Rest AP-Paliperidone LA
From Psychiatrynet
There are 2 switch possibities:
Number 1 (the general approach):
- Day 1: Switch to oral risperidone (or oral paliperidone): see this switch in the main cross table.
- Day 1-29: Maintain on oral risperidone (or oral paliperidone) and examine the effects.
- Day 30: stop oral risperidone (or oral paliperidone) and administer paliperidone-LA: see this switch in the main cross table.
Oral risperidone has better and more stable bioavailability properties than has oral 9-OH-risperidone=paliperidone. Food increases the absorption with 50-60% of the latter.
Number 2 (if a patient in the past reacted well on risperidon or paliperidone=9-OH-risperidone):
Rest AP is a collection of antipsychotic drugs having similar properties with respect to switching. A switch to member of the 'rest-AP' group from anotherdrug should be read as rest AP-anotherdrug. Similarly, a switch from a member of the 'rest-AP' group to anotherdrug should be read as anotherdrug-rest AP. | ||||||||||||||||
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Switch medication from Rest AP to Paliperidone_LA.
Stop Rest AP - Week 1-3: approx. 75% of initial dose
- Week 4-6: approx. 50% of initial dose
- Week 7-9: approx. 25% of initial dose
- Week 10: stop
Start Paliperidone_LA- Day 1: Start depot according general dosing advice (Dotted line in graph)
More information- During this switch you could monitor ECG, especially in patients prone to QT-conduction problems.
- There is a possibility of QT interval prolongation.[1]
- Alternatively, first switch to oral form and then switch to depot to manage possible (adverse) reactions.
— Rest AP — Paliperidone_LA- ↑ Stöllberger C, Huber JO, Finsterer J, Antipsychotic drugs and QT prolongation. Int Clin Psychopharmacol. 2005 Sep;20(5):243-51.
