Subject: A retrospective, cross-sectional observational survey study to analyse the role of Paliperidone injection in patients with schizophrenia.
Schizophrenia is a psychiatric brain disorder characterized by multiple symptom domains, including positive symptoms (e.g. hallucinations, delusions), negative symptoms (e.g. emotional apathy, lack of drive), and cognitive deficits (e.g. impaired memory). The early onset of the disease, along with its chronic course, make it a disabling disorder for many patients and their families.1
Schizophrenia occurs worldwide, and for decades it was generally thought to have a uniform lifetime morbid risk of 1% across time, geography, and sex. In 2017, 3•5 million people had schizophrenia in India and it contributed to 9.8% to DALYs due to mental disorders in India. The prevalence of schizophrenia increased swiftly in young age groups, peaked in the 35–44 years age group.2
Antipsychotic medications are effective for reducing psychotic symptoms in acute episodes of schizophrenia. The selection of medication should be based on a person’s past response to medication, the side effects that might be particularly harmful in individual circumstances, and routes of administration. Except for clozapine, most of the currently used antipsychotic medications have similar efficacy; however, they differ in side effects. Antipsychotic medications are effective when the levels in the central nervous system are sufficient to occupy approximately 70% of D2 receptors.3 But there is no evidence that increasing doses of an antipsychotic medication to achieve receptor occupancies above these levels will lead to increased efficacy, but higher doses increase the risk of adverse effects
Despite improved tolerability, adherence to oral SGAs did not prove any better than to oral FGAs. LAI-SGAs (long acting injection) were developed once again to improve adherence rates. Thus, the goal of LAI treatment has remained the same, to improve adherence as a means to reduce the risk of symptom exacerbation, relapse and hospitalisation4
Several studies have shown that LAI-APs may reduce the risk of relapse and hospitalisation. There is also some preliminary evidence that LAIs may reduce comorbid violent behaviour in patients with schizophrenia
Paliperidone palmitate once-monthly long-acting injection (PP-LAI) has been approved for the treatment of schizophrenia by the Food and Drug Administration in 2009 and by the European Medicines Agency in 2011. PP-LAI is hydrolysed to paliperidone, the primary active metabolite of risperidone. The PP-LAI mechanism of action is a combination of central dopamine D2 and serotonin 5HT2A receptor antagonism. As well, PP-LAI showed an antagonism for α1 and α2-adrenergic receptors and, to a lesser extent, for H1 histaminergic receptors, without affinities for cholinergic or muscarinic receptors.
Paliris LA (Paliperidone) injections are marketed by Sun Pharmaceutical Industries Ltd. Although every product is marketed only after regulatory approval, it is important to know how it performs in day-to-day practice of individual medical practitioners. For this purpose, we have planned to conduct a retrospective, cross-sectional, observational survey to assess the role of Paliperidone injection in patients with schizophrenia.
We invite you to participate in this data collection activity. All you need to do is to report on a standard form your experience with Paliperidone in the normal course of your practice. If you agree to participate, you will need to fill data collection forms (which we call DCF).
We trust you and we are partners in promoting safe and effective drug therapy. In that spirit we hope you will consent to participate in this study. If you do, please sign and return the enclosed reply along with your visiting card for accuracy of records.
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