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Paliperidone extended-release: does it have a place in antipsychotic therapy?
Drug Des Devel Ther. 2011 Mar 11; 5:125-46.DD

Abstract

Paliperidone (9-hydroxy-risperidone), the active metabolite of risperidone, was approved for treating schizophrenia worldwide in 2006 as paliperidone extended-release (PER), and became the first second-generation antipsychotic specifically licensed for treating schizoaffective disorder in 2009. However, at the same time, its comparatively high cost gave rise to concerns about the cost-effectiveness of PER as compared with its precursor, risperidone. This paper reviews the existing knowledge of the pharmacology, kinetics, efficacy, tolerability, and fields of application of PER, and compares PER with risperidone in order to determine whether it has a place in antipsychotic therapy. An independent assessment of all relevant publications on PER published until July 2010 was undertaken. PER has a unique pharmacological profile, including single dosing, predominantly renal excretion, low drug-drug interaction risk, and differs from risperidone in terms of mode of action and pharmacokinetics. High-level evidence suggests that PER is efficacious and safe in schizophrenia, schizoaffective disorder, and acute manic episodes. There is a striking lack of published head-to-head comparisons between PER and risperidone, irrespective of indication. Low-level evidence shows a lower risk for hyperprolactinemia and higher patient satisfaction with PER than with risperidone. PER adds to the still limited arsenal of second-generation antipsychotics. In the absence of direct comparisons with risperidone, it remains difficult to come to a final verdict on the potential additional therapeutic benefits of PER which would justify its substantially higher costs as compared with risperidone. However, in terms of pharmacology, the available evidence cautiously suggests a place for PER in modern antipsychotic therapy.

Authors+Show Affiliations

Department of Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany. maximilian.gahr@uni-ulm.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

21448450

Citation

Gahr, Maximilian, et al. "Paliperidone Extended-release: Does It Have a Place in Antipsychotic Therapy?" Drug Design, Development and Therapy, vol. 5, 2011, pp. 125-46.
Gahr M, Kölle MA, Schönfeldt-Lecuona C, et al. Paliperidone extended-release: does it have a place in antipsychotic therapy? Drug Des Devel Ther. 2011;5:125-46.
Gahr, M., Kölle, M. A., Schönfeldt-Lecuona, C., Lepping, P., & Freudenmann, R. W. (2011). Paliperidone extended-release: does it have a place in antipsychotic therapy? Drug Design, Development and Therapy, 5, 125-46. https://doi.org/10.2147/DDDT.S17266
Gahr M, et al. Paliperidone Extended-release: Does It Have a Place in Antipsychotic Therapy. Drug Des Devel Ther. 2011 Mar 11;5:125-46. PubMed PMID: 21448450.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Paliperidone extended-release: does it have a place in antipsychotic therapy? AU - Gahr,Maximilian, AU - Kölle,Markus A, AU - Schönfeldt-Lecuona,Carlos, AU - Lepping,Peter, AU - Freudenmann,Roland W, Y1 - 2011/03/11/ PY - 2011/03/10/received PY - 2011/3/31/entrez PY - 2011/3/31/pubmed PY - 2011/11/16/medline KW - antipsychotic treatment KW - bipolar disorder KW - extended-release KW - paliperidone KW - psychopharmacology KW - schizophrenia KW - second-generation antipsychotics SP - 125 EP - 46 JF - Drug design, development and therapy JO - Drug Des Devel Ther VL - 5 N2 - Paliperidone (9-hydroxy-risperidone), the active metabolite of risperidone, was approved for treating schizophrenia worldwide in 2006 as paliperidone extended-release (PER), and became the first second-generation antipsychotic specifically licensed for treating schizoaffective disorder in 2009. However, at the same time, its comparatively high cost gave rise to concerns about the cost-effectiveness of PER as compared with its precursor, risperidone. This paper reviews the existing knowledge of the pharmacology, kinetics, efficacy, tolerability, and fields of application of PER, and compares PER with risperidone in order to determine whether it has a place in antipsychotic therapy. An independent assessment of all relevant publications on PER published until July 2010 was undertaken. PER has a unique pharmacological profile, including single dosing, predominantly renal excretion, low drug-drug interaction risk, and differs from risperidone in terms of mode of action and pharmacokinetics. High-level evidence suggests that PER is efficacious and safe in schizophrenia, schizoaffective disorder, and acute manic episodes. There is a striking lack of published head-to-head comparisons between PER and risperidone, irrespective of indication. Low-level evidence shows a lower risk for hyperprolactinemia and higher patient satisfaction with PER than with risperidone. PER adds to the still limited arsenal of second-generation antipsychotics. In the absence of direct comparisons with risperidone, it remains difficult to come to a final verdict on the potential additional therapeutic benefits of PER which would justify its substantially higher costs as compared with risperidone. However, in terms of pharmacology, the available evidence cautiously suggests a place for PER in modern antipsychotic therapy. SN - 1177-8881 UR - https://www.unboundmedicine.com/medline/citation/21448450/Paliperidone_extended_release:_does_it_have_a_place_in_antipsychotic_therapy L2 - https://dx.doi.org/10.2147/DDDT.S17266 DB - PRIME DP - Unbound Medicine ER -