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• W2561291005 abstract "Owing to the various adverse effects of antipsychotic drugs, including extrapyramidal symptoms (EPS) and cardiovascular diseases, due consideration must be given to minimizing their use in the maintenance phase. Antipsychotic drugs are given by tapering their dose, extending the dosing interval, and so forth, as part of a treatment strategy to minimize the adverse effects while at the same time maintaining efficacy. Here, we report two schizophrenia patients whose long-acting-injections (LAI) dosing intervals were extended from 4 weeks to 6 weeks after they became non-psychotic while undergoing LAI treatment, with the objective of observing their EPS. Two patients were assessed who fulfilled the following criteria for at least 3 months during LAI treatment with stable mental symptoms: (i) Positive and Negative Syndrome Scale (PANSS) total score <75; and (ii) a score <3 for all PANSS parameters, namely, conceptual disorganization, hallucinatory behavior, suspiciousness, and unusual thought content. Informed consent was obtained and the patients’ anonymity has been preserved. The two outpatients were a 24-year-old woman with paranoid schizophrenia (duration of illness, 6 years) who experienced bradykinesia, dystonia, and dyskinesia under paliperidone palmitate LAI treatment (50 mg); and a 58-year-old man with disorganized schizophrenia (duration of illness, 27 years) who experienced bradykinesia, akathisia, and dyskinesia under aripiprazole once-monthly treatment (400 mg). Six months after the LAI dosing intervals were extended from 4 weeks to 6 weeks, the following characteristics improved: PANSS negative score (female patient: 19 to 13; male patient: 26 to 24), Drug-Induced Extrapyramidal Symptoms Scale (female patient: 6 to 3; male patient: 7 to 4), Abnormal Involuntary Movement Scale (female patient: 8 to 4; male patient: 6 to 3), and Barnes Akathisia Scale (female patient: 0 to 0; male patient: 3 to 0). The PANSS Positive score remained unchanged (11 in both). The patients were taking no other drugs. In this study, the LAI dosing intervals were extended from 4 weeks to 6 weeks in order to improve EPS and negative symptoms to some extent during maintenance therapy. The psychiatric symptoms were stable during therapy, leading to improved quality of life and living skills. In clinical practice, the dosing interval is generally prescribed on the basis of serum half-life, although its validity has not been investigated thoroughly. Consistent with previous studies,1 it is suggested that extended dosing intervals of LAI in stabilized schizophrenic patients improve the negative symptoms, bradykinesia, akathisia, dystonia, and dyskinesia, without increasing the risk of a relapse. Consistent with this case report, earlier studies have suggested new treatment possibilities as a result of extending the traditionally prescribed dosing interval of oral antipsychotic drugs.2 Therefore, the results indicate the possibility of lessened adverse effects as a result of extending the dosing interval of LAI in the maintenance phase. Dr Suzuki has received honoraria from Janssen, Otsuka, Dainippon Sumitomo, Shionogi, and Yoshitomiyakuhin. Dr Hibino has received honoraria from Janssen, Lilly, Otsuka, and GlaxoSmithKline. Dr Inoue has received honoraria from Eisai and Meiji. Dr Mikami has received research supports from Mitsubishi Tanabe, Otsuka, Shionogi, and honoraria from Otsuka, Mitsubishi Tanabe, and Lilly." @default.
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• W2561291005 date "2017-02-11" @default.
• W2561291005 modified "2023-10-16" @default.
• W2561291005 title "Benefit of extending the dosing interval of long-acting antipsychotic injections on schizophrenics with extrapyramidal symptoms" @default.
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• W2561291005 doi "https://doi.org/10.1111/pcn.12501" @default.
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