From the Journals

Switching long-acting injectables deemed safe in schizophrenia



Patients with schizophrenia who have efficacy or tolerability concerns with paliperidone palmitate or risperidone long-acting injection can be switched safely to aripiprazole lauroxil, a small prospective, open-label study suggests.

“To our knowledge, this is the first prospective study of the safety of switching from other long-acting injectable antipsychotics to [aripiprazole lauroxil],” wrote Brian J. Miller, MD, and his associates.

The 6-month study included 51 patients (mean age, 40.6 years; 72.5% male) who were switched to aripiprazole lauroxil from either of the other long-acting injectables, reported Dr. Miller of Augusta University, Georgia, and his associates. They observed rates of discontinuation for any reason and discontinuation related to the new medication regimen. The study found that, at 6 months, all-cause discontinuation was 30.4% and medication-related discontinuation was 9.2% (Schizophr Res. 2019 Feb 7. doi: 10.1016/jschres.2019.01.38).

Statistically significant improvements were seen with aripiprazole lauroxil based on scores on the Clinical Global Impressions–Severity and the Brief Psychiatric Rating Scale. Safety was assessed by tracking adverse events; the observed adverse events were consistent with aripiprazole lauroxil’s known safety profile. Those improvements and tolerability seen with aripiprazole lauroxil are important, because the reasons for the switch had included experiencing residual symptoms or issues of tolerability with the previous treatment.

“The clinical benefit observed in the study occurred irrespective of the investigator-determined [aripiprazole lauroxil] dosing regimen, suggesting that clinicians have the flexibility to select the regimen that is most compatible with the individual needs of their patients,” the authors added.

The full report can be found in Schizophrenia Research.

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