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Examination of Patients Diagnosed with Schizophrenia and Bipolar Disorder Type 1 Using Paliperidone Palmitate Once-Monthly Long-Acting Injectable

Year 2021, Volume: 54 Issue: 1, 90 - 95, 27.04.2021
https://doi.org/10.20492/aeahtd.754208

Abstract

PURPOSE: Incompliance with drug therapy is an important problem in patients diagnosed with schizophrenia and bipolar disorder. Long-acting anpsychotic (AP) injectables provide important advantages in such situations. In this study, we aimed to examine the patients who were followed up at the psychiatry outpatient clinic of our hospital and who used paliperidone palmitate once-monthly long-acting injectable (PP1A).
MATERIAL AND METHOD: In this retrospective cohort study, we examined patients who managed by PP1A with a diagnosis of schizophrenia and bipolar disorder type 1 (BB1) between 10/06/2019-10/06/2020, who continued treatment for at least six months, or discontinued the treatment. All of the data was obtained from the hospital registration system. Clinical global impression scale (CGI) scores were used.
RESULTS: In the study, which included twenty-eight (9 female [7 schizophrenia + 2 BB1], 19 male [13 schizophrenia + 6 BB1]) patients, no significant difference was found between the genders in terms of mean age, diagnosis, disorder onset age, duration of PP1A use, CGI scores (p>0.05). There was a significant difference between genders in terms of assault history (p=0.035), mental retardation comorbidity (p=0.047), depot AP usage history (p=0.010). In total, only one woman with BB1 could not tolerate PP1A and discontinued treatment. The comorbidity of type 2 diabetes mellitus (p=0.026) and hypertension (p=0.020) and the use of additional oral AP to PP1A (p=0.021) were more frequent in patients with BB1. Since seven patients with schizophrenia benefited PP1A, paliperidone palmitate was switched to 3-monthly depot injectable (PP3A). There was no patient who switched to PP3A after PP1A in BB1 patients. According to the CGI applied at the end of the sixth month, PP1A provided a more significant clinical improvement in schizophrenia patients than BB1 (p=0.009).
CONCLUSION: In the literature, data related to the use of PP1A in bipolar disorder is limited. In the current studies, no information was provided about the subtype of bipolar disorder. In this sense, our study is the first study to examine PP1A usage in BB1. In addition, our findings show that PP1A has a positive effect on clinical improvement in schizophrenia patients in line with other studies in the literature.

