Quetiapine-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):
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Switch medication from Quetiapine to Paliperidone_LA.[5] [6]
Stop Quetiapine - 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.[7]
- 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.
— Quetiapine — Paliperidone_LA
- ↑ 1.0 1.1 1.2 KNMP; Informatorium Medicamentorum 2023; Monografie "quetiapine" (Dutch)
- ↑ NVZA; Toxicology.org; Monografie 73 (dutch)
- ↑ Woods SW Chlorpromazine equivalent doses for the newer atypical antipsychotics J Clin Psychiatry 2003;64:663-667
- ↑ Drugs.com quetiapine-fumarate
- ↑ 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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