Skip to main content
SpringerLink
Log in

Effects on Satisfaction and Service Engagement of Paliperidone Palmitate Compared with Oral Paliperidone in Patients with Schizophrenia: An Open Label Randomized Controlled Trial

  • Original Research Article
  • Published:
Clinical Drug Investigation Aims and scope Submit manuscript

Abstract

Background and Objective

Clinical practice guidelines recommend antipsychotic monotherapy, including oral and long-acting formulations, in the treatment of schizophrenia. This open-label, randomized, controlled trial aimed to evaluate the efficacy and tolerability in patients with schizophrenia of once-monthly long-acting paliperidone palmitate (PP1M) compared with oral paliperidone extended release (ER), with a particular focus on satisfaction, subjective well-being, and service engagement.

Methods

Seventy-two consecutive outpatients with schizophrenia (DSM-5) were randomly assigned for 6 months to: (1) PP1M (50–150 mg equivalent) or (2) paliperidone ER (6–12 mg/day). Participants were assessed at baseline and after 6 months with the Treatment Satisfaction Questionnaire for Medication (TSQM); the Subjective Well-being under Neuroleptics Scale (SWN-K); the Service Engagement Scale (SES); the Clinical Global Impression–Schizophrenia (CGI–SCH); and the Personal and Social Performance (PSP) score. ANOVA repeated measures was performed. Intention-to-treat analysis with last observation carried forward was conducted.

Results

We found a significant within-subjects effect (trial duration) for all rating scale except for cognitive symptoms and the TSQM domain “side effects”. A significant effect between subjects (treatment modality) was found for the CGI negative symptoms, the TSQM domains “overall satisfaction” and “convenience,” and the SES. There were seven drop-outs (9.7%): twi due to hyperprolactinemia and five for lack of compliance.

Conclusions

Significant differences between the two formulations were found. PP1M was superior to paliperidone ER on global treatment satisfaction and convenience, on service engagement, and in reducing negative symptoms.

The trial was registered in the Australian New Zealand Clinical Trials Registry (ANZCTR) with the code: ACTRN12618001113246.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Zipursky RB, Reilly TJ, Murray RM. The myth of schizophrenia as a progressive brain disease. Schizophrenia Bullettin. 2013;39:1363–72.

    Article  Google Scholar 

  2. Kane JM, Kishimoto T, Correll CU. Assessing the comparative effectiveness of long-acting injectable vs. oral antipsychotic medications in the prevention of relapse provides a case study in comparative effectiveness research in psychiatry. J Clin Epidemiol. 2013;66(8 Suppl):S37–41.

    Article  Google Scholar 

  3. Hargarter L, Cherubin P, Bergmans P, Keim S, Rancans E, Bez Y, Parellada E, Carpiniello B, Vidailhet P, Schreiner A. Intramuscular long-acting paliperidone palmitate in acute patients with schizophrenia unsuccessfully treated with oral antipsychotics. Prog Neuropsychopharmacol Biol Psychiatry. 2015. https://doi.org/10.1016/j.pnpbp.2014.11.006.

    Article  PubMed  Google Scholar 

  4. Warner R. Recovery from schizophrenia and the recovery model. Curr Opin Psychiatry. 2009;22(4):374–80.

    Article  Google Scholar 

  5. Pietrini F, Spadafora M, Tatini L, Talamba GA, Andrisano C, Boncompagni G, Manetti M, Ricca V, Ballerini A. LAI versus oral: a case–control study on subjective experience of antipsychotic maintenance treatment. Eur Psychiatry. 2016;37:35–42.

    Article  CAS  Google Scholar 

  6. Awad AG, Voruganti LN. Impact of atypical antipsychotics on quality of life in patients with schizophrenia. CNS Drugs. 2004;18(13):877–93.

    Article  CAS  Google Scholar 

  7. Haro JM, Salvador-Carulla L. The Schizophrenia outpatient health outcome(SOHO) study: implications for the treatment of schizophrenia. CNS Drugs. 2006;20(4):293–301.

