Safety and Efficacy of Paliperidone Palmitate in Pediatric Patients with Autism and Intellectual Disability

Seth Simpson; Kelli C Dominick; Craig A Erickson; Martine Lamy

doi:10.1007/s10803-024-06372-9

Safety and Efficacy of Paliperidone Palmitate in Pediatric Patients with Autism and Intellectual Disability

J Autism Dev Disord. 2024 May 13. doi: 10.1007/s10803-024-06372-9. Online ahead of print.

Authors

Seth Simpson¹, Kelli C Dominick^{2

3}, Craig A Erickson^{4

5}, Martine Lamy^{4

5}

Affiliations

¹ Shodair Children's Hospital, 2755 Colonial Dr., Helena, MT, 59601, USA.
² Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA. Kelli.dominick@cchmc.org.
³ Division of Child and Adolescent Psychiatry (MLC 4002), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA. Kelli.dominick@cchmc.org.
⁴ Department of Psychiatry, University of Cincinnati College of Medicine, Cincinnati, OH, USA.
⁵ Division of Child and Adolescent Psychiatry (MLC 4002), Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.

PMID: 38740696
DOI: 10.1007/s10803-024-06372-9

Abstract

This retrospective chart review examines the safety, tolerability and effectiveness of long acting injectable paliperidone palmitate (P-LAI) targeting irritability in twenty-six youth and transition-aged individuals with autism spectrum disorder (ASD) and/or intellectual disability (ID) over a 3-year window. Clinical response was evaluated via prospectively assigned Clinical Global Impressions Severity (CGI-S) and Improvement (CGI-I) scales as well as number of hospital presentations. P-LAI was well tolerated with only 3 patients stopping P-LAI due to side effects. The average duration of P-LAI treatment was 21.1 months. Difficulty with medication compliance was the most common reason for initiating P-LAI. There was a statistically significant improvement in CGI-I, CGI-S and hospital visits and no change in BMI noted. Given the potential difficulty of medication administration in this population, this evidence of safety, tolerability as well as preliminary data supporting effectiveness is an important addition to the literature regarding psychopharmacologic management of irritability in youth with ASD and ID.

Keywords: Antipsychotic; Autism; Children; Intellectual disability; Long acting injectable; Paliperidone.