Please consider that non-compliance is a major contributing factor in poor clinical outcomes for schizophrenia- and there are many reasons for non compliance. You may or may not be able to address those based on your resources.
Depot injections have demonstrable efficacy in the treatment of schizophrenia with a decreased incidence of tradive dyskinseas as compared to traditional neuroleptics. The drawback is that for at least the first month, oral risperidone is necessary- the effect of the depot injection begins at 2 - 3 weeks. Getting a patient to accept an injection every few weeks can be easier than to expect compliance with daily oral medication. (Cost: injections are more expensive.)
In the first answer you received, the 2nd publication may be quite helpful. It appeared in Neuropsychiatric disorder treatment, October 2008, 4(5): 919-927.
See also the comparison in this jama article:
RESULTS Therewas no statistically significant difference in the rate of efficacy failure forpaliperidone palmitate compared with haloperidol decanoate (adjusted hazard ratio, 0.98; 95%CI, 0.65-1.47). The number of participants who experienced efficacy failurewas 49 (33.8%) inthe paliperidone palmitate group and 47 (32.4%) in the haloperidol decanoate group. Onaverage, participants in the paliperidone palmitate group gained weight and those in thehaloperidol decanoate group lostweight; after 6 months, the least-squares mean weightchange for those taking paliperidone palmitatewas increased by 2.17 kg (95%CI, 1.25-3.09) andwas decreased for those taking haloperidol decanoate (−0.96 kg; 95%CI, −1.88 to −0.04).Patients taking paliperidone palmitate had significantly higher maximum mean levels of serumprolactin (men, 34.56 μg/L [95%CI, 29.75-39.37] vs 15.41 μg/L [95%CI, 10.73-20.08];P
As you can see from the attached paper - there is no real difference to the "classical" haldol-decanoat (except prices!).
Hello,
Until, there has not been a real assessment of the long term adverse events with the use of paliperidone. Most of studies showe a reporting bias of adverse reactions (report only if occurs in more of 10% of study population), thus making tough for reasearchers to combine and compare the data in meta-analysis of this subject.
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