Efficacy and safety of once-monthly paliperidone palmitate long-acting injection in an elderly patient with schizophrenia

BMJ Case Rep. 2015 Aug 26;2015:bcr2015212149. doi: 10.1136/bcr-2015-212149.


We present detailed data on the efficacy and safety profile of paliperidone palmitate once-monthly long acting injectable (PP1M-LAI) in the treatment of schizophrenia in an elderly Caucasian woman. PP1M-LAI was initiated with starting doses of 150 and 100 mg on treatment days 1 and 8, respectively. Subsequent 100 mg doses of PP1M-LAI were then administered at 4-weekly intervals. The primary efficacy variable was the change in Positive and Negative Syndrome Scale (PANSS) total score from baseline. Safety assessment variables included assessment of treatment emergent adverse events, clinical laboratory tests, vital sign measurements, ECG, Calgary Depression Scale for Schizophrenia (CDSS), mini-mental status examination, Abnormal Involuntary Movement Scale (AIMS), Barnes Akathisia Rating Scale (BARS), Simpson-Angus Scale for the Assessment of Extrapyramidal Side Effects (SAS) and WHO Quality of Life-BREF (WHO-QOL-BREF). The aforementioned variables were all monitored for changes from baseline over a period of 28 weeks. A reduction of PANSS total score was noted over the 28 weeks, demonstrating the efficacy of PP1M-LAI for the treatment of schizophrenia in our patient. Improvements were also noted in the BARS score, SAS score and WHO-QOL-BREF. Negative findings were observed with regard to several pre-established safety variables such as blood glucose levels, prolactin levels, QTC intervals and weight. Overall, the addition of PP1M-LAI to the treatment regime improved the control of psychotic symptoms. However, iatrogenic consequences arising from the use of PP1M-LAI need to be considered and balanced against the primary efficacy of the medication.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antipsychotic Agents / administration & dosage*
  • Antipsychotic Agents / adverse effects
  • Female
  • Humans
  • Injections, Intramuscular
  • Paliperidone Palmitate / administration & dosage*
  • Paliperidone Palmitate / adverse effects
  • Psychiatric Status Rating Scales
  • Quality of Life
  • Recurrence
  • Schizophrenia / drug therapy*
  • Treatment Outcome


  • Antipsychotic Agents
  • Paliperidone Palmitate