Postinjection delirium/sedation syndrome in patients with schizophrenia receiving olanzapine long-acting injection: Results from a large observational study

Meyers, Kristin J.; Upadhyaya, Himanshu P.; Landry, John; Chhabra-Khanna, Rashna; Falk, Deborah M.; Rao, Balasubramanya S; Jones, Meghan E.

doi:10.1192/bjpo.bp.116.004382

Cited by 19 publications

(24 citation statements)

References 10 publications

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“…The safety profile of SGA-LAIs, such as olanzapine, aripiprazole, risperidone, and PP, are generally analogous to OAPs,79 except for the post-injection delirium/sedation syndrome with olanzapine LAI 114. Other side-effects include variable incidences of psychotic symptoms, EPS events, and metabolic/endocrine-related TEAEs (weight gain, hyperprolactinemia, and impaired glucose metabolism) 115.…”

Section: Review Of Evidencementioning

confidence: 99%

<p>Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia</p>

Mathews¹,

Gopal²,

Nuamah³

et al. 2019

NDT

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Antipsychotics are the mainstay in schizophrenia management, and long-acting injectable (LAI) antipsychotics contribute to the successful maintenance of treatment by improving non-adherence and preventing relapses. Paliperidone palmitate 3-monthly (PP3M) formulation is the only available LAI antipsychotic that offers an extended 3-month window of stable plasma drug concentration, enabling only four injections per year. This paper summarizes clinically relevant endpoints from available evidence for PP3M to bridge translational research gaps and provide measurable outcomes that can be interpreted in clinical practice. Low number-needed-to-treat (NNT) for relapse prevention (NNT [95% CI] 6-month estimate: 4.8 [3.2; 10.0]; 12-month estimate: 3.4 [2.2; 7.0]), and high number-needed-to-harm (NNH [95% CI] akathisia, 27.1 [12.3; −667.1]; tremor, 80.0 [22.5; 67.3]; dyskinesia, −132.6 [44.5; −23.2]; parkinsonism, 160.0 [28.9; −49.8]) quantify the relative benefits and low propensity for adverse events with PP3M. Symptom remission and reductions in positive and negative symptoms indicate treatment stability. Additionally, meaningful functional remission, reduced dosing frequency, and freedom from daily negotiations favorably impact patient preference and attenuate burdensome aspects of caregiving, representing important healthcare determinants that enhance prospects of treatment continuity in schizophrenia. This information can potentially improve clinicians’ judgment of treatment choices, clinical response, and patient selection in routine care. Taken together, PP3M is a valuable antipsychotic treatment option, meriting consideration for a broader role in the long-term management of schizophrenia; its utility should not be limited to patients with poor adherence or when oral antipsychotics have failed.

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Section: Review Of Evidencementioning

confidence: 99%

<p>Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia</p>

Mathews¹,

Gopal²,

Nuamah³

et al. 2019

NDT

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“…In Romania, LAIs are usually initiated in psychiatric departments and they were administered in psychiatry hospitals, during day admissions, for better monitoring the patients. Moreover, olanzapine- LAI requires a period of minimum 3 h of medical monitoring after administration, and a family member must accompany the patient home (these measures are imposed for the prevention of post- injection delirium/sedation syndrome) [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Long-Acting Injectable Antipsychotics (LAIs) Prescribing Trends during the COVID-19 Pandemic in Romania

et al. 2022

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Long acting injectable antipsychotics (LAIs) are considered the ideal treatment for schizophrenia, especially for young patients with high rates of non-adherence. In the current COVID-19 pandemic, it has been reported that the administration of LAIs decreased in some areas. The aim of this study was to evaluate the impact of COVID-19 pandemic on the initiation of LAIs. This is a retrospective mirror- image study covering a total period of 24 months: 12 months before and 12 months after the declaration of COVID-19 pandemic on March 11, 2020. During the study period, out of 218 patients admitted with schizophrenia, only 15 (1.3%) received LAIs at discharge. There was a 48.3% reduction in LAIs initiation compared to the pre-pandemic period (29 LAIs initiations in 2019 from 224 admissions). Despite the 27% reduction in the total number of admissions (1500 in 2019 vs. 1100 in 2020), the number of admissions with schizophrenia remained almost the same (224 in 2019 vs. 218 in 2020). COVID-19 pandemic brought an important challenge in the treatment of patients with schizophrenia, especially in the initiation of LAIs. This could have an important impact on the relapse rate in the next period.

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“…It has a weak effect on mental illness with negative symptoms. 17 Guo et al found that olanzapine combined with escitalopram was better than olanzapine alone in the treatment of schizophrenia with depression. 18 Paroxetine is mostly used to treat depression patients with anxiety disorder.…”

Section: Discussionmentioning

confidence: 99%

Paroxetine combined with olanzapine in the treatment of schizophrenia

et al. 2020

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Objective: To investigate the clinical efficacy of paroxetine combined with olanzapine in the treatment of senile schizophrenia with depression. Methods: Eighty-four elderly schizophrenic patients with depression who were admitted to our hospital from August 2016 to February 2018 were selected as research subjects and randomly divided into observation group and control group using random number table, 42 cases in each group. The control group was treated with olanzapine orally, while the observation group was treated with olanzapine and paroxetine orally. The level of homocysteine (Hcy) in the two groups was analyzed before and after treatment. The efficacy was evaluated by the Positive and Negative Symptoms Scale (PANSS) score and Hamilton Depression Scale (HAMD) score. The adverse reactions of the two groups were compared. Results: After treatment, the level of serum Hcy in the observation group was significantly lower than that in the control group (P<0.05), and it was close to the normal level. There was no significant difference in PANSS score between the two groups before treatment (P>0.05). After treatment, the negative factor score and PANSS score in the observation group were significantly lower than those in the control group, and the differences were statistically significant (P<0.05). The HAMD score of the two groups had no significant difference before treatment (P>0.05). After treatment, the HAMD score of the observation group was significantly lower than that of the control group (P<0.05). The difference of incidence of adverse reactions between the two groups had no statistical significance (P>0.05). Conclusion: Paroxetine combined with olanzapine has a definite clinical effect in the treatment of senile schizophrenia with depression. It can effectively reduce the level of serum Hcy, relieve the symptoms of schizophrenia, and alleviate the depressive symptoms of patients, with high safety. It is worth promoting. doi: https://doi.org/10.12669/pjms.36.3.846 How to cite this:Wang N, Zheng N, Dong M, He J. Paroxetine combined with olanzapine in the treatment of schizophrenia. Pak J Med Sci. 2020;36(3):---------. doi: https://doi.org/10.12669/pjms.36.3.846 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Postinjection delirium/sedation syndrome in patients with schizophrenia receiving olanzapine long-acting injection: Results from a large observational study

Cited by 19 publications

References 10 publications

<p>Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia</p>

<p>Clinical relevance of paliperidone palmitate 3-monthly in treating schizophrenia</p>

Long-Acting Injectable Antipsychotics (LAIs) Prescribing Trends during the COVID-19 Pandemic in Romania

Paroxetine combined with olanzapine in the treatment of schizophrenia

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