment for the first time with clozapine or PPLAI between June 2017 and June 2019 in a UK mental health trust providing in-patient and out-patient services. Results: The study included 64 patients starting clozapine and 120 patients starting PPLAI. Incidence of infection was greater in clozapine starters than in PPLAI starters (28% vs 6%; p = 0.001; adjusted odds ratio 5.82 (95% confidence interval (CI) = 2.15–15.76, p = 0.001). Infectious episodes in clozapine patients were not related to changes in neutrophil counts. Incident infection in the clozapine group was highest in the first 3 months of treatment. The most commonly reported infection in the clozapine group was chest infection; however, the majority of infections were non-chest-related. Conclusion: Patients starting clozapine showed a substantially increased likelihood of infection compared with patients starting PPLAI.

Paliperidone palmitate: Experience in a community mental health unit

2017 ◽  
Vol 41 (S1) ◽  
pp. s804-s805
Author(s):  
L. Carrión Expósito ◽  
G.M. Chauca Chauca ◽  
E.L. Guadalupe
Keyword(s):  
Mental Health ◽  
Retrospective Study ◽  
Maintenance Dose ◽  
Lower Number ◽  
Paliperidone Palmitate ◽  
Health Unit ◽  
Dose Number ◽  
Competing Interest ◽  
Long Acting ◽  
Mental Health Unit

IntroductionThere are many jobs that offer advantages of treatment with long-acting injectable in psychosis.ObjectiveTo know the changes in the different variables after the start of paliperidone palmitate (PP).Material and methodWe performed a descriptive and retrospective study. Were evaluated patients who received maintenance therapy with PP during 48 months.ResultsThe sample was composed of 29 patients: 72.4% men and 27.6% women. Average age of 46.21 years. In Figures 1, 2 and 3 show data obtained in relation to compliance with treatment, relapse, maintenance dose, number of admissions and visits to emergency departments respectively.ConclusionsThe administration of PP is associated with a higher level of compliance with treatment. The patients presented a lower number of relapses, hospitalizations and visits to the emergency room. The maintenance dose more used is 150 mg.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Paliperidone palmitate versus oral risperidone and risperidone long-acting injection in patients with recently diagnosed schizophrenia

2014 ◽  
Vol 29 (1) ◽  
pp. 45-55 ◽  
Author(s):  
Dong-Jing Fu ◽  
Cynthia A. Bossie ◽  
Jennifer K. Sliwa ◽  
Yi-Wen Ma ◽  
Larry Alphs
Keyword(s):  
Paliperidone Palmitate ◽  
Oral Risperidone ◽  
Long Acting

scholarly journals Characteristics of Psychiatric Patient's Use of One Emergency Department and Crisis Services and Comparison of Models of Care for Patients with Borderline Personality Disorder in the Frequency of Use of Emergency Services

2019 ◽  
Author(s):  
Ramamohan Veluri ◽  
Stacey Roles ◽  
Roberta Heale ◽  
Vicky P. K. H. Nguyen ◽  
M. Elizabeth Renouf
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Emergency Department ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Borderline Personality ◽  
Urgent Care ◽  
Frequent Users ◽  
Care Services ◽  
Ed Visits

Abstract Background: The cost of urgent mental health care services is high, both to the system as well as the individual and strategies that prevent these visits are paramount. Frequent users of the emergency department (ED) are a small percentage of ED patients but account for a large percent of visits. In particular, studies show that those patients with borderline personality disorder commonly present to urgent care. Given the rising number of ED visits and the corresponding cost to the health care system, it is important to explore strategies for avoidable or preventable visits to the ED, coupled with directing resources that ensure access to appropriate quality care. Methods: This research was a prospective chart review of the population of frequent users diagnosed with psychiatric illness in the (ED) and crisis (CRI) services at one hospital. Detailed analysis revealed characteristics of the patients who presented to the ED and CRI with a mental health diagnosis. Additional analysis of the subgroup of these patients with borderline personality disorder and/or self-harming behaviour was completed to determine the impact of the model of psychiatric care on subsequent crisis or ED visits in the year after the index visit. Results: The majority of patients presenting for mental health issues did so once. The mean number of subsequent presentations to the ED was 5.00 demonstrating that a small number of patients presented many times. Male patients were trending toward significance for number of ED and CRI visits. Patients with borderline personality disorder and/or self-harming behaviours in a model of care that offered increased access to services were less likely to visit the ED and CRI. Conclusions: Unstable or complex patients with psychiatric issues often present at the ED and CRI. Accessibility to community care services has the potential to reduce the number of ED and CRI visits and is a critical factor when considering this less stable group.

scholarly journals Drug information update: paliperidone palmitate for schizophrenia

2013 ◽  
Vol 37 (5) ◽  
pp. 164-166 ◽  
Author(s):  
Abraham M. Nussbaum ◽  
T. Scott Stroup
Keyword(s):  
Side Effects ◽  
Optimal Dose ◽  
Paliperidone Palmitate ◽  
Serum Prolactin ◽  
Sexual Side Effects ◽  
Study Results ◽  
The Us ◽  
Reported Study ◽  
Information Update ◽  
Long Acting

Aims and methodTo review the evidence for the use of paliperidone palmitate for people with schizophrenia and schizophrenia-like illnesses. We searched the Cochrane Schizophrenia Group Specialised Register and contacted the manufacturer of paliperidone palmitate, the US Food and Drug Administration, and the authors of papers that reported study results.ResultsBased on the evidence from five short-term, placebo-controlled studies, paliperidone palmitate is efficacious as an antipsychotic. Its adverse effects are similar to those of the closely related compounds paliperidone and risperidone. Extrapyramidal side-effects, weight gain and tachycardia are more common with paliperidone palmitate than placebo. Paliperidone palmitate was associated with substantial increases in serum prolactin but not with increased sexual side-effects in these studies. In two studies paliperidone palmitate was similar to depot risperidone.Clinical implicationsPaliperidone palmitate is an effective antipsychotic whose optimal dose appears to be between 39 and 234 mg every 4 weeks. We have no data assessing its long-term effectiveness or comparing it with any long-acting injected antipsychotic other than depot risperidone.

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