Brittany Weger, PharmD Candidate; Ali Goforth, PharmD Candidate; Alexandra Cunha, PharmD Candidate; Shaina Schwartz, PharmD, BCPP; Julie Cooper, PharmD, BCPS, BCCPHigh Point University, High Point, NCType: Original Research. Background: Individuals with depression are at an increased risk of cardiovascular disease, which may be further complicated by antidepressant-associated QTc prolongation and Torsades de Pointe (TdP). Currently, there is no consensus guidance on QTc calculation, risk assessment, or post-incident management for such cases. Objectives: This review investigates documented cases of antidepressant-associated QTc prolongation and TdP to understand clinical decision-making in these patients. Methods: A structured literature search was conducted to identify case reports describing QTc prolongation or TdP in individuals taking an antidepressant. Reports published between January 2000 and March 2021 were eligible for inclusion. Articles describing patients with antidepressant overdose or omitting a diagnosis of depression, baseline QTc measurement, or maximum QTc measurement were excluded except in the event of sudden cardiac death outside the hospital setting. Bazett, Fridericia, Framingham, and Hodges formulas were used to calculate QTc. Mayo, Tisdale, and RISQ-PATH tools were used to calculate risk scores. Results: A total of 11 case reports met criteria for inclusion. The average patient was a 53.5-year-old female taking an SSRI with baseline and maximum QTc measurements of 420 msec and 535 msec, respectively. Four patients experienced TdP. The three risk scoring tools agreed in 4/11 (36%) cases. For the remaining 7/11 (64%) cases the Tisdale and RISQ-PATH scores identified risk as “low” whereas the Mayo score identified risk as “high”. Only one case specified the QT correction formula utilized. The most common intervention was to stop the antidepressant (45%, 5/11). Conclusions: Available case reports demonstrate a lack of consistency regarding QT correction formula used, risk evaluation techniques, and clinical management strategies. The Mayo risk scoring tool was the most conservative while Tisdale was the least conservative. Future research in this area can seek to develop a standardized approach for antidepressant-associated QTc prolongation in patients.Casey M. Tiefenthaler, PharmD1; Kelly C. Lee, PharmD, MAS, APh, FCCP, BCPP1,21 UC San Diego Health, San Diego, CA; 2 UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences, La Jolla, CAType: Original Research. Purpose: Transgender adults are highly stigmatized members of society. Consequently, they are significantly more likely to be diagnosed with mood or anxiety-related disorders compared to cisgender individuals. Research efforts directed towards reducing adverse mental health outcomes are warranted. The purpose of this study was to investigate antidepressant prescribing patterns between gender identities and age groups. Methods: In this cross-sectional study, antidepressant prescribing data were collected from adults diagnosed with gender dysphoria (GD) during a 17-year timeframe between January 1, 2005 and October 31, 2021. Eligible patients had a concomitant diagnosis for mood or anxiety-related disorder at the time of their GD diagnosis. Patients with bipolar or obsessive-compulsive disorder were excluded. The primary outcome was to compare classes of antidepressants and number of prescriptions at the time of GD diagnosis between transgender females (MtF), transgender males (FtM), and non-binary (NB) individuals. Secondary outcomes included age group differences in prescribing patterns and gender identity differences in prevalence of comorbid psychiatric illnesses. Results: Of 131 patients who met inclusion criteria, 43% (n = 56) were identified as MtF, 41% (n = 54) as FtM, and 16% (n = 21) as NB. The most common concomitant diagnoses were mood disorders (n = 96, 73%) and generalized anxiety disorder (GAD) (n = 67, 51%). Approximately 37% (n = 48) of patients did not have an active antidepressant prescription at the time of GD and mood and/or anxiety disorder diagnosis. There was no significant difference in number of psychotropic prescriptions between gender identities (P = .357) or age group (P = .378). However, MtFs were prescribed bupropion at significantly higher rates than FtM and NB patients (16%, 11%, 0%, P = .046). Moreover, the prevalence of GAD was significantly greater among FtMs (P = .044) and those ≤ 40 years old (P < .001). Conclusions: Although there was no observable difference in the number of antidepressant prescriptions between gender or age groups, a staggering 37% of patients were not prescribed any antidepressants at time of their GD and mood and/or anxiety disorder. This serendipitous finding elucidates a potential gap in mental healthcare treatment among transgender adults. The study presents a potential opportunity for clinicians to address these health disparities faced by the highly marginalized