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Risperidone has been approved as an atypical antipsychotic medication for use in adults with schizophrenia, with efficacy demonstrated in clinical trials that compared it with placebo and typical antipsychotics. Risperidone has an oral bioavailability of approximately 50%, and the usual formulation is palmitate, a soft-gelatinous film-coating type of risperidone that is readily absorbed after oral administration. The authors studied the efficacy and safety of switching to paliperidone palmitate in adult patients with schizophrenia who had received risperidone for at least 4 weeks and had been switched to paliperidone palmitate for at least 6 weeks. The authors also investigated the efficacy and safety of switching to paliperidone palmitate in patients who were maintained on antipsychotic medication during periods of dosing interval interruption. After switching to paliperidone palmitate, the Brief Psychiatric Rating Scale (BPRS) total score was significantly improved in patients with schizophrenia in the evaluable sample. The data also showed that conversion to paliperidone palmitate at a dose of 3.5 mg was more effective than the conversion to paliperidone palmitate at a dose of 3 mg in improving the BPRS total score. In the pooled safety analysis, the rate of extrapyramidal symptom (EPS) worsening on paliperidone palmitate was higher than that on oral risperidone. However, the rate of EPS worsening on paliperidone palmitate was not significantly different from that on placebo or oral risperidone. Mean (SD) occurrence of treatment-emergent adverse events, all-cause discontinuation, and serious adverse events were similar across treatments. The results of this study show that switching from risperidone to paliperidone palmitate is effective and safe for patients with schizophrenia. The data also
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