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Invega vs Aristada
Introduction
For patients with schizophrenia or other types of psychosis, certain drugs that alter the concentrations of compounds in the brain called neurotransmitters can help manage hallucinations, delusions and improve cognition. Invega (paliperidone) and Aristada (aripiprazole lauroxil) are two such medications prescribed for schizophrenia. They each impact different neurotransmitters in the brain but both have stabilizing effects on psychotic symptoms. Invega is an atypical antipsychotic affecting dopamine D2 receptors and serotonin 5-HT2A receptors, reducing their activity which helps to balance mood and perception. Aristada, on the other hand, is also classified as an atypical antipsychotic but it works by partially blocking dopamine D2 receptors and serotonin 5-HT1A receptors while antagonizing serotonin 5-HT2A receptors - this combination aids in managing psychotic symptoms.
Invega vs Aristada Side By Side
| Attribute | Invega | Aristada |
|---|---|---|
| Brand Name | Invega | Aristada |
| Contraindications | Should not be taken if you are taking, or have recently been on treatment with dopamine agonists. Not recommended for patients with certain heart conditions without close monitoring. | Should not be taken if you are taking, or have recently been on treatment with dopamine agonists. Not recommended for patients with certain heart conditions without close monitoring. |
| Cost | $1,300/month | $1,500 for a single injection lasting 2 months |
| Generic Name | Paliperidone | Aripiprazole lauroxil |
| Most Serious Side Effect | Severe nervous system reaction, serotonin syndrome symptoms, low sodium levels, vision problems, heart-related issues. | Allergic reactions, increased suicidal thoughts or self-harm, seizures, severe agitation, neuroleptic malignant syndrome. |
| Severe Drug Interactions | Dopamine agonists | Dopamine agonists |
| Typical Dose | 3–12 mg/day | 441–882 mg every month, or 882 mg every six weeks to two months |
What is Invega?
Paliperidone (the generic name for Invega) is an atypical antipsychotic medication that marked significant progress in comparison to the first class of antipsychotics known as typical antipsychotics. Paliperidone was approved by the FDA in 2006. Invega functions by adjusting levels of dopamine and serotonin, two important neurotransmitters involved in mood regulation, effectively maintaining a balance within the brain. It is prescribed primarily for schizophrenia and schizoaffective disorder treatment.
On the other hand, Aripiprazole lauroxil (Aristada) is another type of atypical antipsychotic with similar uses but different mechanisms and side effect profiles. While both medications work on dopamine and serotonin receptors, Aristada has a more complex mechanism involving partial agonism – it stimulates and blocks receptors simultaneously to maintain balance. This unique action may lead to fewer side effects compared to other drugs like Invega that have stronger blocking effects on these neurotransmitters.
What conditions is Invega approved to treat?
Invega is approved for the treatment of different forms of psychotic disorders:
- Schizophrenia, a mental disorder that affects a person's ability to think, feel, and behave clearly
- Schizoaffective disorder (as monotherapy or in combination with mood stabilizers and/or antidepressants)
On the other hand, Aristada is only approved by FDA for the treatment of schizophrenia.
How does Invega help with these illnesses?
Invega, or paliperidone, helps to manage symptoms of psychiatric disorders like schizophrenia by managing levels of dopamine and serotonin in the brain. It does this by acting as an antagonist at both dopamine D2 receptors and serotonin 5-HT2A receptors. These are types of neurotransmitters that play crucial roles in behavior, cognition, mood, memory and other brain functions. In conditions like schizophrenia, there can be an imbalance or disrupted functioning of these neurotransmitters causing symptoms such as hallucinations or delusions. By acting on these receptors, Invega can help restore a more normal balance thereby reducing the negative effects associated with these disorders.
Similarly Aristada (aripiprazole lauroxil) also works to correct imbalances in certain chemical messengers (neurotransmitters), specifically dopamine and serotonin within the brain which contribute to psychotic illnesses such as schizophrenia. However each medication has its unique pharmacokinetic profile influencing factors such as how long it stays active within the body which may suit different individual's needs better.
What is Aristada?
Aristada is a brand name for aripiprazole lauroxil, which is an atypical antipsychotic used to treat schizophrenia. It works by altering the actions of chemicals in the brain. Unlike typical antipsychotics, Aristada does not primarily block dopamine D2 receptors in the brain; instead it acts as a partial agonist on these receptors along with serotonin 5-HT1A and antagonist at serotonin 5-HT2A. This results in an overall effect that can help reduce symptoms like hallucinations and improve concentration.
First approved by FDA in 2015, Aristada offers multiple dosing options which might be beneficial for patients unable to keep up with daily medication regimen due to their illness or lifestyle factors. Its side-effect profile differs from typical antipsychotics such as Invega (paliperidone) because it's less likely to cause significant weight gain or changes in metabolism associated with other drugs of this class. However, common side effects may include restlessness, insomnia and constipation.
What conditions is Aristada approved to treat?
Aristada is approved for the treatment of:
- Schizophrenia, a chronic and severe mental disorder that affects how a person thinks, feels, and behaves.
This medication can help manage symptoms by reducing hallucinations, improving concentration, decreasing negative thoughts or experiences and enhancing overall mood stability. It's important to note that Aristada is not intended as a cure for schizophrenia but rather works as an effective component in managing the condition alongside other forms of therapy.
How does Aristada help with these illnesses?
