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Chen XM, Jiang ZL, Wu X, Li XG. Lithium carbonate-induced giant goiter and subclinical hyperthyroidism in a patient with schizophrenia: A case report and review of literature. World J Clin Cases 2024; 12:4357-4364. [PMID: 39015924 PMCID: PMC11235530 DOI: 10.12998/wjcc.v12.i20.4357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 05/01/2024] [Accepted: 05/27/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND Lithium carbonate is used to manage various mood disorders, but it can cause thyroid abnormalities, including goiter, hypothyroidism, and hyperthyroidism. In rare cases, it can lead to giant goiter and subclinical hyperthyroidism, which may require surgical intervention in severe cases. CASE SUMMARY This case represents a rare development of giant goiter and subclinical hyperthyroidism in a schizophrenia patient who was subjected to prolonged lithium carbonate treatment. The enlarged thyroid gland caused pressure on the airway and recurrent laryngeal nerve, which led to respiratory distress, hoarseness, and dysphagia. The immediate danger of suffocation required urgent surgical intervention. In this report, we describe the case of a 41-year-old Chinese woman. This sheds light on the etiology and challenges associated with managing a giant goiter. The patient underwent a subtotal thyroidectomy to relieve airway compression and facilitate airway expansion. Prior to the procedure, the patient was given iodine to prepare. Concurrently, changes were made to the psychiatric medication regimen. Following surgery, the patient's respiratory function and vocal cord functionality improved significantly, and her mental state remained stable. CONCLUSION It is essential to monitor thyroid function, test thyroid antibody levels, and perform thyroid ultrasounds consistently in all patients undergoing long-term lithium carbonate treatment. This vigilance helps prevent severe and potentially life-threatening thyroid enlargement.
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Affiliation(s)
- Xing-Ming Chen
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, Guangdong Province, China
| | - Zhi-Li Jiang
- Department of General Surgery, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, Guangdong Province, China
| | - Xiang Wu
- Department of General Surgery, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, Guangdong Province, China
| | - Xu-Guang Li
- Department of General Surgery, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510370, Guangdong Province, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province, The Ministry of Education of China, Guangzhou Medical University, Guangzhou 511436, Guangdong Province, China
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Wang G, Ding F, Chawarski MC, Hao W, Liu X, Deng Q, Ouyang X. Randomized Controlled Trial of Paliperidone Extended Release Versus Risperidone for the Treatment of Methamphetamine-Associated Psychosis in Chinese Patients. Front Psychiatry 2020; 11:237. [PMID: 32296355 PMCID: PMC7141424 DOI: 10.3389/fpsyt.2020.00237] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 03/11/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The efficacy or tolerability of paliperidone extended release (ER) in the treatment of methamphetamine (METH)-associated psychosis (MAP) is unknown. This study was designed to assess the tolerability and efficacy of paliperidone ER and risperidone for the treatment of MAP in China. METHODS This 25-day randomized clinical trial involved 120 patients with acute MAP symptoms who were randomized to receive either paliperidone ER or risperidone from baseline to day 25 of an inpatient hospital stay. The primary outcome was changes in the severity of psychosis, which were assessed using the Positive and Negative Syndrome Scale (PANSS) total score changes from baseline to endpoint. RESULTS Overall, 84% of the patients completed the entire study protocol. The PANSS total score, the Clinical Global Impressions-Severity of Illness scale (CGI-S) score, and a METH craving score assessed by a visual analog scale (VAS) showed statistically significant improvements from baseline for the patients in both groups (p < 0.01). The Simpson-Angus Scale (SAS) and the Barnes Akathisia Rating Scale (BARS) scores increased from baseline during treatment in both groups (p < 0.01); there were statistically significant differences between the treatment groups in the SAS scores (p < 0.01). Measures of hypermyotonia, salivation, and dizziness were significantly higher in the risperidone-treated patients than in the paliperidone ER-treated patients (all p < 0.05). CONCLUSION Paliperidone ER and risperidone had similar efficacy and were generally tolerable in the treatment of MAP; however, paliperidone ER had a more favorable adverse event profile than risperidone, particularly regarding extrapyramidal and prolactin-increasing effects. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, identifier NCT01822730. Full date of first registration:03/28/2013.
