Invega (paliperidone) is now indicated for the treatment of psychotic or manic symptoms of schizoaffective disorder following a recent licence extension. The atypical antipsychotic is also indicated in the treatment of schizophrenia.
The recommended dose for the new indication is 6mg once daily, adjusted according to response in 3mg increments at minimum four-day intervals up to a maximum of 12mg once daily. The dose should be reduced in renal impairment. Invega is not recommended for use in patients younger than 18 years and should be used with caution in severe hepatic impairment.
The efficacy of Invega in schizoaffective disorder was assessed in two six-week placebo-controlled trials involving adults with a Positive and Negative Syndrome Scale (PANSS) score of ≥60 and prominent mood symptoms (score of ≥16 on the Young Mania Rating Scale [YMRS] and/or Hamilton Rating Scale 21 for Depression). A dose range of 3-12mg daily was assessed in one study while two dose levels (12mg daily reducing to 9mg if required and 6mg daily reducing to 3mg if required) were assessed in the other.
Pooled data from the two studies showed that Invega improved psychotic and manic symptoms of schizoaffective disorder at the study endpoint relative to placebo when given as monotherapy or in combination with mood stabilisers and/or antidepressants. However, the overall magnitude of effect in terms of PANSS and YMRS scores was greatest when paliperidone was used as monotherapy.
Further Information: Janssen Ltd