population of transgender individuals.Carolanne Wartman, PharmD1,2; David Butterfield, PharmD1,2; Lindsey Anderson, PharmD1,2; Michael Peters, PharmD1; Andrew Schmelz, PharmD1,3; Todd Walroth, PharmD1,2; Carol Ott, PharmD1,21 Eskenazi Health, Indianapolis, IN; 2 Purdue University, West Lafayette, IN; 3 Butler University, Indianapolis, INType: Innovative Practices. Background: According to the 2015 US Transgender Survey, respondents reported experiencing serious psychological distress and attempting suicide at a rate significantly higher than the general population (39% vs 5% and 40% vs 4.6%, respectively). Identified barriers of care included costs of service, fear of being mistreated, and being refused care entirely. Psychiatric pharmacists provide a unique opportunity to deliver comprehensive care to these stigmatized individuals. To the best of our knowledge, there is no current literature describing the impact of a psychiatric pharmacist in an interdisciplinary gender health program. Description of Innovative Service: The Gender Health Program was established in March 2016 and provides primary and specialized care to transgender and nonbinary patients of all gender identities. A board-certified psychiatric pharmacist joined the team in May 2020 through a collaborative practice agreement. The pharmacist conducts patient interviews, medication management, laboratory monitoring, referrals to other healthcare providers, and a safe space for patients. Appointment types include mental health assessment and screening, mental health medication management, hormone therapy assessment and adjustment, and human immunodeficiency virus pre-exposure prophylaxis. Referrals to the pharmacist are made by the psychiatrists, psychiatry residents, family medicine providers and residents, a family medicine nurse practitioner, and mental health therapists. Impact on Patient Care: The pharmacist sees patients independently up to 15 hours per week. The clinical psychiatric pharmacist has seen a total of 94 patients, with a total of 158 appointments from May 2020 to December 2021. Patients ranged from 19 to 57 years of age. Depression and anxiety were the principle diagnosis discussed with patients (78% and 69%, respectively). Further data analysis will include baseline demographics, appointment details (eg, duration, medication changes, laboratory orders), and billing information. Conclusion: The gender diverse population experiences significant psychological distress and stigmatization in and outside of the healthcare setting. Given the high rate of depression, anxiety, and other mental health conditions, psychiatric pharmacists can provide positive health outcomes related to mental health assessments and medication management for this community. Dissemination of the details and impact of this innovative service will provide other institutions a roadmap to reproduce this service in their own health systems.Haley Pals, PharmD, BCPP; Aruna Gottumukkala, MDTomah VA Medical Center, Tomah, WIType: Innovative Practices. Background: Despite the well-known morbidity and mortality benefit of buprenorphine for opioid use disorder (OUD), prescribing restrictions minimize widespread utility and disproportionally affect rural areas of the country. At a rural VA hospital, the outpatient mental health clinic had only two X-waivered psychiatrists to manage an increasing number of patients on buprenorphine. Psychiatric clinical pharmacist practitioners (CPP) had successfully helped the facility close the psychiatrist shortage gap before, thus an innovative collaborative approach was designed to expand CPP services into buprenorphine management. Practice Description: In June of 2020 they hired a psychiatric CPP to treat substance use disorders under a scope of practice with prescriptive authority. Existing buprenorphine patients were transferred to the CPP, where they took over primary management of all mental health conditions, medications, referrals, and lab monitoring. Patients see the X-waivered psychiatrist at least annually but are discussed after each CPP visit and buprenorphine prescription orders are placed for the psychiatrist's signature. New patients wishing to start buprenorphine are seen by the CPP in urgent access appointments and then staffed with an available X-waivered psychiatrist. Impact on Patient Care: From date of hire to December 31, 2021 the CPP has cared for over 80% (n = 53) of the facility's patients with OUD, of whom 34 received buprenorphine and the remaining received extended-release naltrexone injection or no longer needed medication. Those requesting urgent access appointments (n = 13) for buprenorphine assessment were on average seen same-day, compared with historically an average of about 6 days. Not all patients seen for assessment were appropriate for buprenorphine, representing an opportunity to avoid unnecessary psychiatrist intakes and prevent delays in care as wait time is currently 13.5 