Table 1 Second-generation LAI antipsychotics: comparative profile [25, 26, 71]
Aripiprazole monohydrate | Olanzapine pamoate | Paliperidone palmitate once monthlya | Paliperidone palmitate every 3 monthsb | Risperidone microspheres | Risperidone ISM® | |
|---|---|---|---|---|---|---|
Refrigeration | No | No | No | No | Yes | No |
Approved injection site | Deltoid or gluteal muscle | Gluteal muscle | Deltoid or gluteal muscle | Deltoid or gluteal muscle | Deltoid or gluteal muscle | Deltoid or gluteal muscle |
Dosage forms/strengths | Vial kits: 300 mg, 400 mg | Vial kits: 210 mg, 300 mg, 405 mg | Injectable suspension: 39 mg, 78 mg, 117 mg, 156 mg, 234 mg | Injectable suspension: 273 mg, 410 mg, 546 mg, 819 mg | Vial kits: 12.5 mg, 25 mg, 37.5 mg, 50 mg | Vial kits: 75 mg, 100 mg |
Oral supplementation | -Single injection: 10–20 mg for 2 weeks after the initial injection -Double injection: 20 mg of oral aripiprazole on day 1 | No | No | No | For 3 weeks after the initial injection | No |
Dose interval | 4 weeks | 2 or 4 weeks | Monthly | Every 3 months | 2 weeks | 4 weeks |
Starting dose | -Single injection 400 mg -Double injection on day 1 400 mg (deltoid) + 400 mg (gluteal) | 210 mg/2 weeks 300 mg/2 weeks 405 mg/4 weeks | Double injection 234 mg on day 1 and 156 mg on day 8 (deltoid) | 273, 410, 546, 819 mg (3.5 times the last dose of the one-monthly formulation) | 25 mg | 75–100 mg |
Maintenance dose | 400 mg (300–400 mg) | Up to 300 mg/2 weeks | 117 mg (39–234 mg) | 273–819 mg | 25 mg (25–50 mg) | 75 mg |
Time to peak | 5–7 days | 4 days | 13 days | 30–33 days | 4–6 weeks | 48 h |
Time to steady state | 300 mg: 3–4 months 400 mg: 4–8 months | 3 months | 7–11 months | Continues steady state at equivalent dose | 1.5–2 months | 4 weeks |
Post-injection observation or monitoring | No | Yes or at least 3 h | No | No | No | No |