From the Research
Invega Sustenna (paliperidone palmitate) is a long-acting injectable antipsychotic medication that should be used to treat schizophrenia and schizoaffective disorder, with a recommended initiation regimen of 150 mg eq (234 mg) on day 1 and 100 mg eq (156 mg) on day 8, both administered in the deltoid muscle, due to its efficacy in reducing symptoms of schizophrenia and delaying time to relapse, as demonstrated in clinical trials 1, 2.
Key Points
- Invega Sustenna is typically administered once monthly after initial loading doses, with common maintenance doses ranging from 39-234 mg depending on patient response.
- The medication works by blocking dopamine D2 and serotonin 5-HT2A receptors in the brain, helping to reduce psychotic symptoms like hallucinations and delusions.
- Common side effects include injection site reactions, weight gain, drowsiness, and movement disorders, with a favorable safety and tolerability profile compared to other antipsychotic therapies, such as Aripiprazole monohydrate once-monthly, in terms of extrapyramidal symptoms (EPS) incidence and anticholinergic agent use 3.
- Regular monitoring for metabolic changes (weight, blood glucose, lipids) is necessary, and patients should be aware that full therapeutic effect may take several weeks to develop.
Administration and Dosage
- Treatment begins with two initial injections: 234 mg on day 1 and 156 mg on day 8, both in the deltoid muscle.
- Monthly maintenance injections can be given in either deltoid or gluteal muscles.
Efficacy and Safety
- Invega Sustenna has been shown to be effective in controlling the acute symptoms of schizophrenia and delaying time to relapse, with a significantly longer time to relapse than placebo in patients with schizophrenia 1.
- The medication has a generally acceptable tolerability profile, with no new safety concerns compared to oral paliperidone, except for injection site-related reactions 1, 2.