paliperidone-palmitate and Parkinsonian-Disorders

Paliperidone, the major active metabolite of risperidone, is a second-generation antipsychotic that has been developed as an extended-release (ER) oral formulation and a long-acting injectable paliperidone palmitate (PP) formulation. Paliperidone has demonstrated efficacy in the reduction of acute schizophrenia symptoms and clinical benefits were maintained also in the long-term treatments. Paliperidone ER and PP are generally well tolerated with a predictable adverse event profile. Areas covered: Data from studies evaluating safety and tolerability in the acute and maintenance treatment of schizophrenia with paliperidone are reviewed. The reported treatment-emergent adverse events of these formulations are discussed. Expert opinion: In the treatment of schizophrenia and schizoaffective disorders the safety profile has a central role because it can enhance patient compliance. In fact treatment-emergent adverse events are one of the main causes of discontinuation in these patients. In particular the main limitation in the administration of paliperidone could be represented by the onset of hyperprolactinemia (especially in women) and of mild parkinsonism. Paliperidone has a high impact on current long-term drug strategies, especially given the new 3 month long-acting injectable formulation of PP.

Topics: Antipsychotic Agents; Delayed-Action Preparations; Humans; Hyperprolactinemia; Medication Adherence; Paliperidone Palmitate; Parkinsonian Disorders; Psychotic Disorders; Schizophrenia

The aim of the study was to explore the current status of drug-induced parkinsonism and drugs possibly related to drug-induced parkinsonism in Korea.. We conducted a cross-sectional study using the Korea Adverse Event Reporting System database between July 1, 2010, and June 30, 2015. We identified all adverse event reports associated with parkinsonism.. There were 1402 adverse event reports associated with parkinsonism. The number of adverse event reports has increased annually. Among the 1499 drugs associated with parkinsonism, the most common were metoclopramide (49.77%) and paliperidone (16.14%). The major therapeutic groups (the third level of the Anatomical Therapeutic Chemical code) were propulsives (53.87%) and antipsychotics (35.58%). The mean time of onset of parkinsonism was 34.9 days. However, the time of onset of parkinsonism varied by drug, for example, it was 4.6 days for metoclopramide and 37.2 days for paliperidone.. Metoclopramide and antipsychotics were reported in most adverse event reports associated with parkinsonism in Korea.

Topics: Adolescent; Adult; Adverse Drug Reaction Reporting Systems; Aged; Aged, 80 and over; Antiemetics; Antipsychotic Agents; Cross-Sectional Studies; Databases, Factual; Dopamine D2 Receptor Antagonists; Drug-Related Side Effects and Adverse Reactions; Female; Humans; Male; Metoclopramide; Middle Aged; Paliperidone Palmitate; Parkinsonian Disorders; Prevalence; Republic of Korea; Young Adult

The aim of the study was to evaluate the effectiveness and tolerability of doses of paliperidone palmitate (PP) of 175 mgEq and over/28 days in patients with severe schizophrenia [Clinical Global Impression-Severity scale (CGI-S)≥5] and their retention in treatment. A 36-month prospective, observational study was carried out of patients with severe schizophrenia who were treated with 175 mg and over every 28 days of PP to achieve clinical stabilization (N=30). Assessment included CGI-S, WHO Disability Assessment Schedule, Camberwell Assessment of Need, and Medication Adherence Report Scale. Laboratory tests, weight, side effects, reasons for discharge, and hospital admissions were measured. The average dose of PP was 228.7 (11.9) mgEq/28 days. There was one discharge because of side effects. Weight and prolactin levels decreased. After 3 years, CGI-S (P<0.01), Camberwell Assessment of Need (P<0.01), and WHO Disability Assessment Schedule in the four areas (P<0.05) decreased. The Medication Adherence Report Scale increased (P<0.001). There were fewer hospital admissions (P<0.001). Retention in treatment after 36 months was 90%. Tolerability of 175 mgEq/28 days and over of PP was very good, being useful in improving treatment adherence in severely ill patients and helping in this way to achieve clinical stabilization and better social functioning. These patients were clozapine candidates; thus, high doses of PP could be an alternative for them.

Topics: Adult; Antipsychotic Agents; Dose-Response Relationship, Drug; Female; Follow-Up Studies; Humans; Male; Middle Aged; Paliperidone Palmitate; Parkinsonian Disorders; Prospective Studies; Psychiatric Status Rating Scales; Schizophrenia; Severity of Illness Index; Treatment Outcome

Topics: Antipsychotic Agents; Dyskinesia, Drug-Induced; Humans; Isoxazoles; Male; Middle Aged; Paliperidone Palmitate; Parkinsonian Disorders; Psychotic Disorders; Pyrimidines; Substance Withdrawal Syndrome; Syndrome