New treatment option for adolescents with schizophrenia

The licensing of Invega (paliperidone) has been extended to include children from 15 years old with schizophrenia.

Extrapyramidal symptoms are more common in adolescents than in adults taking Invega.
Extrapyramidal symptoms are more common in adolescents than in adults taking Invega.

The recommended starting dose for Invega in adolescents is 3mg once daily given in the morning. For adolescents weighing less than 51kg the maximum daily dose of the atypical antipsychotic is 6mg and for those weighing 51kg or more the dose can be increased to a maximum of 12mg daily. If a dose increase is required it should occur in increments of 3mg daily at intervals of 5 days or more.

Monitoring requirements

Although the safety profile of paliperidone in adolescents is similar to that seen in adults, there is a difference in the frequency of some adverse effects. Sedation, as an effect of paliperidone, should be closely monitored in adolescents. In younger patients it may be advantageous to change the time of administration.

Galactorrhoea occurs more commonly in adolescents than in adults and is suggestive of increased prolactin levels. Prolonged hyperprolactinaemia could affect height, weight, sexual maturation and menstrual functioning; these parameters should be monitored in adolescents taking Invega.

Invega is already indicated for the treatment of schizophrenia and psychotic or manic symptoms of schizoaffective disorder in adults. 

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