paliperidone-palmitate and Syndrome

The aim of this paper is to present a case of paliperidone-induced Pisa syndrome and provide treatment experience.. The case report is combined with a review of the literature.. A 37-year-old man had been diagnosed with paranoid-type schizophrenia for about 10 years. He received three-month treatment of paliperidone extended release (ER) at 6 mg per day, but showed a progressively Pisa-like physical position. We initially added an anticholinergic drug, but saw no improvement. The paliperidone ER was replaced by olanzapine at 10 mg per day, and the Pisa-like symptom improved after 1 month of the drug replacement.. We propose olanzapine as a possible replacement choice for patients with paliperidone-related Pisa syndrome.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Dyskinesia, Drug-Induced; Dystonia; Humans; Male; Olanzapine; Paliperidone Palmitate; Psychiatric Status Rating Scales; Schizophrenia, Paranoid; Syndrome

Topics: Adolescent; Antipsychotic Agents; Dyskinesia, Drug-Induced; Dystonia; Humans; Isoxazoles; Male; Paliperidone Palmitate; Pyrimidines; Schizophrenia; Syndrome

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

Long-acting injectable (LAI) formulations of antipsychotics are valuable treatment alternatives for patients with psychotic disorders, and understanding their safe use is critical. Post-injection delirium/sedation syndrome (PDSS) has been reported following treatment with one atypical antipsychotic LAI. Clinical databases of risperidone LAI and paliperidone palmitate were explored to identify if cases of PDSS had been observed. No cases of PDSS were identified in 15 completed trials of 3,164 subjects (approximately 115,000 injections) or the postmarketing safety database of risperidone LAI. Only one case of PDSS was identified among 10 completed trials (3,817 subjects, 33,906 injections) of paliperidone palmitate-that case having been reported in a patient randomized to treatment with placebo. Examination of these prospective databases finds no evidence that risperidone LAI and paliperidone palmitate are associated with PDSS and suggest that findings seen with another antipsychotic LAI are not generalizable.

Topics: Chemistry, Pharmaceutical; Clinical Trials as Topic; Conscious Sedation; Databases, Factual; Delayed-Action Preparations; Delirium; Humans; Injections, Intramuscular; Isoxazoles; Paliperidone Palmitate; Palmitates; Prospective Studies; Risperidone; Syndrome

Topics: Antipsychotic Agents; Dyskinesia, Drug-Induced; Female; Humans; Isoxazoles; Middle Aged; Paliperidone Palmitate; Pyrimidines; Syndrome