    Article  CAS  Google Scholar 

  8. Barbui C, Kikkert M, Mazzi MA, Becker T, Bindman J, Schene A. Comparison of patient and clinician perspectives in the assessment of antipsychotic medication adherence. Psychopathology. 2009;42(5):311–7.

    Article  Google Scholar 

  9. Gharabawi GM, Greenspan A, Rupnow M. Reduction in psychotic symptoms as a predictor of patient satisfaction with antipsychotic medication in schizophrenia: data from a randomized double-blind trial. BMC Psychiatry. 2006;6:45.

    Article  Google Scholar 

  10. Jones PB, Barnes TRE, Davies L, et al. Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia. Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CULASS 1). Arch Gen Psychiatry. 2006;63(10):1079–87.

    Article  CAS  Google Scholar 

  11. Mohamed S, Rosenheck R, McEvoy J, Swartz M, Stroup S, Lieberman JA. Cross-sectional and longitudinal relationships between insight and attitudes toward medication and clinical outcomes in chronic schizophrenia. Schizophr Bull. 2009;35(2):336–46.

    Article  Google Scholar 

  12. Yang F, Li J, Tan YL, Liang WY, Zhang R, Wang N, Feng W, Cai S, Zhuo JM, Zhang LL. Treatment satisfaction with paliperidone extended-release tablets: open-label study in schizophrenia patients dissatisfied with previous antipsychotic medication. Neuropsychiatr Dis Treat. 2017. https://doi.org/10.2147/ndt.s130483.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hofer A, Kemmler G, Eder U, Edlinger M, Hummer M, Fleischhacker WW. Quality of life in schizophrenia: the impact of psychopathology, attitude toward medication, and side effects. J Clin Psychiatry. 2004;65(7):932–9.

    Article  Google Scholar 

  14. Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, Keefe RS, Davis SM, Davis CE, Lebowitz BD, Severe J, Hsiao JK; Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators. 10. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005;353(12):1209–23. Erratum in: N Engl J Med. 2010;363(11):1092–3.

  15. Parellada E, Bioque M. Barriers to the use of long-acting injectable antipsychotics in the management of schizophrenia. CNS Drugs. 2016;30(8):689–701. https://doi.org/10.1007/s40263-016-0350-7.

    Article  CAS  PubMed  Google Scholar 

  16. Kwon JS, Kim SN, Han J, Lee SI, Chang JS, Choi JS, Lee HJ, Cho SJ, Jun TY, Lee SH, Han C, Lee KU, Lee KK, Lee E. Satisfaction of immediate or delayed switch to paliperidone palmitate in patients unsatisfied with current oral atypical antipsychotics. Int Clin Psychopharmacol. 2015;30(6):320–8.

    Article  Google Scholar 

  17. Schreiner A, Caspi A, Bergmans P, Cherubin P, Keim S, Lara E, Pinchuk I, Schuepbach D, Suleman S, Hargarter L. Switching from oral atypical antipsychotic monotherapy to paliperidone palmitate once-monthly in non-acute patients with schizophrenia: a prospective, open-label, interventional study. Psychopharmacology (Berl). 2017;234(1):3–13.

    Article  CAS  Google Scholar 

  18. Isitt JJ, Nadipelli VR, Kouassi A, Fava M, Heidbreder C. Health-related quality of life in acute schizophrenia patients treated with RBP-7000 once monthly risperidone: an 8-week, randomized, double-blind, placebo-controlled, multicenter phase 3 study. Schizophr Res. 2016;174(1–3):126–31.

    Article  Google Scholar 

  19. Bradley GM, Couchman GM, Perlesz A, Nguyen AT, Singh B, Riess C. Multiple-family group treatment for English- and Vietnamese-speaking families living with schizophrenia. Psychiatr Serv. 2006;57(4):521–30.

    Article  Google Scholar 

  20. Roeg D, van de Goor I, Garretsen H. Predicting initial client engagement with community mental health services by routinely measured data. Community Ment Health J. 2015;51(1):71–8.

