The purpose of this research study is to compare the "real-world" effectiveness of two FDA-approved and widely used long-acting injectable antipsychotic medications (paliperidone palmitate and haloperidol decanoate) in patients with schizophrenia or schizoaffective disorder who are expected to benefit from the improved medication compliance associated with injectable medications. The goal is to evaluate the effects of the medications on outcomes of importance to patients (relapse, symptoms, adverse effects, functioning) as well as policy makers (all of the above plus costs).
The purpose of this comparative effectiveness research study is to learn more about different medications called antipsychotics that are used to treat schizophrenia or schizoaffective disorder. Specifically, we are looking at long-acting medications that are given by injection every month, instead of being taken by mouth every day. In this multi-site study, we are comparing the risk and benefits of two FDA-approved long-acting injectable medications (paliperidone palmitate and haloperidol decanoate). Study participants with schizophrenia or schizoaffective disorder are expected to benefit from the improved medication schedule. This study aims to enroll 360 individuals with schizophrenia or schizoaffective disorder for whom treatment with a long-acting injectable antipsychotic medication is likely to be helpful. Study participants will be randomly assigned to treatment with either paliperidone palmitate and haloperidol decanoate for up to 24 months. Participants will have an equal chance of being assigned to each medication, however participants will not know which medication they are taking.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
TRIPLE
Enrollment
311
haloperidol decanoate injections, 25-200 mg once a month
Paliperidone palmitate injections, 39 mg - 234 mg once a month
VA Palo Alto Heathcare Systems
Palo Alto, California, United States
Yale University/Connecticut Mental Health Center
New Haven, Connecticut, United States
University of Miami School of Medicine
Miami, Florida, United States
Medical College of Georgia
Augusta, Georgia, United States
University of Iowa Hospital
Iowa City, Iowa, United States
Clinical Research Institute
Wichita, Kansas, United States
Clinical Insights, Inc.
Glen Burnie, Maryland, United States
John D. Dingell VA Medical Center
Detroit, Michigan, United States
Sparrow St. Lawrence Hospital, Michigan State University Psychiatry
Lansing, Michigan, United States
Kansas City Veterans Affairs Medical Center
Kansas City, Missouri, United States
...and 12 more locations
Efficacy Failure
Efficacy failure as indicated by psychiatric hospitalization, need for crisis intervention, clinical decision that oral antipsychotic medication cannot be discontinued in less than eight weeks, a clinical decision to discontinue the medication due to inadequate benefit, or the ongoing or repeated need for adjunctive antipsychotic medication.
Time frame: 24 months
Changes in Psychiatric Symptoms
The Positive and Negative Syndrome Scale measures the core symptoms associated with schizophrenia. The measure includes 30 items rated from 1=absent to 7=extremely severe. Full range of scores is 30-210 with higher scores representing more severe illness. Reductions in symptoms over time represent improvement.
Time frame: Baseline to 6 months
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