Pharmacological treatment for schizophrenia is now more accessible to patients

A new treatment for schizophrenia called Invega (Paliperidone) has been added to the Pharmaceutical Benefits Schedule. This move by the government to subsidise Invega will ease the financial burden of treatment, and will increase the pharmacological options available to tackle serious mental illnesses.

What is schizophrenia?

Schizophrenia is a psychiatric illness that is characterised by disturbances in the way an individual thinks, feels and behaves. Schizophrenia can include a range of symptoms such as hallucinations (seeing or hearing things that are not there), delusions (beliefs that are not true), disorganised or odd thinking and emotional disturbances (such as depressed mood). The variability in patients with schizophrenia is very high and one patient may present with symptoms that are quite unlike another patient.

An individual with schizophrenia who has severe symptoms is said to be experiencing an episode of psychosis. Some individuals with schizophrenia may function well or at least better between episodes. Others may continue experiencing severe symptoms for months or years if treatment is not sought.

Pharmacological treatment for schizophrenia is the first line treatment option to address the, often, distressing symptoms. Treatment can reduce the severity of symptoms and improve the personal and social functioning of individuals with schizophrenia.

What is Invega?

Invega (Paliperidone) is an antipsychotic medicine used in the treatment of schizophrenia. Invega is available in dosages of 3, 6, 9 or 12 mg by prescription only. Invega may be used to treat patients in the acute (severe) phase of psychosis, or to help prevent the recurrence of symptoms of schizophrenia. Invega is one of several second-generation (atypical) antipsychotic medications that are collectively considered the most desirable first-line pharmacological treatments for schizophrenia.

How does it work?

Invega works to correct the chemical imbalances associated with psychosis and schizophrenia. As with most anti-psychotic medications, the precise mechanism of action is not well understood. However, Invega is thought to affect the dopamine and serotonin pathways in the brain. Invega is a prolonged release tablet. This means that the effects of the medication are released slowly and consistently over a relatively long time frame.

Several recent studies have found that Invega leads to significant improvements in patients functioning (compared to untreated patients). Patients prescribed Invega over a period of 6 weeks showed improvements in social functioning, a reduction in disorganised thoughts and hostility, and a reduction in positive symptoms (e.g., hallucinations) and an improvement in negative symptoms (e.g., depressed mood). Further research has demonstrated that improvements in symptoms and general functioning can be maintained for a further 2 to 3 months if Invega therapy is continued.

PBS listing details

The price for 28 tablets is $31.30 (or $5 if you qualify for concession). The government absorbs the majority of the manufacture’s charge of $247.93 for 28 tablets.

References

Pharmaceuticals Benefits Schedule [homepage on the Internet]. Canberra: The Commonwealth of Australia, Department of Health and Ageing, 2008. [updated 2008 April 7; cited 2008 May 16]. Available from: http://www.pbs.gov.au/html/consumer/search/results?medicine=invega&form-type=simple
SANE Australia [homepage on the Internet]. Canberra: Schizophrenia Australia Foundation; c2005 [cited 2008 May 18]. Schizophrenia Fact Sheet 2; [About 2 screens]. Available from: http://www.sane.org/information/factsheets/schizophrenia.html
SANE Australia [homepage on the Internet]. Canberra: Schizophrenia Australia Foundation; c2005 [cited 2008 May 18]. Psychosis Fact Sheet 1; [About 2 screens]. Available from: http://www.sane.org/information/factsheets/psychosis.html
Kramer MJ, Simpson G, Maciulis V, Kushner S, Vijapurkar U, Lim P, et al. Paliperidone Extended-Release Tablets for Prevention of Symptom Recurrence in Patients With Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled Study. J. Clin Psychopharmacol 2007; 27:6–14.
Kane J, Canas F, Kramer M, Ford L, Gassmann-Mayer C, Lim P et al. Treatment of schizophrenia with paliperidone extended-release tablets: A 6-week placebo-controlled trial. Schizophr Res. 2006; 90:147-161.
Davidson M, Emsley R, Kramer M, Ford L, Gassmann-Mayer C, Lim P, et al. Efficacy and safety and early response of paliperidone extended release tablets (paliperidone ER): results of a 6-week, randomized, placebo-controlled study. Schizophr Res 2007; 93:117-130.
Marder S, Kramer M, Ford L, Eerdekens E, Lim P, Eerdekens M, et al. Efficacy and Safety of Paliperidone Extended-Release Tablets: Results of a 6-Week, Randomized, Placebo-Controlled Study. Biol. Psychiatry 2007; in press.