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1 1* 2* R971 C Clinical guidelines of paliperidone palmitate ZHANG Hong-yan 1 HUANG Ji-zhong 2 SI Tian-mei 1 SHU Liang 1 HAO Wei 3 MEI Qi-yi 4 ZHAO Jing-ping 3 YU Xin 1 ZHANG Ming-yuan 2 1 Peking University Sixth Hospital Peking University Institute of Mental Health Key Laboratory of Mental Health Ministry of Health Peking University Beijing China 2 Shanghai Mental Health Center Shanghai China 3 Institute of Mental Health Xiangya No. 2 Hospital of Central South University Changsha China 4 Suzhou Guangji Hospital Suzhou China Abstract Paliperidone palmitate is an atypical long acting antipsychotics which can fast onset in acute phase and continuously improve the symptoms in maintenance phase. It has the solid efficacy and convenient administration which offer a new option for schizophrenia treatment and will help patients to adhere the treatment and prevent relapse. As the sole long acting antipsychotics with monthly injection it was approved by CFDA in 2011 and indicated for the acute and maintenance treatment of schizophrenia. Based on the published manuscripts and clinical experience CSCG China Schizophrenia Coordination Group organized the experts to write this paper which will discuss the characteristic of paliperidone palmitate on pharmacology applicable patients dosage information and adverse reaction. We hope this clinical usage guideline of paliperidone palmitate could provide the useful suggestion for clinical practice and make more patients get benefits. Key words paliperidone palmitate long acting antipsychotics schizophrenia relapse clinical guideline paliperidone palmitate sally_zhy@ sina. com junghjz@ sina. cn *

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3 9- CYP 2D D 2 5-2A 5-HT 2A K d ng ml % ~ 80% D 2 14 NE α 2 K i NE 5-HT α 2 NE 5-HT 5-HT NE D RS yl -1-yl HT 7-4H- 1 2-a -9-yl- K i HT 7 D 2 DA D 2 13 α 1 H mg mg d 1 d 126 d d 8 10 ng ml % ~ 80% D K i D 3

4 28% AUC 25 ~ 150 mg C max 100 mg % 25% 20 P450 CYP 21 10% CYP 14 CYP450 2D6 19 CYP450 3A4 / ~ 150 mg 25 ~ 49 d kg m - 2 < 25 kg m P

5 EPS ~ ~ mg d mg 75 ~ 150 mg eq mg mg

6 / 150 mg 100 mg 100 mg 75 mg ~ mg 35. 6% mg 39. 2% 2 2 d mg d mg /mg /mg /mg 2 3 ~ 4 5 ~ 6 ~ ~ ~ ~ ~ 800 > ~ ~ 25 > ~ ~ 160 > d 8 2 d d 6 d d 4 ~ /mg 2 /mg ~ 75 mg eq. > 6 < ~ 100mg eq ~ 150 mg eq mg mg d d mg d mg ~

7 % QTc 450 ms kg QTc QTc 470 ms QTc 450 ms < 90 kg EPS ml min - 1 < 80 ml min - 1 d mg 1 75 mg 50 mg < 50 ml min EB/OL ar-5wwnvogtweszgz2x6bta06gkcnfxdlucm_wvlq http / /wenku. baidu. com /link url = YvKGG14YTQ0RQL 5z20oT6u8D4Gqtql6srxAnFQwqeG4cPyQXRs-lfdDjFAQGxvKZc_ 2 LIEBERMAN JA KOREEN AR CHAKOS M et al. Factors influencing treatment response and outcome of first-episode schiz-

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