    Article  Google Scholar 

  21. Boudreaux JG, Crapanzano KA, Jones GN, Jeider TA, Dodge VH, Hebert MJ, Kasofsky JM. Using mental health outreach teams in the emergency department to improve engagement in treatment. Community Ment Health J. 2016;52(8):1009–14

    Article  Google Scholar 

  22. Rossi A, Galderisi S, Rocca P, Bertolino A, Mucci A, Rucci P, Gibertoni D, Aguglia E, Amore M, Andriola I, Bellomo A, Biondi M, Callista G, Comparelli A, Dell’Osso L, Di Giannantonio M, Fagiolini A, Marchesi C, Monteleone P, Montemagni C, Niolu C, Piegari G, Pinna F, Roncone R, Stratta P, Tenconi E, Vita A, Zeppegno P, Maj M, Italian Network for Research on Psychoses. The relationships of personal resources with symptom severity and psychosocial functioning in persons with schizophrenia: results from the Italian Network for Research on Psychoses study. Eur Arch Psychiatry Clin Neurosci. 2017;267(4):285–94.

    Article  Google Scholar 

  23. Hough D, Gopal S, Vijapurkar U, Lim P, Morozova M, Eerdekens M. Paliperidone palmitate maintenance treatment in delaying the time-to-relapse in patients with schizophrenia: a randomized, double-blind, placebo-controlled study. Schizophr Res. 2010;116(2–3):107–17.

    Article  Google Scholar 

  24. Gopal S, Vijapurkar U, Lim P, Morozova M, Eerdekens M, Hough D. A 52-week open-label study of the safety and tolerability of paliperidone palmitate in patients with schizophrenia. J Psychopharmacol. 2011;25(5):685–97.

    Article  CAS  Google Scholar 

  25. Mauri M, Mauri MC, Adami M, Reggiardo G, Giulio C. Efficacy and tolerability of paliperidone ER in patients with unsatisfactorily controlled schizophrenia by other antipsychotics: a flexible-dose approach. Int Clin Psychopharmacol. 2015;30(6):329–37.

    Article  Google Scholar 

  26. Mauri MC, Reggiori A, Paletta S, Di Pace C, Altamura AC. Paliperidone for the treatment of schizophrenia and schizoaffective disorders—a drug safety evaluation. Expert Opin Drug Saf. 2017;16(3):365–79.

    Article  CAS  Google Scholar 

  27. Chen CY, Tang TC, Chen TT, Bai YM, Tsai HH, Chen HL, Huang CJ, Chen CK, Chen CC, Hsiao MC, Liu CY, Yeh HS, Chiu NY, Hsiao CC, Chen CS, Su TP. Efficacy, tolerability, and safety of oral paliperidone extended release in the treatment of schizophrenia: a 24-week, open-label, prospective switch study in different settings in Taiwan. Neuropsychiatr Dis Treat. 2018;14:725–32.

    Article  CAS  Google Scholar 

  28. Emsley R, Parellada E, Bioque M, Herrera B, Hernando T, García-Dorado M. Real-world data on paliperidone palmitate for the treatment of schizophrenia and other psychotic disorders: a systematic review of randomized and nonrandomized studies. Int Clin Psychopharmacol. 2018;33(1):15–33. https://doi.org/10.1097/YIC.0000000000000195.

    Article  PubMed  Google Scholar 

  29. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Arlington: American Psychiatric Association; 2013.

    Book  Google Scholar 

  30. Harrington CA, English C. Tolerability of paliperidone: a meta-analysis of randomized, controlled trials. Int Clin Psychopharmacol. 2010;25(6):334–41.

    Article  Google Scholar 

  31. Atkinson MJ, Sinha A, Hass SL, Colman SS, Kumar RN, Brod M, Rowland CR. Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes. 2004;26(2):12.

    Article  Google Scholar 

  32. Naber D. A self-rating to measure subjective effects of neuroleptic drugs, relationships to objective psychopathology, quality of life, compliance and other clinical variables. Int Clin Psychopharmacol. 1995;10(Suppl 3):133–8.

