Partial antagonist-Paliperidone LA

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):

Partial antagonist Aripiprazole Brexpiprazole Cariprazine

Paliperidone long acting Type Antipsychotic Group Atypical AP links Medscape Paliperidone PubChem 23724979 PubMed Paliperidone Kompas (Dutch) Paliperidone Wikipedia Paliperidone more info

Switch medication from Partial antagonist to Paliperidone_LA.
Partial antagonist is a collection of antipsychotic drugs having similar properties with respect to switching. A switch to member of the 'partial antagonist' group from anotherdrug should be read as partial antagonist-anotherdrug. Similarly, a switch from a member of the 'partial antagonist' group to anotherdrug should be read as anotherdrug-partial antagonist.

Stop Partial antagonist

• Week 1-6: Continue drug at usual dose
• Week 7: Stop drug

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.

• Alternatively, first switch to oral form and then switch to depot to manage possible (adverse) reactions. With a direct switch to a depot it is advisable to administer a low testdose in order to exclude adverse reactions.
  

— Partial antagonist
— Paliperidone_LA

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