days. Psychiatrist time is saved by the CPP managing these buprenorphine patients, which allows them to focus on more complex patients or those needing diagnostic clarification. Conclusion: A collaborative approach to buprenorphine management utilizing a psychiatric CPP as the primary provider improved access to care at this rural facility. While collaboration decreases time burden for X-waivered psychiatrists, care could be more efficient and timely if a CPP could independently prescribe buprenorphine.Ian McGrane, PharmD1,2; Robert Munjal, MD2; Shelby Skauge, PharmD Candidate1; Jason Molinaro, MD21 The University of Montana, Missoula, MT; 2 Providence St Patrick Hospital, Missoula, MTType: Therapeutic Case Report. Background: Bipolar disorder (BD) may be considered “late-stage” when the burden of disease is more treatment resistant and may require clozapine or electroconvulsive therapy (ECT). A common scenario is when a patient with BD had a preferential response to lithium, but can no longer take it due to end-stage renal disease. In this case, there are essentially three options – a) trial and error of novel or previously failed mood stabilizer or antipsychotics, b) cautious retrial of lithium, and c) ECT. Patient History: Our patient is a 75-year-old female who had her first episode of depression in her late twenties and episodes of mania in 2001, 2017 and 2020. These episodes of mania included grandiose and hyper-religious delusions. The patient had largely maintained psychiatric stability without psychiatric admissions while on lithium; but developed end-stage renal disease and required dialysis since 2018. Combination treatments of lamotrigine/quetiapine, divalproex/risperidone, and divalproex/olanzapine where previously attempted before she convinced her outpatient provider she did not have BD, and was treated with fluoxetine. Subsequently, she became manic and was admitted to our inpatient psychiatric hospital. We attempted combination treatments with quetiapine/divalproex, followed by quetiapine/lithium, and finally asenapine/lithium. Divalproex at 875 mg per 24-hour period yielded a pre-dialysis concentration of 57 mcg/mL. Quetiapine 300 mg nightly yielded a pre-dialysis concentration of 16 ng/mL. While taking 600 mg of lithium after dialysis and 300 mg on all other days except Sunday, pre- and post-dialysis lithium concentrations were 0.81 and 0.22 mmol/L, respectively. Mania was minimally abated, and after 46 days of hospitalization, bilateral ECT was initiated. After ECT #11 the patient was psychiatrically stable for discharge. She received weekly, then biweekly, and eventually monthly maintenance ECT until 2.5 months post-discharge for an additional 6 treatments. Review of Literature: An extensive PubMed search was performed to identify best practices for pharmacologic management of BD mania during hemodialysis. Our report reviews relevant literature surrounding these therapies and therapeutic drug monitoring. Conclusion: There is not a treatment guideline for BD in patients on hemodialysis and pharmacotherapy is challenging. This is the first report of ECT being effective in these patients.Carolyn O'Donnell, PharmD1,2; Tammie Lee Demler, PharmD, MBA, BCGP, BCPP1,2,3; Eileen Trigoboff, PMHCNS-BC, DNS, DABFN31 Buffalo Psychiatric Center, New York State Office of Mental Health, Buffalo, NY; 2 State University of New York, University at Buffalo School of Pharmacy and Pharmaceutical Sciences, Buffalo, New York; 3 State University of New York, University at Buffalo School of Medicine, Department of Psychiatry, Buffalo, New YorkType: Original Research. Background: Recent studies have shown an association between a low level of high-density lipoprotein cholesterol (HDL-C) levels and increased risk for Parkinson disease, but it is unknown if lower HDL-C levels have the potential to increase Parkinsonian symptoms or other movement disorders in patients taking antipsychotics. Low HDL-C levels can impact the brain through different mechanisms including reduced myelin function, damage to the blood brain barrier, and potential cognitive impairment. However, it is unclear how this impacts movement disorders for patients taking antipsychotics. The objective of this study is to determine if low HDL-C levels lead to a higher risk of movement disorders in an inpatient state psychiatric facility. Methods: Adult patients at an inpatient state psychiatric facility were evaluated to determine if lower HDL-C levels were associated with more Parkinsonian symptoms or movement disorders. Patients were included if they were at the inpatient state psychiatric facility on August 31, 2021 and were taking at least one antipsychotic, had at least one HDL-C level, one history and physical, and at least one Abnormal Involuntary Movement Scale (AIMS) score. Patients were excluded if they had a criminal procedure law designation. Using a two-tailed t-test with unequal variance, patients were assessed to determine if low HDL-C levels