Retrospective Chart Review of an Accelerated Initiation Schedule for Long-Acting Injectable Invega Sustenna
Location
Center for Advanced Learning and Simulation (CALS)
Publication Date
April 2025
Start Date
17-4-2025 8:00 AM
Description
Long-acting injectable (LAI) antipsychotics, such as Paliperidone Palmitate (Invega Sustenna), enhance medication adherence and reduce relapse in schizophrenia and schizoaffective disorder. The standard initiation schedule for Invega Sustenna involves a 234 mg intramuscular dose on day 1 followed by 156 mg intramuscular dose on day 8, before transitioning to monthly maintenance injections. However, the multi-day interval can present logistical challenges during hospitalizations, particularly in inpatient and emergency settings. An accelerated schedule administering both doses on consecutive days could improve logistical efficiency and adherence, but its short-term safety remains unexamined. The objective of this retrospective chart review is to evaluate the short-term tolerability of an accelerated Invega Sustenna initiation schedule. Patients received both loading doses on consecutive days, with clinical status monitored for 24 hours postsecond injection, focusing on adverse effects such as extrapyramidal symptoms, cardiovascular reactions, sedation, allergic reactions, and any required medical interventions. None of the 10 patients reviewed exhibited adverse effects within the 24-hour monitoring period, suggesting the accelerated initiation schedule is well tolerated in the short term. This approach may improve treatment adherence, reduce hospitalization length, and enhance logistical efficiency in inpatient and emergency settings. However, limitations include a small sample size and a short follow-up period. Future studies should examine long-term safety, efficacy, and pharmacokinetic differences between the standard and accelerated regimens. These findings support the potential of an accelerated initiation schedule as a viable alternative to the standard regimen.
Recommended Citation
Shields, Matthew MD; Shaikh, Heba MD, MPH; Erwin, Madeline MD; and Hanson, Erik MD, "Retrospective Chart Review of an Accelerated Initiation Schedule for Long-Acting Injectable Invega Sustenna" (2025). Dept. of Psychiatry Research Symposium. 18.
https://digitalscholar.lsuhsc.edu/psych_rd/2025/presentations/18
Retrospective Chart Review of an Accelerated Initiation Schedule for Long-Acting Injectable Invega Sustenna
Center for Advanced Learning and Simulation (CALS)
Long-acting injectable (LAI) antipsychotics, such as Paliperidone Palmitate (Invega Sustenna), enhance medication adherence and reduce relapse in schizophrenia and schizoaffective disorder. The standard initiation schedule for Invega Sustenna involves a 234 mg intramuscular dose on day 1 followed by 156 mg intramuscular dose on day 8, before transitioning to monthly maintenance injections. However, the multi-day interval can present logistical challenges during hospitalizations, particularly in inpatient and emergency settings. An accelerated schedule administering both doses on consecutive days could improve logistical efficiency and adherence, but its short-term safety remains unexamined. The objective of this retrospective chart review is to evaluate the short-term tolerability of an accelerated Invega Sustenna initiation schedule. Patients received both loading doses on consecutive days, with clinical status monitored for 24 hours postsecond injection, focusing on adverse effects such as extrapyramidal symptoms, cardiovascular reactions, sedation, allergic reactions, and any required medical interventions. None of the 10 patients reviewed exhibited adverse effects within the 24-hour monitoring period, suggesting the accelerated initiation schedule is well tolerated in the short term. This approach may improve treatment adherence, reduce hospitalization length, and enhance logistical efficiency in inpatient and emergency settings. However, limitations include a small sample size and a short follow-up period. Future studies should examine long-term safety, efficacy, and pharmacokinetic differences between the standard and accelerated regimens. These findings support the potential of an accelerated initiation schedule as a viable alternative to the standard regimen.