Objectives: Second-generation antipsychotics (SGA) are commonly used in several psychopathologies. Paliperidone, a new SGA, offers a potential new treatment option for adolescents, with several advantages including single dosage per day and availability in hepatic problems. In this report, it was aimed to investigate the efficacy and tolerability of paliperidone in a small sample of adolescent inpatients.
Methods: Demographic and clinical variables of eleven adolescents (6 male, 5 female) were evaluated. Of paliperidone, efficacy was assessed with clinical global impression scale-severity (CGI-S) for all cases, Young Mania Rating Scale (YMRS) for those with bipolar disorders, and positive and negative syndrome scale (PANNS) for those with psychosis. Tolerability was assessed with Simpson-Angus Extrapyramidal Side Effects Scale (SAS). Data was analyzed in descriptive statistics (frequency, mean and standard deviation).
Results: The mean age was 16.1 years and mean duration of paliperidone use was 20.1 days. Diagnoses of patients were psychotic disorder (n=5), bipolar disorder (n=3, 2 cases with psychotic symptoms), conduct disorder (n=1), and conduct disorder with comorbid bipolar disorder not otherwise specified (n=2). Mean paliperidone dose was 9.8 mg/day. Mean improvements were 1.2 in CGI-S scores (n=11), 20.3 in PANNS total score (n=7) and 17.8 in YMRS score (n=5). Seven patients had a score higher than 0.3 on SAS (63.6%).
Conclusion: Results showed clinically meaningful improvements in symptom measurements of different disorders. However, side effects should be evaluated regularly in adolescents. Future prospective studies with large samples are needed for definite conclusions.