Negative, disorganized and depressive symptoms are among the major unmet needs in the treatment of patients with schizophrenia. The objective of this analysis was to explore the impact of flexibly dosed paliperidone palmitate (PP) on negative and depressive symptoms, disorganized thoughts, subjective well-being and treatment satisfaction in adult non-acute but symptomatic patients with schizophrenia previously unsuccessfully treated with oral antipsychotics.

International, prospective 6-month open-label multicenter study. Outcomes analyzed were changes from baseline to endpoint in negative symptoms, disorganized thoughts and anxiety/depression Marder factors of the Positive and Negative Syndrome Scale (PANSS), patient well-being (Subjective Well-Being with Neuroleptics, short version), and patient treatment satisfaction.

593 patients (intent-to-treat population), 63.1% male, mean age 38.4±11.8 years, 78.6% paranoid schizophrenia, were analyzed. 74.5% of patients completed the study. Mean baseline PANSS negative subscale scores (20.2±5.4) improved significantly by -3.5±5.4 points from baseline to endpoint (95% confidence interval [CI] -3.9;-3.0), the PANSS negative symptoms Marder factor score improved from 19.6±5.6 to 16.1±5.7 (95%CI of change -3.9;-3.1), and the disorganized thoughts Marder factor score improved from 16.2±4.4 to 13.9±4.6 (95%CI -2.6;-1.9). Similarly, the anxiety/depression Marder factor score improved from 9.3±3.1 to 7.6±3.1 (95%CI -2.0;-1.5, all p<0.0001). Subjective well-being (SWN-S) increased from 80.1±17.2 at baseline to 85.5±17.3 at endpoint (95%CI 4.0;6.7), and treatment satisfaction improved significantly from 55.3±19.6 to 63.9±22.8 (95%CI 6.4;11.0, both p<0.0001).

Paliperidone palmitate treatment of non-acute but symptomatic patients with schizophrenia showed significant and clinically relevant improvements in negative and depressive symptoms, disorganized thoughts, subjective well-being and patient treatment satisfaction.