New Age Antipsychotic: Iloperidone

Abstract

Schizophreniais a heterogeneous, chronic, severe, and disabling brain disorder that has affected people throughout history. Schizophrenia is a severely debilitating psychiatric disorder observed worldwide, with a median lifetime prevalence of 0.7%-1.0%. Iloperidone possesses stronger affinity for serotonin (5-HT2A) than dopamine (D 2) receptors, and its efficacy is roughly comparable to that of other (nonclozapine) antipsychotics. In May 2009, the Food and Drug Administration approved iloperidone for the acute treatment of schizophrenia in adults. Iloperidone may be a useful and safe option for the treatment of schizophrenia. Several confirmatory trials of iloperidone reported to reduced the symptoms of schizophrenia at oral doses from 12 to 24 mg, which was more effective than placebo in reducing positive and negative syndrome total score and Brief Psychiatric Rating scale scores. Iloperidone was found to be as effective as haloperidol and risperidone in post-hoc analysis. In several clinical studies, most common adverse events reported were dizziness, dry mouth, dyspepsia and somnolence, with few extra pyramidal symptoms and metabolic changes in short and long-term studies in adults. As per adverse effect concern, akathisia was rare in case of iloperidone but prolongation of the corrected QT (QTc) interval was comparable to haloperidol and ziprasidone. Further comparative studies are needed to assess the benefit/risk profile of iloperidone and its role in the treatment of schizophrenia.

Long-term Effectiveness and Tolerability Profile of Iloperidone in Patients of Psychosis

“…In the present study, most patients were from rural area since our catchment area was predominantly rural. Shah et al 15 in contrast reported that incidence of schizophrenia was higher in urban than in rural settings. Iloperidone was assessed for long-term evaluation as it has proven efficacy, causes minimal adverse effects as well as exhibits better compliance and tolerability.…”

“…It was obvious from our observations that iloperidone remained effective throughout and that tolerance to iloperidone did not develop even on long-term basis since upward titration of doses at intervals was not required and majority of patients were well controlled on maintenance dose. Shah et al 15 observed that between 25 and 50% of schizophrenic patients attempt suicide, and 10% eventually succeed, contributing to a mortality rate eight times greater than that of the general population. In our study, none of the patients attempted suicide, indicating iloperidone not only prevented suicidal attempts but was also fully efficacious in controlling signs and symptoms of the disease.…”