influenced both movement disorders shown on initial physical exam, progress notes, and AIMS scores over a one-year period. Results: Of the 89 patients included in the study, there were eight patients with an AIMS score greater than zero and 34 patients with a low HDL-C level of less than 40 mg/dL for men and 50 mg/dL for women. There was no significance when comparing a patient's movements, AIMS scores, and HDL-C levels to suggest that lower HDL-C levels lead to more movement disorders in patients taking antipsychotics. Conclusion: From the results of this study, there is no clear association between patients with lower HDL-C levels and increased movement disorders or AIMS scores. Some of the patients were taking medications for movement disorders, which might have influenced their presentation, but in those patients, there was not a significant change in AIMS scores throughout their inpatient stay.Christie Costello, PharmD, BCPS; Caroline Crites, PharmD Candidate; Christine Rarrick, PharmD, MBA, BCPS, BCPP; Sophie Robert, BPharm, PharmD, BCPP; Erin Weeda, PharmD, BCPSMedical University of South Carolina (MUSC) Health, Charleston, SCType: Original Research. Purpose: Droperidol is a butyrophenone antipsychotic used off-label to manage agitation. A black box warning emerged secondary to reports of corrected QT (QTc) interval prolongation and torsades de pointes causing a decrease in utilization. Droperidol was recently added to our institutional formulary for the management of agitation in the emergency department (ED) and usage has since increased. Patients commonly receive haloperidol, a similar butyrophenone antipsychotic, in combination with lorazepam and diphenhydramine at our institution. Lack of consensus exists regarding which agent to use based on effectiveness and safety in this patient population. Methods: A retrospective chart review was conducted of patients ≥ 18 years of age who presented to the ED from July 1, 2020 to June 30, 2021 with a psychiatric consult and received either parenteral droperidol or haloperidol. The primary outcome was to assess the efficacy of droperidol versus haloperidol in acute agitation based on additional medications required for sedation within 120 minutes. Secondary outcomes included the need for restraints, QTc > 500 milliseconds within 240 minutes post-administration, hypotension (systolic blood pressure < 90 and/or diastolic blood pressure < 50), respiratory depression (respiratory rate < 12), or bradycardia (heart rate < 60) post-administration. Results: A total of 298 patients were included (149 in each group). More patients presented with a chief complaint of psychosis in the droperidol group compared to haloperidol (33% vs 26%, respectively). The median doses of droperidol and haloperidol were 3.75 mg and 5 mg, respectively. There were more co-administered medications for agitation within 5 minutes for haloperidol (74%) compared to droperidol (44%) (P < .001). This largely included lorazepam and diphenhydramine for haloperidol and midazolam for droperidol. Patients requiring additional medications for sedation within 120 minutes were higher in the droperidol group (34%) than the haloperidol group (15%) (P < .001). There were no statistically significant differences in secondary outcomes. Conclusions/Future Directions: Patients in the droperidol group required further medications for sedation within 2 hours, however more patients in the haloperidol group received co-administered medications, likely driven by our institutions long-standing practice of combination agents with haloperidol. There were no differences in QTc prolongation or other adverse effects.Katie H. Comanici, PharmD, MPH; Molly A. Nichols, PharmD, MATS; Stephanie Arnett, PharmD, CDCES; Catherine R. Scott, CPHQ; Carol A. Ott, PharmD, BCPP; Rakhi Karwa, PharmD, BCPSDepartment of Pharmacy Practice, Purdue University College of Pharmacy, West Lafayette, INType: Original Research. Purpose: This study aims to understand how pharmacies and their personnel interact with medication for opioid use disorder (MOUD) current care practices by identifying barriers, facilitators, and opportunities through the perspective of peer recovery coaches. Methods: Ten peer recovery coaches were included, with five working in a rural or rural/mixed county in Indiana and five working in an urban county. A semi-structured interview was conducted individually with each participant. General topics covered in the interview were perspectives on their current role in MOUD therapy, their experiences at prescriber offices as well as at pharmacies regarding MOUD therapy, and how current MOUD care practices in those two settings could be improved upon. After all interviews were conducted, the data was analyzed using preconceived deductive codes as well as inductive codes that evolved with the project. One coder analyzed all ten transcripts, of which three were additionally analyzed by a second coder separately to confirm