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Stump TA, Nelson LA, Liu Y, et al. The effects of concurrent oral paliperidone or risperidone use with paliperidone long-acting injection. Ment Health Clin. 2021;11(1):12-18doi: 10.9740/mhc.2021.01.012.
Stump, T. A., Nelson, L. A., Liu, Y., Kriz, C. R., Iuppa, C. A., Diefenderfer, L. A., Lang, S. E., Elliot, E. S. R., & Sommi, R. W. (2021). The effects of concurrent oral paliperidone or risperidone use with paliperidone long-acting injection. The mental health clinician, 11(1), 12-18. https://doi.org/10.9740/mhc.2021.01.012
Stump, Trevor A, et al. "The effects of concurrent oral paliperidone or risperidone use with paliperidone long-acting injection." The mental health clinician vol. 11,1 (2021): 12-18. doi: https://doi.org/10.9740/mhc.2021.01.012
Stump TA, Nelson LA, Liu Y, Kriz CR, Iuppa CA, Diefenderfer LA, Lang SE, Elliot ESR, Sommi RW. The effects of concurrent oral paliperidone or risperidone use with paliperidone long-acting injection. Ment Health Clin. 2021 Jan 08;11(1):12-18. doi: 10.9740/mhc.2021.01.012. eCollection 2021 Jan. PMID: 33505820; PMCID: PMC7800326.
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Ment Health Clin. 2021 Jan 08;11(1):12-18. doi: 10.9740/mhc.2021.01.012. eCollection 2021 Jan.

The effects of concurrent oral paliperidone or risperidone use with paliperidone long-acting injection.

The mental health clinician

Trevor A Stump, Leigh Anne Nelson, Yifei Liu, Carrie R Kriz, Courtney A Iuppa, Lauren A Diefenderfer, Shelby E Lang, Ellie S R Elliot, Roger W Sommi

Affiliations

  1. Behavioral Health Clinical Pharmacist, Cleveland Clinic Marymount Hospital, Cleveland, Ohio.
  2. Associate Professor of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri.
  3. Clinical Research Coordinator, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri.
  4. Clinical Manager, Center for Behavioral Medicine, Kansas City, Missouri.
  5. Clinical Pharmacist, Center for Behavioral Medicine, Kansas City, Missouri.
  6. Director of Pharmacy, Center for Behavioral Medicine, Kansas City, Missouri.
  7. Associate Dean, Vice Chair and Professor of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri.

PMID: 33505820 PMCID: PMC7800326 DOI: 10.9740/mhc.2021.01.012

Abstract

INTRODUCTION: Dosing recommendations for paliperidone long-acting injectable antipsychotic (LAIA) do not include oral antipsychotic (OAP) overlap; however, OAPs are often given concurrently despite limited evidence describing both the risks and benefits of this practice.

METHODS: A retrospective chart review was conducted in patients initiated on paliperidone palmitate (PP) during a psychiatric hospitalization to compare patients who received OAP overlap versus those who did not. The primary outcome is the proportion of patients who receive prescription claims for benztropine, a medication commonly prescribed for extrapyramidal symptoms, at the time of LAIA discontinuation and 6 months postdischarge. Secondary outcomes include prescription claims for beta blockers and diphenhydramine, number of psychiatric emergency visits and hospitalizations, length of stay of the index hospitalization, frequency of LAIA discontinuation and the time to LAIA discontinuation.

RESULTS: There is a significant difference in the proportion of benztropine prescription claims in the OAP overlap group versus the no-overlap group at the time of LAIA discontinuation (30% vs 0%,

DISCUSSION: Patients who receive OAP overlap while receiving PP receive more benztropine and have more psychiatric emergency visits and hospitalizations than those treated without OAP. Larger studies with better control for confounding variables are needed to confirm these results.

© 2021 CPNP. The Mental Health Clinician is a publication of the College of Psychiatric and Neurologic Pharmacists.

Keywords: adverse events; benztropine; decompensation; long-acting injectable antipsychotic; oral antipsychotic overlap; paliperidone palmitate

Conflict of interest statement

Disclosures: L.A.N. reports that she is on the speaker's bureau of Alkermes and has received research grant support from Alkermes; Janssen Scientific Affairs, LLC; Otsuka Pharmaceutical Development &

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