    PubMed  Google Scholar 

  33. Naber D, Moritz S, Lambert M, Pajonk FG, Holzbach R, Mass R, Andresen B. Improvement of schizophrenic patients’ subjective well-being under atypical antipsychotic drugs. Schizophr Res. 2001;50(1–2):79–88. Erratum in: Schizophr Res. 2002;57(1):125. Rajonk F [corrected to Pajonk FG].

  34. Tait L, Birchwood M, Trower P. A new scale (SES) to measure engagement with community mental health services. J Ment Health. 2002;11(2):191–8.

    Article  Google Scholar 

  35. Guy W. ECDEU Assessment Manual for Psychopharmacology. Clinical Global Impressions. Rockville: National Institute for Mental Health; 1976. p. 218–22.

    Google Scholar 

  36. Haro JM, Kamath SA, Ochoa S, Novick D, Rele K, Fargas A, Rodríguez MJ, Rele R, Orta J, Kharbeng A, Araya S, Gervin M, Alonso J, Mavreas V, Lavrentzou E, Liontos N, Gregor K, Jones PB, SOHO Study Group. The Clinical Global Impression-Schizophrenia scale: a simple instrument to measure the diversity of symptoms present in schizophrenia. Acta Psychiatr Scand Suppl. 2003;416:16–23.

    Article  Google Scholar 

  37. Marchiaro L, Rocca P, LeNoci F, Longo P, Montemagni C, Rigazzi C, Bogetto F. Naturalistic, retrospective comparison between second-generation antipsychotics and depot neuroleptics in patients affected by schizophrenia. J Clin Psychiatry. 2005;66(11):1423–31.

    Article  CAS  Google Scholar 

  38. Morosini PL, Magliano L, Brambilla L, Ugolini S, Pioli R. Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatr Scand. 2000;101(4):323–9.

    CAS  PubMed  Google Scholar 

  39. Levitan B, Markowitz M, Turkoz I, Fu DJ, Gopal S, Alphs L. Benefit-risk assessment of paliperidone oral extended-release tablet versus monthly injectable for maintenance treatment of schizophrenia. Int Clin Psychopharmacol. 2016;31(6):315–22.

    Article  Google Scholar 

  40. Fu DJ, Turkoz I, Walling D, Lindenmayer JP, Schooler NR, Alphs L. Paliperidone palmitate once-monthly maintains improvement in functioning domains of the Personal and Social Performance scale compared with placebo in subjects with schizoaffective disorder. Schizophr Res. 2018;192:185–93.

    Article  Google Scholar 

  41. Liu M, Liu X, Miao X, Gao X. Effects of paliperidone extended-release tablets and risperidone on cognitive function in patients with first-episode schizophrenia. Chin J New Drugs. 2012;21(4):419–22.

    CAS  Google Scholar 

  42. Suzuki H, Inoue Y, Mikami K, Gen K. The influence and changes in the dosages of concomitantly used psychotropic drugs associated with the discontinuation of donepezil in severe Alzheimer’s disease with behavioral and psychological symptoms on dementia: a preliminary open-label trial. Int J Psychiatry Clin Pract. 2014;4(1):37–42.

    Google Scholar 

  43. Chen F, Zhou H, Lu Z. Cognitive effect of flexible-dose oral paliperidone extended-release tablets in treating acute schizophrenia. Chin J New Drugs. 2012;21(19):2297–301.

    CAS  Google Scholar 

  44. Shi C, Yu X, Kang L, et al. Paliperidone ER treatment and the improvement of social and cognitive function in patients with schizophrenics—a 24-week, single arm, open-label study. Schizophr Res. 2014;153(Suppl 1):S118.

    Article  Google Scholar 

  45. Shi C, Yao SQ, Xu YF, Shi JG, Xu XF, Zhang CP, Jin H, Yu X. Improvement in social and cognitive functioning associated with paliperidone extended-release treatment in patients with schizophrenia: a 24-week, single arm, open-label study. Neuropsychiatr Dis Treat. 2016;24(12):2095–104.