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Affiliation(s)
- Gang Wang
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Fan Ding
- Wuhan Wudong Hospital, The Second Mental Hospital of Wuhan, Wuhan, China
| | | | - Wei Hao
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, China National Clinical Research Center for Mental Health Disorders, Mental Health Institute of the Second Xiangya Hospital, National Technology Institute of Psychiatry, Central South University, Changsha, China
| | - Xuebing Liu
- Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Qijian Deng
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, China National Clinical Research Center for Mental Health Disorders, Mental Health Institute of the Second Xiangya Hospital, National Technology Institute of Psychiatry, Central South University, Changsha, China
| | - Xuan Ouyang
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, China National Clinical Research Center for Mental Health Disorders, Mental Health Institute of the Second Xiangya Hospital, National Technology Institute of Psychiatry, Central South University, Changsha, China
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Si T, Zhuo J, Feng Y, Lu H, Hong D, Zhang L. Long-term efficacy and safety of paliperidone palmitate once-monthly in Chinese patients with recent-onset schizophrenia. Neuropsychiatr Dis Treat 2019; 15:1685-1694. [PMID: 31303756 PMCID: PMC6603286 DOI: 10.2147/ndt.s191803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Accepted: 04/02/2019] [Indexed: 11/23/2022] Open
Abstract
Background: The subgroup analysis of a primary study (NCT01051531) evaluated the effect of long-term paliperidone palmitate once-monthly (PP1M) therapy in Chinese patients with recent-onset schizophrenia responding unsatisfactorily to previous oral antipsychotics. Patients and methods: This 18-month, open-label study consisted of 3 phases - screening (7 days), treatment (18 months) and end-of-study/withdrawal visit. All enrolled patients (18-50 years) received PP1M: 150 mg eq. (day 1), 100 mg eq. (day 8) followed by a once-monthly flexible dose (50, 75, 100 or 150 mg eq.). Efficacy and safety were assessed. Results: Among the 118 enrolled Chinese patients, 68 completed the treatment (mean age: 25.6 years; male: 54.7%). A clinically meaningful change from baseline to day 548 was observed in Positive and Negative Syndrome scale (primary endpoint, mean [SD]: -15.3 [20.76]), Personal and Social Performance scale (15.9 [19.65]), Clinician Global Impression-schizophrenia score (-1.2 [1.54]) and Medication Satisfaction Questionnaire score (0.9 [1.73]). Commonly reported treatment-emergent adverse events (TEAEs) included insomnia (13.9%), injection-site pain (13.9%), upper respiratory tract infection (13.0%), restlessness (13.0%) and akathisia (13.0%). Serious TEAEs were reported in 9.3% patients with schizophrenia being most common (6.5%) and one death (suicide) was observed. Conclusion: Efficacy of PP1M corroborate findings from earlier studies and no new safety concerns emerged in this Chinese subgroup of patients with schizophrenia.