References

  • 1.) Taylor D. Psychopharmacology and adverse effects of antipsychotic long acting injections. Br J Psychiatry 2009;195:S13-S19.
  • 2.) Aksoy I, Orum MH. Haloperidol decanoate-induced acneiform eruption: A case report. Medicine Science 2018;7(3):707-708.
  • 3.) Cordiner M, Shajahan P, McAvoy S, et al. Effectiveness of long-acting antipsychotics in clinical practice: 1. A retrospective, 18-month follow up and comparison between paliperidone palmitate, risperidone long-acting injection and zuclopenthixol decanoate. Ther Adv Psychopharmacol 2016;6(1):22-32.
  • 4.) Örüm MH, Kara MZ. Zuklopentiksol dekanoat uzun etkili depo enjeksiyon kullanımına bağlı yüz ve periferik ödem: Bir olgu sunumu. Med J West Black Sea 2019;3(1):26-29.
  • 5.) Alphs L, Benson C, Cheshire-Kinney K, et al. Real-world outcomes of paliperidone palmitate compared to Daily oral antipsychotic therapy in schizophrenia: A randomized, open-label, review board-blinded 15-month study. J Clin Psychiatry 2015;76(5):554-561.
  • 6.) Alphs L, Mao L, Lynn Starr H, et al. A pragmatic analysis comparing once-monthly paliperidone palmitate versus daily oral antipsychotic treatment in patients with schizophrenia. Schizophr Res 2016;170(2-3):259-264.
  • 7.) Fu DJ, Turkoz I, Simonson RB, et al. Paliperidone Palmitate Once-Monthly Injectable Treatment for Acute Exacerbations of Schizoaffective Disorder. J Clin Psychopharmacol 2016;36(4):372-376.
  • 8.) Jawad I, Watson S, Haddad PM, et al. Medication nonadherence in bipolar disorder: a narrative review. Ther Adv Psychopharmacol 2018;8(12):349-363.
  • 9.) Buoli M, Ciappolino V, Altamura AC. Paliperidone palmitate depot in the long-term treatment of psychotic bipolar disorder: a case series. Clin Neuropharmacol 2015;38:209-211.
  • 10.) Deslandes PN, Ward EH, Norris K, et al. Effectiveness of paliperidone long-acting injection in clinical practice. Ther Adv Psychopharmacol. 2018;8(5):139-145.
  • 11.) Ozen ME, Orum MH, Kalenderoglu A. Difficult patient in psychiatry practice: A case-control study. Adıyaman Üni Sağlık Bilimleri Derg 2018;4(3):1064-1073.
  • 12.) Örüm MH, Eğilmez OB. Şizofreni tanılı bir hastada elektrokonvülsif tedavi ve paliperidon ile başarılı bir şekilde tedavi edilen Cotard sendromu: Bir olgu sunumu. Fırat Tıp Dergisi 2020;25(2):108-110.
  • 13.) Ozen ME, Orum MH, Kalenderoglu A. The burden of schizophrenia on caregivers. Psychiatry Behav Sci 2018;8(3):105-110.
  • 14.) Ran MS, Xiao Y, Zhao X, et al. Family history of psychosis and outcome of people with schizophrenia in rural China: 14-year follow-up study. Asian J Psychiatr 2018;32:14-19.
  • 15.) Egilmez OB, Orum MH. Evaluation of adolescent patients hospitalized in an adult psychiatry service: Data for 2015-2018. KOU Sag Bil Derg 2020;6(2):118-122.
  • 16.) http://www.adiyaman.gov.tr/nufus-bilgileri. Erişim Tarihi: 17/06/2020.
  • 17.) Guy W. ECDEU Assessment Manual for Psychopharmacology, Revised US Dept Health, Education and Welfare publication (ADM), Rockville, National Institude of Mental Health, s.76-338, 1976.
  • 18.) Greene M, Yan T, Chang E, et al. Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder. J Med Econ 2018;21(2):127-134.
  • 19.) Bioque M, Bernardo M. The current data on the 3-month paliperidone palmitate formulation for the treatment of schizophrenia. Expert Opin Pharmacother 2018;19(14):1623-1629.
  • 20.) Taylor DM, Sparshatt A, O'Hagan M, et al. Effect of paliperidone palmitate on hospitalisation in a naturalistic cohort - a four-year mirror image study. Eur Psychiatry 2016;37:43-48.
  • 21.) Whale R, Pereira M, Cuthbert S, et al. Effectiveness and Predictors of Continuation of Paliperidone Palmitate Long-Acting Injection Treatment: A 12-Month Naturalistic Cohort Study. J Clin Psychopharmacol 2015;35(5):591-595.
  • 22.) Chaudhary K, Patel MM, Mehta PJ. Long-Acting Injectables: Current Perspectives and Future Promise. Crit Rev Ther Drug Carrier Syst 2019;36(2):137-181.
  • 23.) Morris MT, Tarpada SP. Long-Acting Injectable Paliperidone Palmitate: A Review of Efficacy and Safety. Psychopharmacol Bull 2017;47(2):42-52.

Paliperidon Palmitat Aylık Uzun Etkili Enjeksiyon Kullanan Şizofreni ve Bipolar Bozukluk Tip 1 Tanılı Hastaların İncelenmesi

Year 2021, Volume: 54 Issue: 1, 90 - 95, 27.04.2021
https://doi.org/10.20492/aeahtd.754208