    Article  Google Scholar 

  46. Takekita Y, Koshikawa Y, Sakai S, Sunada N, Onohara A, Nishida K, Yoshimura M, Kato M, Serretti A, Kinoshita T. Cognitive function and risperidone long-acting injection vs. paliperidone palmitate in schizophrenia: a 6-month, open-label, randomized, pilot trial. BMC Psychiatry. 2016;16:172.

    Article  Google Scholar 

  47. Zhang L, Li J, Zhao Y, Su Y, Si T. Critical evaluation of paliperidone in the treatment of schizophrenia in Chinese patients: a systematic literature review. Neuropsychiatr Dis Treat. 2016;11(12):113–31.

    Google Scholar 

  48. Kane J. Progress defined—short-term efficacy, long-term effectiveness. Int Clin Psychopharmacol. 2001;16(Suppl 1):S1–8.

    Article  Google Scholar 

  49. Awad AG, Voruganti LN. The impact of newer atypical antipsychotics on patient-reported outcomes in schizophrenia. CNS Drugs. 2013;27(8):625–36.

    Article  Google Scholar 

  50. Schreiner A, Aadamsoo K, Altamura AC, Franco M, Gorwood P, Neznanov NG, Schronen J, Ucok A, Zink M, Janik A, Cherubin P, Lahaye M, Hargarter L. Paliperidone palmitate versus oral antipsychotics in recently diagnosed schizophrenia. Schizophr Res. 2015;169(1–3):393–9.

    Article  Google Scholar 

  51. Hasan A, Falkai P, Wobrock T, Lieberman J, Glenthøj B, Gattaz WF, Thibaut F, Möller HJ. World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: update 2012 on the long-term treatment of schizophrenia and management of antipsychotic-induced side effects. World J Biol Psychiatry. 2013;14(1):2–44.

    Article  Google Scholar 

  52. Staring AB, Van der Gaag M, Koopmans GT, Selten JP, Van Beveren JM, Hengeveld MW, Loonen AJ, Mulder CL. Treatment adherence therapy in people with psychotic disorders: randomised controlled trial. Br J Psychiatry. 2010;197(6):448–55.

    Article  CAS  Google Scholar 

  53. Weiden PJ, Olfson M. Cost of relapse in schizophrenia. Schizophr Bull. 1995;21(3):419–29.

    Article  CAS  Google Scholar 

  54. Adams T. The conversational and discursive construction of community psychiatric nursing for chronically confused people and their families. Nurs Inq. 2001;8(2):98–107.

    Article  CAS  Google Scholar 

  55. Leucht C, Heres S, Kane JM, Kissling W, Davis JM, Leucht S. Oral versus depot antipsychotic drugs for schizophrenia–a critical systematic review and meta-analysis of randomised long-term trials. Schizophr Res. 2011;127(1–3):83–92.

    Article  Google Scholar 

  56. Tiihonen J, Haukka J, Taylor M, Haddad PM, Patel MX, Korhonen P. A nationwide cohort study of oral and depot antipsychotics after first hospitalization for schizophrenia. Am J Psychiatry. 2011;168(6):603–9.

    Article  Google Scholar 

  57. Kim SW, Lee YH, Jang JE, Yoo T, Kim JM, Shin IS, Yoon JS. Comparison of attitudes toward long-acting injectable antipsychotics among psychiatrists and patients. Int Clin Psychopharmacol. 2013;28(2):80–6.

    Article  Google Scholar 

  58. Carbon M, Correll CU. Thinking and acting beyond the positive: the role of the cognitive and negative symptoms in schizophrenia. CNS Spectr. 2014;19(Suppl 1):38–52.

    PubMed  Google Scholar 

  59. Barrio P, Batalla A, Castellví P, Hidalgo D, García M, Ortiz A, Grande I, Pons A, Parellada E. Effectiveness of long-acting injectable risperidone versus oral antipsychotics in the treatment of recent-onset schizophrenia: a case–control study. Int Clin Psychopharmacol. 2013;28(4):164–70.