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Affiliation(s)
- Tianmei Si
- National Clinical Research Center for Mental Disorders & The Key Laboratory of Mental Health, Ministry of Health (Peking University), Beijing, People's Republic of China.,Peking University Institute of Mental Health/The Sixth Hospital, Beijing, People's Republic of China
| | - Jianmin Zhuo
- Janssen (China) Research & Development Center, Johnson & Johnson (China) Investment Ltd., Shanghai, People's Republic of China
| | - Yu Feng
- Department of Neuroscience, Janssen Pharmaceutical Companies of Johnson and Johnson, Singapore
| | - Huafei Lu
- Medical Affairs, Xi'an Janssen Pharmaceuticals, Beijing, People's Republic of China
| | - Di Hong
- Medical Affairs, Xi'an Janssen Pharmaceuticals, Beijing, People's Republic of China
| | - Lili Zhang
- Medical Affairs, Xi'an Janssen Pharmaceuticals, Beijing, People's Republic of China
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4
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Gu Y, Peng H, Dai J, Gao H, Yang X, Sheng J, Zhang C. Evaluation of paliperidone on social function in patients with chronic schizophrenia. Gen Psychiatr 2018; 31:e000011. [PMID: 30582124 PMCID: PMC6234969 DOI: 10.1136/gpsych-2018-000011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/28/2018] [Accepted: 06/01/2018] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The impairment of social function is widespread in the patients with chronic schizophrenia, which seriously affects family, life and work conditions. AIMS The main purpose of this study was to investigate the efficacy of paliperidone in the treatment of social function in chronic schizophrenia. METHODS A total of 81 patients who met the standard criteria for schizophrenia and long-term hospitalised inpatients were randomly divided into the treatment group and normal control group following a 1- year prospective follow-up study. The reatment group (41 cases) used paliperidone extended-release tablets for reducing dosage, as appropriate, based on the original treatment strategy; and the control group (40 cases) used the former drugs. All patients were assessed using the Positive and Negative Symptom Scales (PANSS), and the Treatment Emergent Symptom Scale (TESS) was used to assess adverse drug reactions. The Hospitalised Psychiatric Patients' Social Functions Rating Scale (SSPI) was used to assess social function of participants before and after 8 weeks, 6 months and 1 year of treatment. RESULTS At baseline there were no significant differences between the two groups in age, duration of illness, educational background and dosage of antipsychotic drugs (converted into chlorpromazine equivalency). There was statistically significant difference in PANSS positive symptoms by interaction effect (Fgroup×time=18.24, df=3237, p<0.001) and time effect (Ftime=21.66, df=3, p<0.01) and the difference in PANSS positive symptoms by grouping effect (Fgroup=0.68, df=1, p=0.41) was not statistically significant. The difference of grouping effect of PANSS negative symptoms (Fgroup=9.93, df=1, p=0.002), time effect (Ftime=279.15, df=3, p<0.001) and interaction effect (Fgroup × time=279.15, df=3237, p<0.001) were statistically significant. There were statistically significant differences in the grouping effect (Fgr oup=6.59, df=1, p=0.012), time effect (Ftime=152.97, df=3, p<0.001) and interaction effect (Fgroup × time=148.82, df=3237, p<0.001) of PANSS general pathological symptoms, the same as the total score of the PANSS, which showed large differences in grouping effect (Fg roup=7.04, df=1, p=0.001), time effect (Ftime=210.78, df=3, p<0.001) and interaction effect (Fgroup × time=205.20, df=3237, p<0.01). We found in the total SSPI score, grouping effect (Fgroup=31.70, df=1, p<0.001), time effect (Ftime=161.84, df=3, p<0.001) and interaction effect (Fgroup × time=132.74, df=3237, p<0.001) were demonstrated to be significantly different. Even though adverse reactions occurred 7 times in the treatment group and 44 times in the control group based on the Treatment Emergent Symptom Scale (TESS), incidence rate was significantly lower than that of the control group (χ²=18.854, p<0.001). CONCLUSION Paliperidone can safely and effectively improve negative symptoms and social function in patients with chronic schizophrenia.
