Influencing Factors and Predictors of Early Response in Schizophrenia Patients Receiving the Paliperidone Extended-Release Tablets (Paliperidone ER)

Abstract

ObjectivePaliperidone extended-release tablet (paliperidone ER) is a new oral psychotropic agent developed for schizophrenia treatment. There have been some studies about paliperidone's good efficacy and tolerability. Clinicians appear to change the antipsychotic medication to paliperidone ER. However, it is not known what patients are favorable responsive to paliperidone ER. The aim of this study was to evaluate the characteristics of early responders and investigate predictors of acute response when the medications changed to paliperidone ER.MethodsData were analyzed from schizophrenic patients who participated in a multi-center, open-label, non-comparative clinical trial. Total 320 patients were examined in this study. Sociodemographic, psychopathology, social function and metabolic data were evaluated. Unpaired t-test for continuous and χ2 for categorical data, respectively, were used to compare early responder and non-responders. Logistic regression analysis was used to establish a prediction model.Results38.7% of study subjects (124 of 320) responded to paliperidone ER treatment. Logistic regression analysis showed that a good paliperidone ER response was more likely when patients were social drinkers, when patients had started medication at inpatient, when negative symptoms were less severe, and when patients' social relationship and self-care were better.ConclusionEarly response to paliperidone ER treatment is associated with less negative symptoms and good social relationships and self-care. Strategies to reduce these symptoms may contribute to early response to paliperidone ER.

Dose Adjustment Model of Paliperidone in Patients With Acute Schizophrenia: A post hoc Analysis of an Open-Label, Single-Arm Multicenter Study

“…The results showed that 41.2% of participants who completed the 8-week trial remained on the initial dose of 6 mg/day, while the dose was increased in 54.6% of participants. Although the recommended initiation dose of paliperidone ER is 6 mg/day (1,6), studies suggested that a dose higher than 6 mg could be more effective in selected patients (7,(18)(19)(20). According to a study in which schizophrenia cases were stabilized during an 8week run-in phase and then observed for symptom recurrence after the stabilization phase, 45% and 47% of all patients received paliperidone ER at 9 and 12-15 mg/day, respectively, during the flexible dosing (3-15 mg/day) run-in phase (18).…”

“…It is an active metabolite of risperidone (9-OH risperidone) and has almost the same pharmacological profile, with a high affinity for the dopamine D2 receptor and the serotonin 5-hydroxytryptamine 2A receptor ( 5 ). Early studies suggested paliperidone extended-release (ER) with a starting dose of 6 mg once daily without titration ( 1 , 6 ). However, it is currently admitted that titration is necessary for some patients ( 7 ).…”

“…Schizophrenia is a chronic and disabling mental disorder with serious physical, social, and economic consequences (1). Many antipsychotic agents have been developed, showing good effects on positive symptoms (2)(3)(4).…”