Abstract

AMAÇ: İlaç tedavisine uyumsuzluk, şizofreni ve bipolar bozukluk tanılı hastalardaki önemli bir sorundur. Uzun etkili anpsikotik (AP) enjeksiyonlar bu tür durumlarda önemli avantajlar sağlamaktadır. Biz bu çalışmada hastanemizin psikiyatri polikliniğinde takip edilen ve paliperidon palmitat aylık uzun etkili enjeksiyon (PP1A) kullanan hastaları incelemeyi amaçladık.
GEREÇ VE YÖNTEM: Bu geriye dönük kohort çalışmada, 10/06/2019-10-06/2020 tarihleri arasında şizofreni ve bipolar bozukluk tip 1 (BB1) tanısıyla PP1A başlanan, tedaviye en az altı ay devam eden ya da tedaviyi bırakan hastaları inceledik. Verilerin tamamı hastane kayıt sisteminden elde edildi. Klinik global izlenim ölçeği (KGİÖ) skorları kullanıldı.
BULGULAR: Yirmi sekiz (9 kadın [7 şizofreni+2 BB1], 19 erkek [13 şizofreni + 6 BB1]) hastanın dâhil edildiği çalışmada cinsiyetler arasında ortalama yaş, tanı, hastalık başlangıç yaşı, PP1A kullanım süresi, KGİÖ skorları açısından anlamlı farklılık saptanmadı (p>0,05). Cinsiyetler arasında darp edilme öyküsü (p=0,035), zekâ geriliği komorbiditesi (p=0,047), depo AP kullanım öyküsü (p=0,010) açısından anlamlı farklılık saptandı. Totalde sadece BB1 tanılı bir kadın hasta PP1A’yı tolere edememiş ve tedaviyi bırakmıştı. BB1 hastalarında tip 2 diyabetes mellitus (p=0,026) ve hipertansiyon (p=0,020) komorbiditesi ve PP1A’ya ek oral AP kullanımı (p=0,021) daha fazlaydı. Yedi tane şizofreni hastasında PP1A kullanımından fayda görüldüğü için paliperidon palmitat 3 aylık depo enjeksiyon (PP3A)’ya geçilmişti. BB1 hastalarında PP1A sonrası PP3A’ya geçilen hasta yoktu. Altıncı ayın sonunda uygulanan KGİÖ’ye göre, PP1A şizofreni hastalarında BB1’e göre daha anlamlı bir klinik düzelme sağlamıştı (p=0,009).
SONUÇ: Literatürde, bipolar bozuklukta PP1A kullanımı ile ilişkili veriler sınırlıdır. Mevcut çalışmalarda bipolar bozukluk alt tipi konusunda bilgi verilmemiştir. Bu anlamda çalışmamız BB1’de PP1A kullanımını inceleyen ilk çalışmadır. Ayrıca bulgularımız literatürdeki diğer çalışmalarla uyumlu olarak PP1A’nın şizofreni hastalarında klinik düzelmeye olumlu etkisi olduğunu göstermektedir.

