Paliperidone Linked to Better Outcomes Than Oral Antipsychotic Agents for Schizophrenia

Researchers assessed adherence to treatment and hospital readmission rates in patients undergoing treatment with oral antipsychotics vs LAI paliperidone for schizophrenia.

The following article is a part of conference coverage from Psych Congress 2021 , held October 29th through November 1, 2021, in San Antonio, Texas. The team at Psychiatry Advisor will be reporting on the latest news and research conducted by leading experts in psychiatry. Check back for more from the Psych Congress 2021.


Treatment with paliperidone palmitate 1- and/or 3-month (PP1M/PP3M) was found to be  associated with better outcomes and lower hospital readmission rates among individuals with schizophrenia compared with treatment with oral antipsychotics (OAP), according to study results recently presented at Psych Congress 2021, held from October 29 to November 1, 2021, in San Antonio, Texas.

This study included 295 adults (average age, 39.7±12.3 years; 48.8% women) with a diagnosis of schizophrenia, all of whom were covered by Oklahoma Medicaid. Among these individuals, 62% were treated with PP1M/PP3M, and 38% were treated with OAP, with all treatments being administered between 2016 and 2020. A multivariable, machine-learning lasso regression was used to assess 30-day readmission rates and outcomes of medication adherence (45-day treatment gaps and proportion of days covered [PDC]) with adjustments for schizophrenia type, prescriber characteristics, Deyo-Charlson Comorbidity Index, duration of follow-up, index year, other mental health diagnoses, year since first schizophrenia diagnosis, and demographics).

The researchers used a multivariable regression model to reveal that those with PDC of at least 80% had 65.9% lower odds of readmission (P <.01). Those with a 45-day treatment gap were 2.7-times more likely to be readmitted (P <.01). OAP-treatment switches correlated with 18.5% lower PDC compared with PP1M/PP3M, as well as 92.3% more 45-day treatment gaps and a 1.9-fold greater risk for 30-day readmission (P <.05).

The study authors concluded that Medicaid members experienced “improved outcomes with PP1M/PP3M compared [with] OAP-treatment switches, with significantly lower adjusted odds of readmission associated with higher adherence.”

Disclosure: This clinical trial was supported by Janssen Scientific Affairs, LLC. Please see the original reference for a full list of authors’ disclosures.


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Nguyen MM, Dickson MC, Patel C, Grabich SC, Benson C, Skrepnek GH. Adherence and readmissions associated with paliperidone palmitate 1- and 3-month versus oral antipsychotic agent treatment switches among adult Medicaid members diagnosed with schizophrenia. Presented at: Psych Congress 2021; October 29-November 1, 2021; San Antonio, Texas. Abstract 141.