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Affiliation(s)
- Yan Gu
- Department of Psychiatry, Shanghai Civil Affairs First Mental Health Center, Shanghai, China
| | - Hong Peng
- Department of Psychiatry, Shanghai Civil Affairs First Mental Health Center, Shanghai, China
| | - Jingjing Dai
- Department of Psychiatry, Shanghai Civil Affairs First Mental Health Center, Shanghai, China
| | - Hui Gao
- Department of Psychiatry, Shanghai Civil Affairs First Mental Health Center, Shanghai, China
| | - Xianghong Yang
- Department of Psychiatry, Shanghai Civil Affairs First Mental Health Center, Shanghai, China
| | - Jialing Sheng
- Department of Psychiatry, Shanghai Civil Affairs First Mental Health Center, Shanghai, China
| | - Chen Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Chen CY, Tang TC, Chen TT, Bai YM, Tsai HH, Chen HL, Huang CJ, Chen CK, Chen CC, Hsiao MC, Liu CY, Yeh HS, Chiu NY, Hsiao CC, Chen CS, Su TP. Efficacy, tolerability, and safety of oral paliperidone extended release in the treatment of schizophrenia: a 24-week, open-label, prospective switch study in different settings in Taiwan. Neuropsychiatr Dis Treat 2018; 14:725-732. [PMID: 29563800 PMCID: PMC5848663 DOI: 10.2147/ndt.s161186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Paliperidone extended release (ER) is an oral psychotropic treatment formulated to release paliperidone at a controlled, gradually ascending rate. We evaluated the efficacy and safety of switching to paliperidone ER in Taiwanese patients with schizophrenia who were unresponsive or intolerant to previous antipsychotic therapy. PATIENTS AND METHODS This was a 24-week, open-label, single-arm, multicenter, Phase IV trial. Based on consulting psychiatrists' judgment, patients were deemed eligible for the switch to paliperidone ER; the switch was achieved by cross-tapering, using a recommended starting dose of 6 mg. Eligibility considerations included lack of efficacy, tolerability, and/or adherence to previous oral antipsychotic medication. RESULTS Of the 297 enrolled patients, 178 (59.5%) completed the study. The main reasons for discontinuation included insufficient efficacy (8.7%), patient decision (8.4%), and adverse events (AEs; 6.4%). Improvements in the: Positive and Negative Syndrome Scale total score and Clinical Global Impression-Severity score were observed only in patients treated at medical centers and not in those treated at psychiatric hospitals. The most common AEs were insomnia, headache, constipation, and extrapyramidal syndrome. One or more serious AEs were reported in 11 (3.7%) patients; none resulted in death. No significant changes in body weight, plasma glucose, or lipid levels were observed. CONCLUSION Switching to paliperidone ER was effective and well tolerated for up to 24 weeks in patients with schizophrenia who were unresponsive or intolerant to previous antipsychotic therapy. The observed differences in treatment between psychiatric hospitals and medical centers with regard to dosage and titration of paliperidone ER warrant further investigation.
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Affiliation(s)
- Ching-Yen Chen
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | | | - Tzu-Ting Chen
- Department of Psychiatry, National Taiwan University Hospital, Yunlin Branch Hospital, Yunlin, Taiwan
| | - Ya Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Huei-Huang Tsai
- Tsao Tun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Hou-Liang Chen
- Tsao Tun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Chun-Jen Huang
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chih-Ken Chen
- Department of Psychiatry, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Chih Chen
- Department of Psychiatry, Changhua Christian Hospital Lukang Branch Hospital, Changhua, Taiwan
| | | | - Chia-Yih Liu
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Psychiatry, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hong-Shiow Yeh
- Department of Psychiatry, Mackay Memorial Hospital, Taipei, Taiwan
| | - Nan-Ying Chiu
- Department of Psychiatry, Changhua Christian Hospital Lukang Branch Hospital, Changhua, Taiwan
| | | | - Cheng-Sheng Chen
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, Cheng Hsin General Hospital, Taipei, Taiwan
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Yang FD, Li J, Tan YL, Liang WY, Zhang R, Wang N, Feng W, Cai S, Zhuo JM, Zhang LL. Treatment satisfaction with paliperidone extended-release tablets: open-label study in schizophrenia patients dissatisfied with previous antipsychotic medication. Neuropsychiatr Dis Treat 2017; 13:1089-1097. [PMID: 28458549 PMCID: PMC5402724 DOI: 10.2147/ndt.s130483] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the changes in treatment satisfaction after switching to paliperidone extended-release (ER) in Chinese schizophrenia patients dissatisfied with their previous antipsychotic treatment. METHODS In this 8-week, open-label, single-arm, multicenter, prospective study, 1,693 patients dissatisfied with previous antipsychotic medication were enrolled and switched to paliperidone ER tablets (3-12 mg/d) based on clinical judgment. The primary efficacy end point was change in Medication Satisfaction Questionnaire (MSQ) score from baseline to week 8. The secondary end points included percentage of patients with MSQ score ≥4, as well as changes in Clinical Global Improvement-Severity (CGI-S) and Personal and Social Performance (PSP) scores. RESULTS MSQ scores increased significantly from baseline (mean [standard deviation {SD}]: 2.48 [0.55]) to week 8 (5.47 [0.89], P<0.0001; primary end point, full analysis set). The percentage of patients with MSQ score ≥4 was 95.9% at week 8, indicating that most of the patients were satisfied with their treatment. Significant (P<0.0001) improvements from baseline to week 8 were noted in CGI-S score (2.37 [1.20]) and PSP score (25.5 [15.0]). A total of 174 (10.28%) patients experienced adverse events (AEs). The most common (>10 patients) events were extrapyramidal disorder (n=84, 4.96%), poor quality sleep (n=18, 1.06%) and akathisia (n=13, 0.77%). The majority of AEs were mild to moderate in severity. No deaths occurred. CONCLUSION Treatment satisfaction improved after switching to paliperidone ER from the previous antipsychotic in Chinese patients with schizophrenia.