References

  • 1.) Taylor D. Psychopharmacology and adverse effects of antipsychotic long acting injections. Br J Psychiatry 2009;195:S13-S19.
  • 2.) Aksoy I, Orum MH. Haloperidol decanoate-induced acneiform eruption: A case report. Medicine Science 2018;7(3):707-708.
  • 3.) Cordiner M, Shajahan P, McAvoy S, et al. Effectiveness of long-acting antipsychotics in clinical practice: 1. A retrospective, 18-month follow up and comparison between paliperidone palmitate, risperidone long-acting injection and zuclopenthixol decanoate. Ther Adv Psychopharmacol 2016;6(1):22-32.
  • 4.) Örüm MH, Kara MZ. Zuklopentiksol dekanoat uzun etkili depo enjeksiyon kullanımına bağlı yüz ve periferik ödem: Bir olgu sunumu. Med J West Black Sea 2019;3(1):26-29.
  • 5.) Alphs L, Benson C, Cheshire-Kinney K, et al. Real-world outcomes of paliperidone palmitate compared to Daily oral antipsychotic therapy in schizophrenia: A randomized, open-label, review board-blinded 15-month study. J Clin Psychiatry 2015;76(5):554-561.
  • 6.) Alphs L, Mao L, Lynn Starr H, et al. A pragmatic analysis comparing once-monthly paliperidone palmitate versus daily oral antipsychotic treatment in patients with schizophrenia. Schizophr Res 2016;170(2-3):259-264.
  • 7.) Fu DJ, Turkoz I, Simonson RB, et al. Paliperidone Palmitate Once-Monthly Injectable Treatment for Acute Exacerbations of Schizoaffective Disorder. J Clin Psychopharmacol 2016;36(4):372-376.
  • 8.) Jawad I, Watson S, Haddad PM, et al. Medication nonadherence in bipolar disorder: a narrative review. Ther Adv Psychopharmacol 2018;8(12):349-363.
  • 9.) Buoli M, Ciappolino V, Altamura AC. Paliperidone palmitate depot in the long-term treatment of psychotic bipolar disorder: a case series. Clin Neuropharmacol 2015;38:209-211.
  • 10.) Deslandes PN, Ward EH, Norris K, et al. Effectiveness of paliperidone long-acting injection in clinical practice. Ther Adv Psychopharmacol. 2018;8(5):139-145.
  • 11.) Ozen ME, Orum MH, Kalenderoglu A. Difficult patient in psychiatry practice: A case-control study. Adıyaman Üni Sağlık Bilimleri Derg 2018;4(3):1064-1073.
  • 12.) Örüm MH, Eğilmez OB. Şizofreni tanılı bir hastada elektrokonvülsif tedavi ve paliperidon ile başarılı bir şekilde tedavi edilen Cotard sendromu: Bir olgu sunumu. Fırat Tıp Dergisi 2020;25(2):108-110.
  • 13.) Ozen ME, Orum MH, Kalenderoglu A. The burden of schizophrenia on caregivers. Psychiatry Behav Sci 2018;8(3):105-110.
  • 14.) Ran MS, Xiao Y, Zhao X, et al. Family history of psychosis and outcome of people with schizophrenia in rural China: 14-year follow-up study. Asian J Psychiatr 2018;32:14-19.
  • 15.) Egilmez OB, Orum MH. Evaluation of adolescent patients hospitalized in an adult psychiatry service: Data for 2015-2018. KOU Sag Bil Derg 2020;6(2):118-122.
  • 16.) http://www.adiyaman.gov.tr/nufus-bilgileri. Erişim Tarihi: 17/06/2020.
  • 17.) Guy W. ECDEU Assessment Manual for Psychopharmacology, Revised US Dept Health, Education and Welfare publication (ADM), Rockville, National Institude of Mental Health, s.76-338, 1976.
  • 18.) Greene M, Yan T, Chang E, et al. Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder. J Med Econ 2018;21(2):127-134.
  • 19.) Bioque M, Bernardo M. The current data on the 3-month paliperidone palmitate formulation for the treatment of schizophrenia. Expert Opin Pharmacother 2018;19(14):1623-1629.
  • 20.) Taylor DM, Sparshatt A, O'Hagan M, et al. Effect of paliperidone palmitate on hospitalisation in a naturalistic cohort - a four-year mirror image study. Eur Psychiatry 2016;37:43-48.
  • 21.) Whale R, Pereira M, Cuthbert S, et al. Effectiveness and Predictors of Continuation of Paliperidone Palmitate Long-Acting Injection Treatment: A 12-Month Naturalistic Cohort Study. J Clin Psychopharmacol 2015;35(5):591-595.
  • 22.) Chaudhary K, Patel MM, Mehta PJ. Long-Acting Injectables: Current Perspectives and Future Promise. Crit Rev Ther Drug Carrier Syst 2019;36(2):137-181.
  • 23.) Morris MT, Tarpada SP. Long-Acting Injectable Paliperidone Palmitate: A Review of Efficacy and Safety. Psychopharmacol Bull 2017;47(2):42-52.
There are 23 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original research article
Authors

Mehmet Hamdi Örüm

Publication Date April 27, 2021
Submission Date June 17, 2020
Published in Issue Year 2021 Volume: 54 Issue: 1

Cite

AMA Örüm MH. Paliperidon Palmitat Aylık Uzun Etkili Enjeksiyon Kullanan Şizofreni ve Bipolar Bozukluk Tip 1 Tanılı Hastaların İncelenmesi. Ankara Eğitim ve Araştırma Hastanesi Tıp Dergisi. April 2021;54(1):90-95. doi:10.20492/aeahtd.754208