In adults with psychosis, how effective is paliperidone in managing psychosis and reducing psychotic symptoms?
studies included in this evidence summary indicate no clear
differences between the effectiveness of oral paliperidone and
other psychotropic medications (risperidone, olanzapine and
quetiapine) in reducing psychotic symptoms in patients with
schizophrenia. Evidence from two RCTs included in a systematic
review also indicated no significant difference between the
effectiveness of palperidone palmitate injection and long-acting
risperidone injection in reducing psychotic symptoms in patients
with schizophrenia. There was some evidence, from one RCT, that
paliperidone may be more effective than quetiapine in reducing
psychotic symptoms in the very short term (2 weeks) in patients
with schizophrenia, who are experiencing acute exacerbations. A
systematic review of adverse effects indicated that the adverse
effects most frequently experienced by patients treated with
paliperidone are extra-pyramidal symptoms, headache, insomnia,
somnolence, tachycardia and weight gain.
Further research is needed to fully elucidate the comparative
effectiveness of paliperidone and other anti-psychotic medications
in reducing psychotic symptoms in adults. In particular a wider
range of comparisons is needed and studies should include patients
with psychotic symptoms arising from conditions other than
schizophrenia (e.g. bipolar disorder).