Clin Psychopharmacol Neurosci.  2016 Aug;14(3):261-269. 10.9758/cpn.2016.14.3.261.

Efficacy and Tolerability of Paliperidone Extended-release in the Treatment of First-episode Psychosis: An Eight-week, Open-label, Multicenter Trial

  • 1Department of Psychiatry, Maeumsarang Hospital, Wanju, Korea.
  • 2Department of Psychiatry, Yeungnam University, Gyeongsan, Korea.
  • 3Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea.
  • 4Department of Psychiatry, Gachon University Gil Medical Center, Gachon University School of Medicine, Incheon, Korea.
  • 5Department of Psychiatry, Konkuk University School of Medicine, Cheongju, Korea.
  • 6Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea.
  • 7Department of Psychiatry, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
  • 8Department of Psychiatry, Kyoungpook National University School of Medicine, Daegu, Korea.
  • 9Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Korea.
  • 10Department of Psychiatry, Hallym University Sacred Heart Hospital, Anyang, Korea.
  • 11Department of Psychiatry, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
  • 12Department of Psychiatry, Chonbuk National University Hospital, Jeonju, Korea.
  • 13Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Jeonju, Korea.


OBJECTIVE: We investigated the efficacy and tolerability of paliperidone extended-release (ER) tablets in patients with first-episode psychosis (n=75).
This was an 8-week, open-label, multicenter trial. The primary outcome variable was scores on the Positive and Negative Syndrome Scale (PANSS); secondary measures included the Scale for the Assessment of Negative Symptoms (SANS), the Cognitive Assessment Interview (CAI), and the Global Assessment of Functioning (GAF). To assess safety, we measured drug-related adverse events, weight, lipid-related variables, and prolactin and administered the Simpson–Angus Rating Scale (SARS), the Abnormal Involuntary Movement Scale (AIMS), the Barnes Akathisia Scale (BAS), the Arizona Sexual Experiences Scale (ASEX), and the Udvalg for Kliniske Undersogelser side effect rating scale (UKU).
The administration of paliperidone ER resulted in significant improvement in the PANSS, SANS, CAI, and GAF scores (p<0.001) over time. This improvement was evident as early as 1 week. The most frequent adverse events were akathisia, somnolence, anxiety, and sedation, which were well tolerated. Modest increases in weight and lipid profiles were also noted. Prolactin levels were substantially increased at the endpoint in both male and female patients.
These results indicate that paliperidone ER is effective and is characterized by good tolerability in the treatment of positive and negative symptoms and cognitive functioning in first-episode psychosis.


Paliperidone extended-release; First-episode psychosis; Efficacy; Tolerability
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