    PubMed  Google Scholar 

  60. Schreiner A, Svensson A, Wapenaar R, Cherubin P, Princet P, Serazetdinova L, Zink M. Long-acting injectable risperidone and oral antipsychotics in patients with schizophrenia: results from a prospective, 1-year, non-interventional study (InORS). World J Biol Psychiatry. 2014;15(7):534–45.

    Article  Google Scholar 

  61. Stevens GL, Dawson G, Zummo J. Clinical benefits and impact of early use of long-acting injectable antipsychotics for schizophrenia. Early Interv Psychiatry. 2016;10(5):365–77.

    Article  Google Scholar 

  62. Hargarter L, Bergmans P, Cherubin P, Keim S, Conca A, Serrano-Blanco A, Bitter I, Bilanakis N, Schreiner A. Once-monthly paliperidone palmitate in recently diagnosed and chronic non-acute patients with schizophrenia. Expert Opin Pharmacother. 2016;17(8):1043–53.

    Article  CAS  Google Scholar 

  63. Schreiner A, Bergmans P, Cherubin P, Hargarter L. The effect of long-acting paliperidone palmitate once-monthly on negative and depressive symptoms in patients with schizophrenia switched from previous unsuccessful treatment with oral aripiprazole. Ther Adv Psychopharmacol. 2017;7(2):59–65.

    Article  CAS  Google Scholar 

  64. Velligan DI, Alphs L, Lancaster S, Morlock R, Mintz J. Association between changes on the Negative Symptom Assessment scale (NSA-16) and measures of functional outcome in schizophrenia. Psychiatry Res. 2009;169(2):97–100.

    Article  Google Scholar 

  65. Tzimos A, Samokhvalov V, Kramer M, Ford L, Gassmann-Mayer C, Lim P, Eerdekens M. Safety and tolerability of oral paliperidone extended-release tablets in elderly patients with schizophrenia: a double-blind, placebo-controlled study with six-month open-label extension. Am J Geriatr Psychiatry. 2008;16(1):31–43.

    Article  Google Scholar 

Download references

Author information

Author notes

  1. Paola Bozzatello and Silvio Bellino contributed equally to the study and are equal first authors.

Authors and Affiliations

  1. Center for Personality Disorders, Department of Neuroscience, “Rita Levi Montalcini”, University of Turin, Via Cherasco 11, 10126, Turin, Italy

    Paola Bozzatello & Silvio Bellino

  2. Department of Neuroscience, “Rita Levi Montalcini”, University of Turin, Turin, Italy

    Irene Mancini, Luisa Sandei & Paola Rocca

  3. Department of Mental Health, A.S.L. TO 3, Turin, Italy

    Enrico Zanalda

  4. Department of Neuroscience and Mental Health, S.S. D. Coordinamento Assistenziale Psichiatrico Ospedale-Territorio, A.O.U. Città della Salute e della Scienza di Torino-Molinette, Turin, Italy

    Paola Rocca

Authors
  1. Paola Bozzatello
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Silvio Bellino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Irene Mancini
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Luisa Sandei
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Enrico Zanalda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Paola Rocca
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Silvio Bellino.

Ethics declarations

Funding

This study was supported by Ministero dell’Istruzione, dell’Università e della Ricerca - MIUR projects “Dipartimenti di Eccellenza 2018-2022” of the Department of Neuroscience “Rita Levi Montalcini”.

Conflict of interest

The authors declare that they have no conflicts of interest.

Informed consent and ethics approval

Each patient participated voluntarily in the study after providing written informed consent. Declaration of Helsinki guidelines (1964) were followed. Ethical approval was obtained from the ethics committee of A.O.U. “Città della Salute e della Scienza-A.O. Ordine Mauriziano-A.S.L.” of Turin.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bozzatello, P., Bellino, S., Mancini, I. et al. Effects on Satisfaction and Service Engagement of Paliperidone Palmitate Compared with Oral Paliperidone in Patients with Schizophrenia: An Open Label Randomized Controlled Trial. Clin Drug Investig 39, 169–178 (2019). https://doi.org/10.1007/s40261-018-0734-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40261-018-0734-1

Search

Navigation