title: Switching to iloperidone: An omnibus of clinically relevant observations from a 12-week, open-label, randomized clinical trial in 500 persons with schizophrenia.
abstract: OBJECTIVE
  To describe secondary analyses from a 12-week, randomized, open-label trial where adult schizophrenia outpatients receiving risperidone, olanzapine, or aripiprazole were switched to iloperidone.
  
  
  METHODS
  Patients were randomized into two groups: one where the antecedent antipsychotic dose was titrated downwards to zero over 2 weeks (n=240), and the other group where the antecedent antipsychotic was abruptly stopped (n=260). Adaptations of the Clinical Global Impression scale were used to evaluate clinical changes. Other assessments included the reporting of adverse events (AEs), study discontinuation, body weight, and metabolic variables.
  
  
  RESULTS
  Improvement was steady throughout the study for both gradual- and immediate-switch groups starting at Week 1 and continuing through Week 12. Discontinuations due to AEs in the first 2 weeks of treatment were higher for the immediate-switch group compared with the gradual-switch group (10.8% vs. 5.4%, NNT 19, 95% CI 10-151). Fewer patients in the gradual-switch group experienced dizziness as an AE, whereas a higher percentage of patients in the immediate-switch group exhibited earlier onset of a therapeutic response within the first 2 weeks; both groups were comparable thereafter with low rates of dizziness and similar efficacy outcomes.
  
  
  CONCLUSIONS
  Switching to iloperidone can be accomplished either with a gradual crossover or immediate discontinuation of the prior antipsychotic; however, the immediate-switch method is associated with greater proportion of initial dizziness. The observed outcomes are consistent with what has been previously reported regarding iloperidone's favorable akathisia/EPS profile and modest impact on somnolence/sedation, body weight, and metabolic variables.
authors.affiliation: New York Medical College, Valhalla, NY.
authors.forename: Leslie
authors.initials: L
authors.lastname: Citrome
authors.affiliation: University of Illinois at Chicago, Chicago, IL.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Weiden
authors.affiliation: ATP Clinical Research, Costa Mesa, CA.
authors.forename: Gus
authors.initials: G
authors.lastname: Alva
authors.affiliation: University School of Medicine Stanford, Stanford, CA.
authors.forename: Ira D
authors.initials: ID
authors.lastname: Glick
authors.affiliation: Wayne State University, Detroit, MI.
authors.forename: Richard
authors.initials: R
authors.lastname: Jackson
authors.affiliation: Washington University School of Medicine, St. Louis, MO.
authors.forename: Greg
authors.initials: G
authors.lastname: Mattingly
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, NJ.
authors.forename: Farid
authors.initials: F
authors.lastname: Kianifard
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, NJ.
authors.forename: Xiangyi
authors.initials: X
authors.lastname: Meng
authors.affiliation: Novartis Pharmaceuticals Corporation, East Hanover, NJ.
authors.forename: Adam
authors.initials: A
authors.lastname: Winseck
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000068180:Aripiprazole; D001569:Benzodiazepines / Q000008:administration & dosage; D004244:Dizziness / Q000139:chemically induced; D005260:Female; D006801:Humans; D007555:Isoxazoles / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D000077152:Olanzapine; D010879:Piperazines / Q000008:administration & dosage; D010880:Piperidines / Q000009:adverse effects / Q000627:therapeutic use*; D015363:Quinolones / Q000008:administration & dosage; D018967:Risperidone / Q000008:administration & dosage; D012559:Schizophrenia / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D014150:Antipsychotic Agents; D007555:Isoxazoles; D010879:Piperazines; D010880:Piperidines; D015363:Quinolones; D001569:Benzodiazepines; D000068180:Aripiprazole; D018967:Risperidone; D000077152:Olanzapine; C081732:iloperidone
keywords: Efficacy; Iloperidone; Safety; Schizophrenia; Switching; Tolerability