[The three-monthly paliperidone palmitate depot in the treatment of schizophrenia]. / Het driemaandelijkse paliperidon-palmitaatdepot bij schizofrenie.

BACKGROUND: A three-monthly formulation of intramuscular paliperidone palmitate has been available on the Dutch and Belgian markets since 2016.
AIM: To provide an overview of the indication, effectiveness and side-effects of this injectable three-monthly formulation of paliperidone and to offer considerations for clinical practice.
METHOD: A clinically-oriented literature study.
RESULTS: Three-monthly paliperidone palmitate depot appears to be as effective as the monthly paliperidone depot and has the same profile of side-effects.
CONCLUSION: Three-monthly paliperidone palmitate is an effective treatment option for schizophrenia. However, future research and clinical practice need to clarify the position of this depot in the treatment trajectory.

Efficacy of bilateral repetitive transcranial magnetic stimulation for negative symptoms of schizophrenia: results of a multicenter double-blind randomized controlled trial.

BACKGROUND: Few studies have investigated the efficacy of repetitive transcranial magnetic stimulation (rTMS) treatment for negative symptoms of schizophrenia, reporting inconsistent results. We aimed to investigate whether 10 Hz stimulation of the bilateral dorsolateral prefrontal cortex during 3 weeks enhances treatment effects. METHOD: A multicenter double-blind randomized controlled trial was performed in 32 patients with schizophrenia or schizo-affective disorder, and moderate to severe negative symptoms [Positive and Negative Syndrome Scale (PANSS) negative subscale ⩾15]. Patients were randomized to a 3-week course of active or sham rTMS. Primary outcome was severity of negative symptoms as measured with the Scale for the Assessment of Negative Symptoms (SANS) and the PANSS negative symptom score. Secondary outcome measures included cognition, insight, quality of life and mood. Subjects were followed up at 4 weeks and at 3 months. For analysis of the data a mixed-effects linear model was used. RESULTS: A significant improvement of the SANS in the active group compared with sham up to 3 months follow-up (p = 0.03) was found. The PANSS negative symptom scores did not show a significant change (p = 0.19). Of the cognitive tests, only one showed a significant improvement after rTMS as compared with sham. Finally, a significant change of insight was found with better scores in the treatment group. CONCLUSIONS: Bilateral 10 Hz prefrontal rTMS reduced negative symptoms, as measured with the SANS. More studies are needed to investigate optimal parameters for rTMS, the cognitive effects and the neural basis.