intercoder reliability. When the list of inductive codes was finalized after all transcripts were initially analyzed, each transcript was analyzed a second time to ensure all inductive codes were applied consistently. Results: Participants had been in recovery for a median of 4 years (range 1.6724) and had been working as a peer recovery coach for a median of 1.38 years (range 0.54). All peer recovery coaches identified themselves as facilitators in MOUD care. Within MOUD current care practices, frequent barriers identified included a lack of treatment standardization, stigma at the pharmacy, access to care, insurance or cost obstacles, and negative attitudes of society. All peer recovery coaches interviewed stated that the public considered using MOUD in one's recovery as trading one addiction for another. Peer recovery coaches viewed interactions with community pharmacies as either neutral or negative, as most participants were unsure of or not confident in pharmacists' knowledge of MOUD. Conclusions and Future Directions: There are many opportunities for community pharmacies to better engage in MOUD care practices. In the future, interviews will be conducted with community pharmacists and prescribers to obtain additional perspectives of those involved in MOUD practice.Logan T. Smith, PharmD Candidate1; Linda D. Logan, PharmD, BCPS, BCACP, BCPP1,2; Linda Campbell, PhD21 University of Georgia College of Pharmacy, Athens, GA; 2 University of Georgia Mary Frances Early College of Education, Athens, GAType: Work in Progress. Background: Mental health and wellbeing are increasingly recognized as important areas of emphasis for student support. Pharmacy and other graduate students are at increased risk of experiencing mental and emotional distress during their professional studies, including anxiety, depression, and academic concerns. Impostor phenomenon (IP) in higher education, also associated with generalized anxiety and depression, has been documented in the literature. Impostor phenomenon is associated with a lack of self-confidence and frustration due to inability to meet self-imposed standards of achievement. Furthermore, worsened physical health and diminished academic and professional success have been correlated with IP, potentially impacting healthcare professionals' ability to provide paramount patient care. Objectives: (1) Evaluate the degree of IP experienced by PharmD and graduate counseling psychology students. (2) Determine whether certain demographic variables correlate with IP. (3) Compare prevalence and degree of IP between PharmD and graduate counseling psychology students. Methods: Participants will be recruited from a public university, being eligible if currently enrolled in either the PharmD program or a graduate degree in counseling psychology and being ≥ 18 years old. Eligible students will receive an email inviting them to participate in an online survey including demographic data, the Clance Impostor Phenomenon Scale (CIPS), a validated IP instrument, the Perceived Stress Scale (PSS-10), and GAD-7. Responses will be anonymous. Outcomes: Reported outcomes will include degree of IP among respondents as average scores and number (%) of respondents falling within each of four intensity levels defined by the CIPS: “Few,” “Frequent,” “Severe,” and “Intense.” Pearson correlation analyses will be utilized to identify the relationships between CIPS score and variables including academic program, race/ethnicity, gender identity, PSS-10 score, GAD-7 score, and class year. Data collection has been completed among pharmacy students (182 respondents). Preliminary analysis revealed no statistical correlation in degree of IP and age, gender identity, or class year (P1 to P4). Non-White students had significantly lower scores on the CIPS, indicating fewer IP feelings (mean CIPS score 67.4 vs. 74.0, P = .002). Both an elevated PSS-10 and GAD-7 score were associated with higher CIPS scores (Pearson's r = .588 and .629 respectively; P < .001). Data collection is ongoing among counseling psychology students.Aleeya A. Barrolle, PharmD Candidate1; Kelly N. Gable, PharmD, BCPP1,2; Nathaniel Dell, AM, MSW, LCSW21 Southern Illinois University Edwardsville (SIUE) School of Pharmacy, Edwardsville, IL; 2 Authors located in St Louis, MOType: Original Research. Background and Purpose: The CDC has reported a sharp increase in overdose deaths from illicitly manufactured fentanyls (IMFs) occurring between April 2020 and April 2021 in the US. Approximately four in ten deaths involved stimulants. Fentanyl testing strips (FTS), when used to directly test drug product, can be a powerful harm reduction tool, promoting safer drug use behaviors and reduced overall overdose risk. This pilot study assessed treatment-seeking service users' knowledge and understanding of IMFs and motivation to use FTS as a method of harm reduction to prevent overdose. Methods: Clients actively engaged in residential-based or office-based