The effects of concurrent oral paliperidone or risperidone use with paliperidone long-acting injection.
| Autor: | Stump TA; Behavioral Health Clinical Pharmacist, Cleveland Clinic Marymount Hospital, Cleveland, Ohio., Nelson LA; Behavioral Health Clinical Pharmacist, Cleveland Clinic Marymount Hospital, Cleveland, Ohio.; Associate Professor of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri.; Clinical Research Coordinator, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri.; Clinical Manager, Center for Behavioral Medicine, Kansas City, Missouri.; Clinical Pharmacist, Center for Behavioral Medicine, Kansas City, Missouri.; Clinical Pharmacist, Center for Behavioral Medicine, Kansas City, Missouri.; Director of Pharmacy, Center for Behavioral Medicine, Kansas City, Missouri.; Associate Dean, Vice Chair and Professor of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri., Liu Y; Associate Professor of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri., Kriz CR; Clinical Research Coordinator, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri., Iuppa CA; Clinical Manager, Center for Behavioral Medicine, Kansas City, Missouri., Diefenderfer LA; Clinical Pharmacist, Center for Behavioral Medicine, Kansas City, Missouri., Lang SE; Clinical Pharmacist, Center for Behavioral Medicine, Kansas City, Missouri., Elliot ESR; Director of Pharmacy, Center for Behavioral Medicine, Kansas City, Missouri., Sommi RW; Associate Dean, Vice Chair and Professor of Pharmacy Practice and Administration, University of Missouri-Kansas City School of Pharmacy, Kansas City, Missouri. |
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| Jazyk: | angličtina |
| Zdroj: | The mental health clinician [Ment Health Clin] 2021 Jan 08; Vol. 11 (1), pp. 12-18. Date of Electronic Publication: 2021 Jan 08 (Print Publication: 2021). |
| DOI: | 10.9740/mhc.2021.01.012 |
| Abstrakt: | 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%, P = .046) but not at 6 months postdischarge. There are also significant differences in the number of psychiatric emergency visits (0.7 vs 0.1, P = .02) and psychiatric hospitalizations (0.6 vs 0.1, P = .029) at the time of LAIA discontinuation. No other differences are observed in defined secondary outcomes. 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. Competing Interests: 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 & Commercialization, Inc; Neurocrine Pharmaceuticals; Boehringer Ingelheim; and Teva Pharmaceutical Industries, Ltd. Y.L. has received research grant support from Alkermes. R.W.S. is on the speaker's bureau of Alkermes; Janssen Scientific Affairs, LLC; and Sunovion and has received research grant support from Alkermes; Janssen Scientific Affairs, LLC; Otsuka Pharmaceutical Development & Commercialization, Inc; Neurocrine Pharmaceuticals; Boehringer Ingelheim; and Teva Pharmaceutical Industries, Ltd. T.A.S., C.R.K., C.A.I, L.A.D., S.E.L., and E.S.R.E. have nothing to disclose. (© 2021 CPNP. The Mental Health Clinician is a publication of the College of Psychiatric and Neurologic Pharmacists.) |
| Databáze: | MEDLINE |
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