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A retrospective, cross-sectional observational survey study to analyse the role of Paliperidone injection in patients with schizophrenia.

Inclusion criteria:

Adult patients diagnosed with symptoms of schizophrenia & prescribed Paliperidone injection as monotherapy.

DEMOGRAPHIC DATA

Initials*

Serial No.*

Age (yr) *

Weight (kgs)*

Gender *

Male Female

Marital status *

Single Married

Name of clinic/hospital*

Date of data collection*

DETAILS OF DIAGNOSIS AND TREATMENT

Diagnosis *

Time since diagnosis*

Newly diagnosed Less than 3 months 3 months to 6 months 6 months to 12 months More than 1 year

Duration of antipsychotic therapy*

Treatment naïve Less than 3 months 3 months to 6 months 6 months to 12 months More than 1 years

Comorbidities, if any

Yes No

Comorbidities, if Yes

Conditions	YES or NO	Year	Months
Depression
Anxiety
Substance use disorder
Mention others if any

Place in therapy *

Use of Paliperidone as monotherapy in:

Naïve patients Switch over from current antipsychotic Other

In case of switchover*

Name of the previous drug

Formulation – Oral Injectable Other

In case of switchover from injectable formulation *

Kindly tick the previous injectable prescribed

Haloperidol

Paliperidone (other brand)

Flupenthixol

Zuclopenthixol

Fluphenazine

Aripiprazole

Risperidone

Other

Dose of Paliperidone Inj.*

25mg 50mg 75mg 100mg 150mg

Reasons for choosing Paliperidone *

Rating scale*

Concomitant medication, if any

Sr. No	Generic Name	Route & Dose	Duration
1
2
3
4
5

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