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Paliperidone for schizophrenia.

A Nussbaum1, T S Stroup

  • 1University of North Carolina Hospitals, Department of Psychiatry, Campus Box #7160, 101 Manning Drive, Chapel Hill, NC 27599-7160, USA. anussbau@unch.unc.edu

The Cochrane Database of Systematic Reviews
|April 22, 2008
PubMed
Summary
This summary is machine-generated.

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Oral paliperidone (paliperidone) is more effective than placebo for schizophrenia, reducing early study withdrawal and psychosis recurrence. However, it increases risks of tachycardia, movement disorders, and prolactin elevation compared to placebo and olanzapine.

Area of Science:

  • Psychiatry
  • Pharmacology

Background:

  • Paliperidone, the active metabolite of risperidone, is available in oral and soon-to-be-released intramuscular formulations.
  • This review focuses on oral paliperidone for schizophrenia and related disorders.

Purpose of the Study:

  • To compare the efficacy and safety of oral paliperidone against other treatments for schizophrenia.
  • To evaluate oral paliperidone's effects on global state, psychosis recurrence, and adverse events.

Main Methods:

  • Systematic review of randomized controlled trials (RCTs) from the Cochrane Schizophrenia Group's Register.
  • Data extraction and analysis using intention-to-treat principles, calculating risk ratios (RR) and weighted mean differences (WMD).

Main Results:

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  • Oral paliperidone demonstrated higher efficacy than placebo, reducing early study discontinuation (RR 0.68) and psychosis recurrence (RR 0.45).
  • Paliperidone was associated with increased risks of tachycardia (RR 1.88), extrapyramidal disorders (RR 2.21), and weight gain (WMD 1.07) compared to placebo.
  • Efficacy of oral paliperidone (≥3 mg/day) was comparable to oral olanzapine (10 mg/day), with paliperidone showing less weight change (WMD -0.88).

    • Conclusions:

    • Oral paliperidone is an effective antipsychotic compared to placebo in short-term schizophrenia treatment.
    • Adverse effects include increased tachycardia, movement disorders, and significant prolactin elevation, similar to risperidone.
    • Paliperidone's efficacy is comparable to olanzapine, but direct comparisons with risperidone are lacking.