Abstract
Paliperidone palmitate every three months (PP3M) is expected to facilitate patient’s treatment compliance and satisfaction. The objective here was to compare PP3M treatment compliance and satisfaction, effectiveness and tolerability, with paliperidone palmitate-monthly (PP1M) in patients with severe schizophrenia. A 24-month prospective, open-label study of patients with severe schizophrenia treated with PP3M after at least 2 years of stabilization with PP1M (n = 84) was carried out. Treatment satisfaction was assessed with the Treatment Satisfaction Questionnaire for Medication (TSQM) and with a Visual Analogue Scale (VAS). Effectiveness was measured with psychiatric hospital admissions and the Clinical Global Impression-Severity (CGI-S) scale. Tolerability assessments included laboratory tests, weight and adverse effects. Reasons for treatment discontinuation were recorded. CGI-S significantly improved after 24 months. Three patients changed back to PP1M due to adverse effects, and four were hospitalized. There were neither abandoning nor significant changes in weight or biological parameters, and lower incidence of side effects, with PP3M treatment. TSQM and VAS scales increased. No differences were found related to doses. Apart from somewhat improvement in treatment adherence, effectiveness, and tolerability, patients with severe schizophrenia lengthy treated with PP1M showed more satisfaction with PP3M, even those who needed high doses to get clinical stabilization.
Highlights
IntroductionPaliperidone palmitate 3-monthly (PP3M) formulation is the only available long-acting injectable (LAI) antipsychotic that offers an extended three-month window of stable plasma drug concentration, enabling only four injections per year [8]
Long-acting injectable (LAI) antipsychotics contribute to the successful maintenance of treatment by improving non-adherence and preventing relapses
The use of second generation antipsychotics (SGAs) long-acting injectable (LAI) has been recommended in the last years to treat those patients at high risk of discontinuation [1,2], they can have more advantages like relapse prevention, high tolerability and low mortality [3,4]
Summary
PP3M formulation is the only available LAI antipsychotic that offers an extended three-month window of stable plasma drug concentration, enabling only four injections per year [8]. It offers advantages apart from long intervals between injections, like tolerability and enhanced patient compliance, and provides significant improvement in psychotic symptoms. This formulation allows patients to maintain therapeutic paliperidone plasma levels with fewer injections, which could subsequently improve functional outcome and quality of life with a sufficient follow-up period [9]. As PP3M requires injections only four times a year and this is expected to facilitate patient’s treatment compliance and satisfaction
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