Are schizophrenia patients more likely to discontinue paliperidone palmitate or risperidone microspheres — and why?

BMC PsychiatryScott Cunningham MD PhD, et al. | June 14, 2022



Whether oral or long-acting antipsychotics are prescribed for treatment of schizophrenia, the discontinuation rate is high. Awareness of risk factors for antipsychotic medication discontinuation will increase the efficacy of intervention strategies to curb medication discontinuation.

Risk factors for anti-psychotic treatment discontinuation over a 1-year follow-up period were identified among patients with schizophrenia (n=25,361) enrolled in the IQVIA Longitudinal Prescription database.

The 1-year anti-psychotic discontinuation rates were as follows: paliperidone palmitate injectable (1- and 3-month), 53.8%; and risperidone microspheres, 85.4%.

Patients who were stable on paliperidone palmitate (3-month) had a lower discontinuation rate (19.2%) than patients who were stable on paliperidone palmitate (1-month; 37.1%).

Discontinuation rates were higher when the medication was prescribed by a general practitioner than a psychiatrist (HR = 1.68). Discontinuation rates were higher for females (HR = 1.07) and patients < 30 years of age (HR = 1.05-1.09).