Pharmacokinetic drug evaluation of paliperidone in the treatment of schizoaffective disorder

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.

Expert opinion: Paliperidone is currently the only medication FDA approved specifically for the treatment of schizoaffective disorder. Paliperidone is an active metabolite of risperidone, 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 12% lower than in healthy subjects while the AUC and CL/F were comparable [14]. In addition, the availability of long acting injectable formulations may be useful for patients who are non-adherent with oral medications. The cost of paliperidone may be a disadvantage.

KEYWORDS:

• Atypical antipsychotic
• paliperidone
• schizoaffective disorder
• pharmacodynamics
• pharmacokinetics

Declaration of interest

M Macaluso has conducted clinical trials research as Principle Investigator for the followingpharmaceutical companies over the last twelve months, Alkermes, Allergan, AssureRx, Eisai, Forum, Lundbeck, Janssen, Naurex/Aptinyx. All clinical trial and study contracts were with and payments made to Kansas University Medical Centre Research Institute, a research institute affiliated with Kansas University School of Medicine Wichita (KUSM-W). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This paper was not funded