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Introduction: Paliperidone Palmitate is the only antipsychotic that has been developed in three different intramuscular long-acting injectable (LAI) dosing regimen: monthly (PP1M), quarterly (PP3M), and from 2020 also twice-yearly (PP6M). The latter was approved for the maintenance treatment of adults with schizophrenia and clinically stabilized with PP1M or PP3M.
Areas Covered: Data from studies evaluating efficacy in the maintenance treatment of schizophrenia with PP6M are reviewed. Since no post-marketing safety studies are currently available, data from spontaneous reporting system databases, FAERS and Eudravigilance, are analyzed and the reported treatment-emergent adverse events of PP6M are discussed.
Expert Opinion: The efficacy of PP6M is comparable to that of PP3M in terms of relapses prevention in patients with schizophrenia previously stabilized on PP3M or PP1M. Also, the maintenance of clinical efficacy in the long term has been demonstrated. Data from pharmacovigilance analyses, as well as from phase 3 studies, show that PP6M is generally well tolerated, consistently with PP3M safety data. PP6M allows a longer dosing interval than any other LAI antipsychotics, potentially reducing nonadherence and disease relapses. In future, an increase in the prescription rates of PP6M is expected and real-world efficacy and tolerability studies will be conducted.
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http://dx.doi.org/10.1080/14737175.2024.2325655 | DOI Listing |
Adv Ther
September 2025
Teva Branded Pharmaceutical Products R&D LLC, West Chester, PA, USA.
Introduction: Pharmacokinetic differences between long-acting injectable antipsychotic (LAI) formulations, combined with a lack of clinical switch studies, contribute to clinician uncertainty when transitioning between LAIs. This analysis employed a population pharmacokinetic (popPK) modeling approach to characterize dosing conversions and switching strategies from intramuscular paliperidone palmitate once monthly (PP1m) to TV-46000, a long-acting subcutaneous formulation of risperidone, once monthly (q1m), with a secondary analysis of PP1m to TV-46000 every 2 months (q2m).
Methods: For PP1m and TV-46000, concentration-time profiles for paliperidone and TV-46000 total active moiety (TAM; risperidone + paliperidone) were simulated on the basis of published popPK models with virtual populations of 5000 patients.
J Clin Psychopharmacol
September 2025
Department of Operations, Clinical Research Unit, Adium S.A., São Paulo, São Paulo,Brazil.
Purpose/background: Schizophrenia is often associated with nonadherence to oral antipsychotic therapy, which increases the risk of relapse, hospitalization, and higher health care costs. To overcome this challenge, long-acting injectable (LAI) antipsychotics, such as paliperidone palmitate, offer a solution by reducing relapse rates. Also, the bioequivalent formulations can enhance treatment accessibility while maintaining efficacy and safety.
View Article and Find Full Text PDFCNS Drugs
August 2025
Department of Pharmacy, The Second Affiliated HospitalZhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
Unlabelled: BACKGROUND AND OBJECTIVE: Patients with schizophrenia exhibit significant interindividual variations in their response to pharmacotherapy, adverse effects, and clinical outcomes. While once-monthly paliperidone palmitate (PP1M) injections can improve treatment adherence and continuity compared with oral formulations, suboptimal therapeutic outcomes are still observed in some patients. Although the mechanisms underlying the variability in efficacy of long-acting injectables (LAIs) remain unclear, studies suggest an association with alterations in plasma protein expression.
View Article and Find Full Text PDFBMC Psychiatry
August 2025
Faculty of Medicine, Department of Psychiatry, Giresun University, Giresun, Turkey.
Background: Capgras syndrome (CS) is a rare delusional disorder characterized by the delusional belief that a relative has been replaced by an identical person. This syndrome is frequently associated with psychotic disorders and neurological diseases.
Case Presentation: In this case report, we describe a 42-year-old woman who developed Capgras syndrome following a severe upper respiratory tract infection.
Eur Psychiatry
August 2025
Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Medical University Innsbruck, Innsbruck, Austria.
Background: This analysis evaluated potential differences in subjective well-being (SW) among patients with early-phase schizophrenia (SZ) randomized to treatment with either long-acting injectable (LAI) or oral aripiprazole or paliperidone within the "European Long-acting Antipsychotics in Schizophrenia Trial" (EULAST).
Methods: A total of 478 patients were followed for up to 19 months. SW was measured using the Subjective Well-being under Neuroleptic Treatment scale (SWN).