Mini Review
A Case of Extrapyramidal Symptoms Secondary to Long-Acting Injectable Paliperidone Palmitate
Samer El Hayek, Bernadette Mdawar and Farid Talih*
Department of Psychiatry, American University of Beirut, Lebanon
Farid Talih, Associate Professor of Clinical Psychiatry, Department of Psychiatry, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.
Received Date: November 20, 2019; Published Date: December 04, 2019
Abstract
Paliperidone palmitate is a long-acting injectable formulation of the atypical antipsychotic paliperidone. The once-monthly injection is approved for acute and maintenance therapy of schizophrenia in adults. Extrapyramidal symptoms are a known adverse effect of antipsychotics; incidence rates of EPS with PP are up to 18%. Given its longer half-life and steady blood levels, PP-induced EPS can cause a sustained and serious functional impairment of several months’ duration, significantly impacting the quality of life. We report a case of severe combined EPS following the first injection of PP. Rapid improvement of symptoms occurred after providing a combination of diphenhydramine, trihexyphenidyl, diazepam, and carbidopa/levodopa.
Keywords: Paliperidone palmitate; Long-acting injectable; Side effects; Extrapyramidal symptoms; Carbidopa/levodopa
Abbreviations:PP: Paliperidone Palmitate; EPS: Extrapyramidal Symptoms; LAI: Long-Acting Injectable; NMS: Neuroleptic Malignant Syndrome; SAS: Simpson-Angus EPS Scale; ESRS: Extrapyramidal Symptom Rating Scale; XR: Extended Release; IM: Intramuscular
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Samer El Hayek, Bernadette Mdawar, Farid Talih. A Case of Extrapyramidal Symptoms Secondary to Long-Acting Injectable Paliperidone Palmitate. Arch Neurol & Neurosci. 5(5): 2019. ANN.MS.ID.000621.
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