Quality of Life With Paliperidone Palmitate for Treatment of Schizophrenia

In part 2 of this video, Gus Alva, MD, Medical Director, ATP Clinical Research, Costa Mesa, California, and his long-time patient, Patrick, continue their discussion on the recent FDA approved a long acting injectable (LAI) paliperidone palmitate administered twice a year, for the treatment of schizophrenia.

Patrick discusses his experience as a patient with schizophrenia, how schizophrenia has affected his daily life, and how this six-month LAI impacts quality of life for patients with schizophrenia.

In the previous part 1, Dr Alva and Patrick discussed the randomized, double-blind, non-inferiority Phase 3 global study which prompted FDA approval, which Dr Alva served as a study investigator on and Patrick participated in.

Read the Transcript:

Patrick, can you discuss how living with schizophrenia has affected your daily life?

Patrick:  I've had a lot of time to come to terms with my illness and how it affects my daily life. I guess maybe I had some cognitive behavioral therapy to reset my manners.

Dealing with schizophrenia in daily life, I hardly feel anything. I've had schizophrenia for so long. The symptoms have come and gone. The treatment has always worked very well. With treatment and proper treatment, it doesn't seem like that big of a deal anymore.

Dr Alva:  One of the big challenges with schizophrenia is that the core symptoms oftentimes involve what people perceive. If they don't know whether what they're hearing, seeing, smelling, tasting, or feeling is true or not, that can be very disconcerting.

Fixed false beliefs including the perception that other people are trying to hurt them, or manipulate them, or deceive them can be very, very vexing and troubling.

Sometimes people end up with disorganized speech or behavior or what is oftentimes dubbed negative symptoms, which include things like the lack of ability to produce speech or be able to have the same emotive state that most people experience. Schizophrenia is a very challenging illness that, unfortunately, is chronic and lifelong.

There's no proven treatment that's available that can irradicate this problem. At best, what we want to do is avoid an exacerbation. For example, Patrick is a testament of the fact that he's not had to be in and out of the hospital. Many people that suffer with schizophrenia are challenged with relapses where they bounce in and out of the hospital.

Oftentimes, people don't necessarily understand fully what the illness entails. They're dealt with in a harsh manner. Fortunately, Patrick is a terrific example of somebody who has followed through with treatment recommendations and has been successful in experiencing life as fully as one can.

Patrick, maybe you can share with us. Part of the reason behind that has been the medicines have been chosen for you but the fact that you've been such a willing participant in this entire process. What are your thoughts?

Patrick:  I know that there's people who respond well to medication. There's also people who don't respond well to medication. I was one who was blessed with being responsive to the medication. I also had a really good family system where everyone had my back. I have a lot of privileges.

Maybe it was a little bit easy for me to come back from a diagnosis as severe as schizophrenia if you have a good system, environment, and things that you need to succeed.

Dr Alva:  So true, Patrick. Thank you for sharing that.

Patrick, do you have any additional thoughts on your expectations of what this twice-yearly treatment will mean for you?

Patrick:  What I told some of the people before was that I was thinking of probably traveling. If I were to leave for 6 months or something or if I were to move -- where I was considering was moving to Arizona -- then I would be able to come back every six months and get another injection. It's a lot more opportunity and freedom to move about.

This is a good treatment option. This is probably the best treatment option for schizophrenia so far. That's just my opinion.

Dr Alva:  Patrick, I feel humbled that right now as you made mention, even in your consideration of moving to Arizona you would think that, "Hey, I only need to travel to see Dr Alva twice a year." The fact that you would want that constancy is humbling and it's highly rewarding for me.

What we're facing with a drug like [paliperidone palmitate]  is that it enables us as clinicians to rethink how we manage a chronic illness like schizophrenia by offering not just the patient but also their loved ones the potential for life that's less defined by taking medicine.

It helps so that we can take a look at addressing some of these critical unmet needs that include treatment adherence concerns and that help us liberate individuals so that they can pursue the things that are more meaningful for them in their lives. Patrick is a testament of the fact that as a team, a doctor and the patient can make such a difference.

Patrick:  That's true. The medication and the support system are the main things for having a successful treatment, at least in my opinion and my personal experience.

Is there any further research being considered, maybe a 9 or 12-month LAI?

Dr Alva: Patrick got started with risperidone. Risperidone is a drug that breaks down to an active ingredient called paliperidone, which is [paliperidone palmitate]. Subsequently, if you can get to the active form of the medicine, that's a better form of medicine.

That's why I shifted Patrick from risperidone over to paliperidone. Subsequently, we took advantage of the fact that paliperidone now was going to be being studied as a once-a-month long-acting injectable, and then 3-month treatment [paliperidone palmitate]every 3 months, and now [paliperidone palmitate]  every 6 months.

Patrick has been a steady passenger and active participant throughout this entire process. I would say that I feel deeply indebted to individuals like Patrick, who have pioneered the space and have opened up so much room for so many more individuals suffering with schizophrenia.

I'm humbled and proud to work with you, Patrick.

Patrick:   I was first on the risperidone before I was on the derivative paliperidone, which is like Dr. Alva was saying is the active ingredient. From the get-go to all the new innovations in the medication, Dr Alva has always redone my subscription for the newest, hippest stuff to come out.

That's why I was chosen for the clinical trials, chosen to be a participant in the campaign. I'm very humbled for you guys as well.