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Assessing Outcomes Between Risperidone Microspheres and Paliperidone Palmitate Long-Acting Injectable Antipsychotics
Hajer G Ibrahim1,2,3, Benjamin J Malcolm4, Hyma P Gogineni3,5,6
1Kaiser Permanente San Jose Medical Center, California.
Summary
Veterans with schizophrenia using risperidone microspheres (long-acting injectable antipsychotics) experienced fewer psychiatric hospitalizations and rehospitalizations compared to those on paliperidone palmitate.
Area of Science:
- Psychiatry
- Pharmacology
- Health Services Research
Background:
- Long-acting injectable antipsychotics (LAIAs) are crucial for managing schizophrenia, schizoaffective disorder, and bipolar I disorder in veterans.
- Limited comparative studies exist for LAIAs like risperidone microspheres and paliperidone palmitate.
- This study addresses the need for direct comparison of these LAIAs in a veteran population.
Purpose of the Study:
- To compare psychiatric hospitalizations in veterans initiated on risperidone microspheres versus paliperidone palmitate.
- To evaluate rehospitalization rates and treatment duration between the two LAIAs.
- To assess the effectiveness of risperidone microspheres compared to paliperidone palmitate in a veteran cohort.
Main Methods:
- A pre-post design was used to analyze hospitalizations before and after LAIA initiation in veterans.
- Included veterans received at least two injections of risperidone microspheres or paliperidone palmitate between 2016-2018.
- Nonadherence criteria differed for each LAIA; nonparametric tests analyzed outcomes.
Main Results:
- Veterans on risperidone microspheres (n=44) had significantly fewer post-LAIA hospitalizations (0.4 vs 0.9; P=.02) than those on paliperidone palmitate (n=53).
- Risperidone microspheres group showed lower rehospitalization rates (22.7% vs 47.2%; P=.013).
- Treatment duration was shorter for risperidone microspheres (41.6 weeks vs 58.2 weeks; P=.04).
Conclusions:
- Risperidone microspheres were associated with reduced psychiatric hospitalizations in veterans.
- Veterans treated with risperidone microspheres were less likely to be rehospitalized.
- Findings suggest potential advantages of risperidone microspheres over paliperidone palmitate for hospitalization reduction in this population.
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