The influence of switching from risperidone to paliperidone on the extrapyramidal symptoms and cognitive function in elderly patients with schizophrenia: A preliminary open-label trial

Abstract

Objective. This study was to evaluate the effects on clinical symptoms and cognitive function of switching the treatment of elderly patients with schizophrenia from risperidone to paliperidone (PAL). Methods. This study was a 12-weeks, preliminary open-label trial. The subjects were 17 inpatients. Their extrapyramidal symptoms (EPS) were assessed using the Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS), Abnormal Involuntary Movement Scale (AIMS), and Barnes Akathisia Scale (BAS), and their cognitive function was assessed using the Brief Assessment Cognition in Schizophrenia: Japanese language version (BACS-J), and their clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression-Severity of illness scale (CGI-S) at the 0 and 12 weeks. Results. The DIEPSS and BAS significantly improved after switching from risperidone to PAL. Furthermore, improvement was found on AIMS. The mean change from baseline in z-score of the digit sequencing task was significantly increased. All items on the PANSS and CGI-S were not significant; however, changes in some cognitive function were correlated with changes in EPS. Conclusions. The results of this study suggest the possibility that switching elderly patients from risperidone to PAL may have improved pre-existing EPS, and may also have helped improve working memory.

Key words::

• Paliperidone
• extrapyramidal symptoms
• working memory
• elderly schizophrenia
• risperidone

Acknowledgements

None.

Statement of interest

Dr Matsumoto has received grant supports from Yoshitomiyakuhin, GlaxoSmithKline, Dainippon Sumitomo, Pfizer, Meiji Seika, Janssen, Mitsubishi Tanabe, and Otsuka as well as honoraria for Lilly, Novartis, Yoshitomiyakuhin, GlaxoSmithKline, Dainippon Sumitomo, Pfizer, Meiji Seika, Otsuka, and Janssen. Dr M. Mikami has received grant to participate in a national meeting from Tokai University School of Medicine. Dr Suzuki has received payment from Janssen, and Dainippon Sumitomo for lectures. Dr Gen received payment from Janssen for lecture. Dr Inoue has received payment from Eisai for lecture. Dr Hibino has received payment from Janssen, Lilly, Otsuka, and GlaxoSmithKline for lectures. Dr Matsumoto has received payment from Janssen, Lilly, Astellas, Otsuka, and Yoshitomiyakuhin for lectures. Dr M. Mikami has received payment from Janssen, Otsuka, Astellas, and Yoshitomiyakuhin for lectures. Dr A. Mikami has no conflict of interest.