Olanzapine LA-Paliperidone LA
From Psychiatrienet
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):
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Switch medication from Olanzapine_LA to Paliperidone_LA.[1] [2]
Stop Olanzapine_LA - Day 1: Last depot injection
Start Paliperidone_LA- Start depot according to general dosing advice on the day you normally would have injected the former depot.
- Testing for acceptance and possible allergic reactions in a low dose can be carried out earlier.
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.[3]
- ↑ Switches are based on literature references on this page and expert opinions of the authors. The authors have used pharmacokinetic and receptor affinity properties to determine the switch schedules
- ↑ Stahl, S. M. (2013). Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). Cambridge University Press.
- ↑ Stöllberger C, Huber JO, Finsterer J, Antipsychotic drugs and QT prolongation. Int Clin Psychopharmacol. 2005 Sep;20(5):243-51.
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