treatment for a substance use disorder were recruited from a community mental health center in the midwestern US to complete a harm reduction-focused survey. With permission, survey questions were adapted from research conducted at Brown School of Public Health. Eligibility criteria included clients age 18 to 89 years of age with self-reported drug use in the past year (eg, heroin, cocaine, methamphetamine). A 20-question survey was administered verbally by a student investigator both in-person and via phone. Institutional Review Board (IRB) approval was obtained from both SIUE and Places for People. Results: Thirty clients completed the survey during the fall of 2021. Of respondents, 80% agreed that in Missouri, IMFs cause more overdoses than heroin. Seventy-three percent indicated concern about a friend overdosing due to IMFs, but only 47% expressed concern about personal risk for overdose. Most (73%) would like to be able to detect if there is fentanyl in their drug before use, but only 17% indicated that they feel confident in their ability to use FTS. Conclusions: Many respondents who were receiving services for past-year substance use lacked understanding of how to use FTS for harm reduction. Clients who primarily use non-opioid/stimulant drug products are at even greater risk for IMF overdose and would likely benefit the most from increased access and education surrounding use of FTS. Our healthcare system must rapidly continue to explore and expand upon overdose prevention efforts, including access to FTS, as urgent action is needed to reduce the continued rise in overdose deaths in the US.Sorina B. Torrez, PharmD Candidate 20221; Austin Buck, PharmD Candidate 20221; Lindsey J. Loera, PharmD1; Claire M. Zagorski, MSc, LP1; Jessica D. Cance, MPH, PhD2; Amanda Bingaman2; Heather Kane, PhD2; Sara Hairgrove2; Lucas G. Hill, PharmD11 The University of Texas at Austin, Austin, TX; 2 RTI International, Research Triangle Park, NCType: Original Research. Background: Deaths involving synthetic opioids in Texas have historically been lower compared to other US states because of the type of heroin available, black tar heroin, a tacky, tar-like substance. However, from 2020 to 2021, overdose deaths due to synthetic opioids increased in Texas by 170%. Little is known about the emergence of fentanyl in states where black tar heroin predominates and such research could yield valuable information to direct future harm reduction efforts. The purpose of this report was to understand the impact of increased fentanyl presence on the black tar heroin market in Austin, Texas. Methods: Adult patients accessing harm reduction services at two mobile outreach syringe services programs (SSP) in Austin, TX were invited to participate in an assessment interview examining their substance use. Potential participants were screened to determine if they met inclusion criteria, which required heroin or fentanyl use in the week prior. Data was collected from July 16, 2021 to July 23, 2021 from 30 participants via a semi-structured interview lasting 4 to 13 minutes and all participants received a $20 local grocery store gift card. Responses were analyzed using a deductive (via NVivo 12.0) and inductive hybrid approach to identify overarching themes discussed by participants. Results: Survey participants identified as male (n=17), female (n=10), and nonbinary (n=3) with a median age of 41.7 years. A majority identified as White (n=15) and were unhoused (n=16) or in temporary/transitional housing (n=4). Emerging themes discussed by participants included unintentional exposure to fentanyl, methods of detecting and identifying fentanyl in their drug supply, and harm reduction strategies to mitigate risks. Many respondents reported being able to identify fentanyl through use of fentanyl test strips, physical inspection, or by experiencing increased effects. Conclusions: Despite the predominance of black tar heroin in this region, people who use drugs in Austin, Texas report increased unintentional exposure to fentanyl. This emergence calls for public health initiatives that aim to reduce associated harms for people who use drugs. Initiatives that support SSPs and increase naloxone and fentanyl test strip access may be beneficial in this patient population.Karen Johnston, PharmD1; Dean Najarian, PharmD1; Sherry Fua, BSN, MSN, MBA, DNP1; Steven Wang, PhD2; Oliver Lopena, PharmD1; H. Lynn Starr, MD11 Janssen Scientific Affairs, LLC, Titusville, NJ; 2 Janssen Research & Development, LLC, Titusville, NJType: Original Research. Background: Paliperidone palmitate 6-month (PP6M) long-acting injection was recently approved for the treatment of adults with schizophrenia. Dorsogluteal injection volumes range from 3.5 mL to 5 mL. Objective: Given the differences in formulation and injection volume of available paliperidone palmitate preparations, this post hoc analysis of a double-blind (DB) noninferiority study evaluated injection site reactions and