Pharmacokinetic Drug Evaluation of Paliperidone in the Treatment of Schizoaffective Disorder.

Pharmacokinetic Drug Evaluation of Paliperidone in the Treatment of Schizoaffective Disorder.

Expert Opin Drug Metab Toxicol. 2017 Jul 04;:

Authors: Macaluso M, Oliver H, Sohail Z

Abstract
INTRODUCTION: This paper reviews the pharmacokinetics, receptor binding, clinical efficacy and safety of paliperidone in the treatment of patients with schizoaffective disorder. Areas Covered: We reviewed the literature using keywords "paliperidone", "schizoaffective disorder" and "clinical trials" with a focus on seminal data papers and information that is clinically relevant to the treatment of schizoaffective disorder. The purpose of this paper is to provide a clinically oriented review of the pharmacokinetic and pharmacodynamic properties of paliperidone including receptor binding, clinical efficacy, safety and tolerability. This paper is not intended to be a systematic or exhaustive review of the literature on paliperidone. Expert Opinion: Paliperidone is currently the only medication FDA approved specifically for the treatment of schizoaffective disorder. Paliperidone is an active metabolite of risperidone and is minimally metabolized in the liver and is primarily known to be cleared through the kidneys. For this reason, paliperidone could be considered for some patients with schizoaffective disorder who also have hepatic impairment. After correcting for the reduced protein binding that is characteristic of hepatically impaired patients, the Cmax was only 12% lower than in healthy subjects while the AUC and CL/F were comparable [14]. In addition, the availability of long acting injectable formulations of one and three month duration may be useful for patients who are non-adherent with oral medications. The cost of paliperidone may be a disadvantage for some patients. However the cost is decreasing now that paliperidone has become available in a generic formulation.

PMID: 28675307 [PubMed - as supplied by publisher]