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Improvement of Behavioural Disorders in a Sample of Persons with Intellectual Disability after Administration of Paliperidone Palmitate

Author(s): Francisco J Zamora-Rodriguez, Idilio Gonzalez-Martinez, Leticia Tolosa-Gutierrez, Juan A. Guisado-Macias, Francisco J Vaz-Leal

Behavioural problems are common in people with an intellectual disability (ID). Psychopharmacological
treatments include several drug groups such as antiepileptics, antidepressants,
and benzodiazepines, although the most extensively used are antipsychotics, especially
risperidone. However, there is little or no literature on the metabolite of its monthly administration
– paliperidone palmitate. The objective of this study was to assess the efficacy and
tolerability of paliperidone palmitate when administered monthly to treat the behavioural
alterations associated with ID.

This was a prospective, observational, open-label, 3-year duration study on adults with intellectual
disabilities (DSM-V criteria) and associated behavioural disorders who had paliperidone
palmitate added to their usual treatment. Pre-treatment and 6 months after starting
the treatment, the participants were given a full blood chemistry panel, and scored on the
Aberrant Behaviour Checklist (ABC) and the UKU side effects scales.

The sample consisted of 34 participants, with a mean age of 40.35 years (18-62), and 64.7% of
them had some concomitant medication at baseline. The mean monthly dose of paliperidone
palmitate was 116.17 mg (75-200 mg). There were statistically significant improvements in all 5
subscales of the ABC scale (being especially strong for irritability and hyperactivity) and in certain
of the metabolic parameters. The treatment was withdrawn in one case due to amenorrhea.

Paliperidone palmitate was associated with significant improvements in behavioural problems
associated with intellectual disability, and was well tolerated. Further studies are necessary
to establish its efficacy and tolerability for this specific population.

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