The impact of long-acting paliperidone in reducing hospitalizations and clinical severity in recent onset schizophrenia: a mirror-image study in real-world clinical setting
Vjekoslav Peitl 1, 2, Branka Aukst Margetić 1, 2, Branka Vidrih 1, 2, Dalibor Karlović 1, 2*
1Department of Psychiatry, University Hospital Center Sestre milosrdnice, Zagreb, Croatia, 2Catholic University of Croatia, Zagreb, Croatia
Received: December 3, 2020; Revised: January 20, 2021; Accepted: January 23, 2021; Published online: January 23, 2021.
© The Korean College of Neuropsychopharmacology. All rights reserved.

Background: Schizophrenia is a debilitating disease that disrupts the lives of many affected individuals and exerts a toll on the health system. Only few studies assessed once-monthly injectable formulation of paliperidone palmitate (PP-1M) and other long-acting antipsychotics in recent onset schizophrenia (ROS).
Aims: To evaluate whether PP-1M is efficacious in reducing frequency and length of hospitalizations and psychosis symptom severity in patients with ROS.
Methods: This mirror-image study included 112 patients, suffering from ROS admitted in a psychiatric ward and successively treated with PP-1M for 1-year. Other psychotic disorders were excluded. We collected socio-demographic data of all subjects included, number and days of hospitalization, as well as Clinical Global Impression-Severity scale (CGI-S) and Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS) scores at the initiation and after 1-year of PP treatment.
Results: After 1-year PP-1M treatment, mean scores of both CGI and CRDPSS significantly decreased (p < 0.001), as well as the mean number of hospitalizations (p = 0.002) and total hospitalization days (p < 0.001) in comparison with those of the previous year.
Conclusion: Our results suggest that PP-1M can be considered as an important therapeutic option in patients with ROS. Its use led to a meaningful reduction in the patient's use of hospital services, as well as a significant clinical improvement of psychotic symptoms in our sample.
Keywords: Paliperidone Palmitate, Psychotic Disorders, Antipsychotic Agents, Pragmatic Clinical Trials