Past Issues

Paliperidone Palmitate for Obsessive-compulsive Symptoms in a Patient with Schizophrenia: An Alternative Choice?

Yun-Shih Lin, Kuo-Tung Chiang, Yueh-Ming Tai

Mr. Chen, a 39-year-old male patient, was diagnosed with schizophrenia when he first admit-ted to our ward during June to August 2003 due to a cluster of disorganized symptoms including paranoid and reference delusion, self-talking, so-cial withdrawal, and aggressive behavior. Meanwhile, He also sustained some obsessive compulsive (OC) symptoms such as repetitive hand-washing, although those symptoms were improved after taking with risperidone. But dur-ing the next eight years due to his poor insight and drug incompliance, Mr. Chen had been admitted repeatly to our hospital for four times. Inspite that he accepted injection of risperidone (25 mg/2 weeks), zuclopenthixol (200 mg/2 weeks), and haloperidol (50 mg/2 weeks) as well as oral amis-ulpride (400 mg/day), his persecutory delusion, arguing with family and violence were persisted with little improvement. Besides, the ritual behav-iors recurred and occupied most of his time, in-cluding compulsive drinking, repeating lying and sitting up on bed, taking tissue paper for sneezing. Those OC symptoms were persisted even under the medication of serotonin specific reuptake in-hibitor (fluoxetine 40 mg/day). In January 2011, he received injection of paliperidone palmitate (150 mg initially, 1 week later 100 mg/month). During the first two weeks of treatment course, his self-care and interfering behavior were mildly im-proved. After a four-week treatment, his occupa-tional function and OC symptoms were dramati-cally improved. As evaluated by the Yale-Brown Obsessive Compulsive Scale (YBOCS), his OC symptoms were rated from a score of 32 before to a score of 6 after a four-week treatment with pali-peridone palmitate. Despite the akathisia had been noticed, his OC symptoms were kept improving in the next one year, under medication with paliperi-done palmitate and finally worked well at a conve-nient store.
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Editorial Committe, Taiwanese Journal of Psychiatry
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