Paliperidone Long-Acting Injections in Huntington's Disease for Motor and Behavioural Disturbances

Clinical Drug Investigation
Nameer van Oosterom, Theo Theodoros

Abstract

Oral antipsychotics are used to treat motor and behavioural disturbances in Huntington's disease (HD). However, patients with behavioural disturbances are often non-compliant, thus the oral route is inappropriate. The effects of antipsychotic long-acting injections (LAI) in HD are significantly underrepresented in literature. Paliperidone LAI (P-LAI), an atypical antipsychotic, has benefits over other antipsychotics LAI with its long dosing interval and no initial oral overlap, but has no documented cases for this indication. This case of a 45-year-old female highlights the use of P-LAI for severe aggression and chorea secondary to HD causing failed placement in assisted-care accommodation and mobility via an electronic-wheelchair. Three weeks after commencing treatment, she could walk unassisted, and displayed no aggression. After 10 months, she still had significant improvements and resided in the same accommodation for 6 months without any concern. Thus, this case suggests that P-LAI may be a treatment option for non-compliant HD patients.

References

Feb 26, 2008·Annals of Clinical Psychiatry : Official Journal of the American Academy of Clinical Psychiatrists·Kevin DuffJane S Paulsen
Jun 11, 2008·Journal of Psychopharmacology·L Waddell, M Taylor
Jul 13, 2013·Frontiers in Neuroscience·Jane Y ChenMichael S Levine
May 7, 2015·Drugs in R&D·Maria Corena-McLeod
Nov 20, 2018·The Lancet. Psychiatry·Vernon Anthony Barnes

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Citations

May 7, 2020·Frontiers in Endocrinology·Samantha Alvarez-HerreraLenin Pavón
Jan 26, 2021·International Clinical Psychopharmacology·Hervé JavelotCoraline Hingray

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