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Affiliation(s)
| | - Juan Li
- Beijing Hui-Long-Guan Hospital
| | | | | | | | | | | | - Shangli Cai
- Department of Medical Affairs, Xian Janssen Pharmaceutical Ltd, Beijing, People's Republic of China
| | - Jian Min Zhuo
- Department of Medical Affairs, Xian Janssen Pharmaceutical Ltd, Beijing, People's Republic of China
| | - Li Li Zhang
- Department of Medical Affairs, Xian Janssen Pharmaceutical Ltd, Beijing, People's Republic of China
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Shi C, Yao SQ, Xu YF, Shi JG, Xu XF, Zhang CP, Jin H, Yu X. Improvement in social and cognitive functioning associated with paliperidone extended-release treatment in patients with schizophrenia: a 24-week, single arm, open-label study. Neuropsychiatr Dis Treat 2016; 12:2095-104. [PMID: 27601904 PMCID: PMC5006669 DOI: 10.2147/ndt.s112542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE This single-arm, open-label study aimed to explore the effects of extended-release paliperidone on social and cognitive function in patients with schizophrenia. METHODS Paliperidone extended-release (flexible dose ranging from 3 to 12 mg/day orally) was administered for 24 weeks in patients with schizophrenia. Patient function was assessed using the personal and social performance scale, measurement and treatment research to improve cognition in schizophrenia initiative-consensus cognitive battery, positive and negative syndrome scale, and clinical global impression-severity. RESULTS Ninety patients were included in the full analysis set, while 72 patients were included in the per protocol set. The personal and social performance score was 54.3±14.3 at baseline, and significantly increased to 73.4±12.6 at week 24 (P<0.001). For the measurement and treatment research to improve cognition in schizophrenia initiative-consensus cognitive battery assessment, six of the nine individual subtests, six of the seven cognitive domains, and total cognitive scores improved significantly (P<0.05) between baseline and endpoint. positive and negative syndrome scale total scores and clinical global impression-severity scores decreased gradually (P<0.001) from week 4 to the conclusion of the study. CONCLUSION Paliperidone extended-release treatment significantly improves social and neurocognitive function as well as symptoms in Chinese patients with schizophrenia.
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Affiliation(s)
- Chuan Shi
- Clinical Research Center, Peking University Sixth Hospital; Clinical Research Center, Peking University Institute of Mental Health; Key Laboratory of Mental Health, Ministry of Health (Peking University); National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing
| | - Shu Qiao Yao
- Clinical Center of Psychology, The Second Xiangya Hospital, Central South University, Changsha, Hunan Province
| | - Yi Feng Xu
- Department of Psychiatry, Institute of Mental Health, Shanghai Jiao Tong University, Shanghai
| | - Jian Guo Shi
- Department of Psychiatry, Xi'an Mental Health Center, Xian, Shanxi Province
| | - Xiu Feng Xu
- Department of Psychiatry, The First Affiliated Hospital of Kunming Medical School, Kunming, Yunnan Province
| | - Cong Pei Zhang
- Department of Psychiatry, The First Haerbin Psychiatric Hospital, Haerbin, Heilongjiang Province, People's Republic of China
| | - Hua Jin
- Department of Psychiatry, University of California at San Diego, La Jolla, San Diego, CA, USA
| | - Xin Yu
- Clinical Research Center, Peking University Sixth Hospital; Clinical Research Center, Peking University Institute of Mental Health; Key Laboratory of Mental Health, Ministry of Health (Peking University); National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing
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