The influence of switching from risperidone to paliperidone on the extrapyramidal symptoms and cognitive function in elderly patients with schizophrenia: a preliminary open-label trial

Int J Psychiatry Clin Pract. 2014 Jan;18(1):58-62. doi: 10.3109/13651501.2013.845218. Epub 2013 Nov 13.

Abstract

Objective: This study was to evaluate the effects on clinical symptoms and cognitive function of switching the treatment of elderly patients with schizophrenia from risperidone to paliperidone (PAL).

Methods: This study was a 12-weeks, preliminary open-label trial. The subjects were 17 inpatients. Their extrapyramidal symptoms (EPS) were assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS), Abnormal Involuntary Movement Scale (AIMS), and Barnes Akathisia Scale (BAS), and their cognitive function was assessed using the Brief Assessment Cognition in Schizophrenia: Japanese language version (BACS-J), and their clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity of illness scale (CGI-S) at the 0 and 12 weeks.

Results: The DIEPSS and BAS significantly improved after switching from risperidone to PAL. Furthermore, improvement was found on AIMS. The mean change from baseline in z-score of the digit sequencing task was significantly increased. All items on the PANSS and CGI-S were not significant; however, changes in some cognitive function were correlated with changes in EPS.

Conclusions: The results of this study suggest the possibility that switching elderly patients from risperidone to PAL may have improved pre-existing EPS, and may also have helped improve working memory.

Publication types

  • Clinical Trial
  • Observational Study

MeSH terms

  • Aged
  • Akathisia, Drug-Induced / drug therapy
  • Antipsychotic Agents / adverse effects
  • Antipsychotic Agents / therapeutic use*
  • Cognition Disorders / drug therapy*
  • Cognition Disorders / etiology
  • Drug Substitution
  • Dyskinesia, Drug-Induced / drug therapy
  • Female
  • Humans
  • Isoxazoles / administration & dosage
  • Isoxazoles / therapeutic use*
  • Male
  • Memory, Short-Term / drug effects
  • Neuropsychological Tests / statistics & numerical data
  • Paliperidone Palmitate
  • Psychiatric Status Rating Scales
  • Pyrimidines / administration & dosage
  • Pyrimidines / therapeutic use*
  • Risperidone / adverse effects
  • Risperidone / therapeutic use*
  • Schizophrenia / complications
  • Schizophrenia / drug therapy*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Antipsychotic Agents
  • Isoxazoles
  • Pyrimidines
  • Risperidone
  • Paliperidone Palmitate