Long-term Effectiveness and Tolerability Profile of Iloperidone in Patients of Psychosis
Abhinav Kuchhal, Shivangna Singh, Hari OK Singh, Alka Yadav, Imran Zaheer
Citation Information :
Kuchhal A, Singh S, Singh HO, Yadav A, Zaheer I. Long-term Effectiveness and Tolerability Profile of Iloperidone in Patients of Psychosis. Int J Adv Integ Med Sci 2017; 2 (2):78-84.
To evaluate the long-term efficacy, tolerability, and safety profile of iloperidone.
Materials and methods
A 12 month, prospective, interventional, open label, flexible dose study was conducted on 50 drug naïve, first-episode patients aged 18 to 65 years, fulfilling the International Classification of Diseases-10 criteria for psychosis, for assessing long-term efficacy and adverse events, including biochemical parameters of iloperidone. Detailed clinical examination was carried out. Sociodemographic data and baseline parameters were recorded.
Results
Two patients dropped out during the course of therapy. M/F ratio was 1.77:1. Mean age of patients was 28.76 ± 10.28 [mean ± standard deviation (SD)] years. Rural/urban ratio was 2.84:1.25. Patients were illiterate, 18 belonged to low socioeconomic class. It was observed that iloperidone was fairly efficacious not only in preventing relapse or aggravation of symptoms but also well restored the patient to almost near-normal till the end point. After 3 months, 20/48 (41.66%) patients showed significant weight gain that was evident. Mean total weight gain from baseline to end point was 2.89 kg and was statistically significant. There was significant rise in body mass index (BMI) but no patient crossed the upper normal limit. Iloperidone did not cause significant rise (p < 0.6955) in fasting blood sugar (FBS), and no significant alterations in total cholesterol (TC), triglyceride, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) cholesterol were recorded. Dizziness was one of the earliest adverse events appearing within 2 to 3 days; others were insomnia, weight gain, increased appetite, anxiety, headache, sedation, etc.
Conclusion
On long-term basis, iloperidone is fairly efficacious and has favorable tolerability profile with modest weight gain and practically no alteration in FBS, and lipid profile as well as absence of extrapyramidal side effects.
How to cite this article
Singh S, Singh HOK, Kuchhal A, Yadav A, Zaheer I. Long-term Effectiveness and Tolerability Profile of Iloperidone in Patients of Psychosis. Int J Adv Integ Med Sci 2017;2(2):78-84.
ICD-10 classification of mental and behavioral disorders. 10th ed. AITBS Publishers; 2007. p. 86-109.
Metabolic side effects of antipsychotic agents: a prospective study in a teaching hospital. NHL J Med Sci 2012;1(1):23-26.
Switching from conventional to novel antipsychotic drugs: results of prospective naturalistic study. Schizophr Res 2002 Oct 1;57(2-3):201-208.
Metabolic syndrome associated with schizophrenia and atypical antipsychotics. Curr Diab Rep 2010 Jun;10(3):209-216.
Schizophrenia, Kaplan and Sadock's synopsis of psychiatry. 10th ed. Lippincott Williams & Wilkins; 2007. p. 467-497.
New generation antipsychotics versus low potency conventional antipsychotics: a systemic review and meta-analysis. Lancet 2003 May 10; 361(9369):1581-1589.
Mechanisms and genetics of antipsychotic associated weight gain. Clin Pharmacol Ther 2011 Jul;90(1):179-183.
Pharmacology of psychosis and mania. In: Brunton LL, Chabner BA, Knollmann BC, editors. Goodman & Gilman's pharmacological basis of therapeutics. 12th ed. New York: McGraw Hill; 2011. p. 417-457.
Cost effectiveness of newer atypical antipsychotics: a review of pharmacoeconomics research evidence. Curr Opin Investig Drugs 2001 Jan;2(1):110-117.
Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005 Sep 22;353(12):1209-1223.
Iloperidone: a clinical overview. J Clin Psychiatry 2011;72 Suppl 1:19-23.
Mechanisms of action of atypical antipsychotic drugs. Implications for novel therapeutic strategies for schizophrenia. Schizophr Res 1991 Mar-Apr;4(2):121-156.
Extended radioligand binding profile of iloperidone: a broad spectrum dopamine/serotonin/norepinephrine receptor antagonist for the management of psychotic disorders. Neuropsychopharmacology 2001 Dec;25(6):904-914.
Randomized comparison of olanzapine versus risperidone for the treatment of first episode schizophrenia: 4 month outcomes. Am J Psychiatry 2006 Dec;163(12):2096-2102.
New age antipsychotic: Iloperidone. Pharmacol Toxicol Biomed Rep 2015;1(2):41-49.
Efficacy of iloperidone in the treatment of schizophrenia initial phase 3 studies. J Clin Psychopharmacol 2008 Apr;28(2 Suppl 1): S4-S11.
Four-week double-blind placebo-and ziprasidone-controlled trial of iloperidone in patients with acute exacerbations of schizophrenia. J Clin Psychopharmacol 2008 Apr;28(2 Suppl 1): S20-S28.
Efficacy of iloperidone is comparable to risperidone in analyses of a placebo- and risperidone-controlled clinical trial for schizophrenia (Poster No. NRI-033). 162nd Annual Meeting American Psychiatric Association; 2009, p. 16-21.
Long term efficacy and safety of iloperidone: results from 3 clinical trials for the treatment of schizophrenia. J Clin Psychopharmacol 2008 Apr;28(2 Suppl 1):S29-S35.
Long term safety and tolerability of iloperidone: results from a 25 week, open-label extension trial. CNS Spectr 2013 Feb;18(1):43-54.
A long-term comparative evaluation of metabolic profile and tolerability of olanzapine versus iloperidone in drug naïve patients of psychosis. Delhi Psychiatr J 2016;19(1):66-77.
Body weight and metabolic adverse effects of asenapine, iloperidone, lurasidone and paliperidone in the treatment of schizophrenia and bipolar disorder: a systematic review and exploratory meta-analysis. CNS Drugs 2012 Sep 1;26(9):733-759.
Safety profile of iloperidone: a pooled analysis of 6-week acute phase pivotal trials. J Clin Psychopharmacol 2008 Apr;28(2 Suppl 1):S12-S19.
Changes in weight and metabolic parameters following long term iloperidone use: a meta-analysis of data from 9 phase II and III trials of iloperidone. Open J Psychiatry 2012 Nov;2(4A):414-422.
Metabolic syndrome in schizophrenia: differences between antipsychotic-naïve and treated patients. J Pharmacol Pharmacother 2013 Jul;4(3):176-186.
Typical and atypical antipsychotics differentially affect long-term incidence rates of the metabolic syndrome in first-episode patients with schizophrenia: a retrospective chart review. Schizophr Res 2008 Apr;101(1-3):295-303.
Iloperidone: a drug for the treatment of schizophrenia. Am J Health Syst Pharm 2011 Feb 15;68(4):301-308.