Dopamine is a neurotransmitter that plays crucial roles in how we feel pleasure, think and plan. It's also heavily involved in motor function. Low levels of dopamine have been associated with disorders like schizophrenia and bipolar disorder. Aristada works by adjusting the levels of dopamine available in the brain, thereby managing some of the symptoms of psychotic conditions such as hallucinations, delusions, thought disturbances, or unusual behavior. Its action on other neurotransmitters may also contribute to its use as an antipsychotic medication. Since it does not significantly affect serotonin levels compared to Invega which impacts both serotonin and dopamine receptors for additional mood-stabilizing effects; Aristada might be prescribed when a patient does not respond well to other typical antipsychotics or may be used in combination with them.
How effective are both Invega and Aristada?
Both paliperidone (Invega) and aripiprazole lauroxil (Aristada) are antipsychotic medications used in the management of schizophrenia, and were approved by the FDA within two years of each other. Since they act on different neurotransmitters, they may be prescribed under different circumstances. The effectiveness of Invega and Aristada in managing symptoms of schizophrenia was directly studied in numerous clinical trials; both drugs exhibited similar efficacy as well as comparable safety profiles.
A 2006 meta-analysis review demonstrated that paliperidone is effective at alleviating symptoms of psychosis from the first week of treatment and also has a favourable side effect profile compared to many other antipsychotics. Furthermore, it is well-tolerated even among elderly populations with dementia-related psychosis. Paliperidone extended-release tablets have become one widely-prescribed medication for schizophrenia due to its once-daily dosing schedule.
Similarly, Aristada showed promise following a 2015 review which indicated that it seems more effective than placebo in treating schizophrenia, appearing similar in efficacy to other common antipsychotics. However, like bupropion for depression treatments mentioned above, Aristada can often be considered only after attempts with first-line treatments have been unsuccessful or intolerable due to side effects. Significant research on its use involves being co-prescribed alongside an SSRI such as Prozac for patients who also suffer from major depressive disorder along with their diagnosis of schizophrenia. Nonetheless, despite differences between them - including pharmacological properties - both Invega and Aristada offer valuable options for healthcare professionals when choosing the right treatment plan for their patients.
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At what dose is Invega typically prescribed?
Oral dosages of Invega range from 3–12 mg/day, but studies have indicated that a dose of 6 mg/day is sufficient for treating schizophrenia in most people. Adolescents may be started on 3 mg/day. In either population, dosage can be increased after a few weeks if there is no response. The maximum dosage that should not be exceeded in any case is 12 mg/day.
Aristada, an injectable antipsychotic medication typically used to treat schizophrenia, has different dosing recommendations depending on the specific formulation of the drug and individual patient needs. Generally speaking though, initial doses can range from 441-882mg injected once monthly or every two months (depending on doctor's advice). Dosage adjustments are made based upon the patient's response and tolerance to treatment; your healthcare provider will monitor this closely.
At what dose is Aristada typically prescribed?
Aristada treatment is typically initiated at a dosage of 441–882 mg every month, or 882 mg every six weeks to two months. The dose can then be adjusted depending on patient response and tolerance. For patients with no previous exposure to aripiprazole, the recommended starting dose of Aristada is 441 mg administered monthly. If there's an inadequate response to the initial dosage after a few weeks, your healthcare provider may consider an adjustment within the range of dosages available (294–1064mg). Each injection should be spaced one month apart for monthly doses or one-and-a-half to two months apart for extended-release injections. It's important that you always follow your doctor’s instructions when taking medication.
What are the most common side effects for Invega?
Common side effects of Invega can include:
- Drowsiness or sleepiness
- Restlessness or feeling like you need to move around (akathisia)
- Unusual movements, mainly in your face or tongue (tardive dyskinesia)
- Increased heart rate
- Nausea, stomach discomfort
- Weight gain
- Headache
On the other hand, Aristada may cause side effects such as:
- Akathisia (feeling restless and unable to sit still)
- Insomnia (difficulty sleeping)
- Decreased sexual drive -Unwanted, uncontrolled movements in your arms, legs or face muscles (dyskinesia) -Upset stomach -Increased weight -Decrease in blood cell count leading to weakness and fatigue
It's important for patients who are considering these medications to discuss these potential side effects with their healthcare provider.
Are there any potential serious side effects for Invega?
Invega and Aristada are both used for the treatment of schizophrenia, but they may have different side effects. Here's what you need to watch out for when taking these medications:
- Any signs of increased suicidal thoughts or self-harm tendencies should be reported immediately.
- Be alert for any signs of an allergic reaction such as difficulty breathing, hives, facial or throat swelling. Also look out for severe skin reactions that include fever, sore throat, burning in your eyes, skin pain followed by a red or purple rash leading to blistering and peeling.
- Vision problems like blurred vision, tunnel vision or seeing halos around lights along with eye pain or swelling can be serious indicators that warrant immediate medical attention.
- If you experience heart-related issues such as fast/pounding heartbeat, fluttering in your chest accompanied by shortness of breath and sudden dizziness (like you might faint), seek medical care right away.
- Low sodium levels can cause headaches confusion slurred speech extreme weakness vomiting loss of coordination unsteadiness if these symptoms occur consult your doctor immediately
- A severe nervous system reaction is also possible with both medications; this reaction could include experiencing unusually stiff muscles high fever sweating confusion rapid uneven heartbeats tremors feeling like passing out seek emergency help if this occurs
- Lastly keep a lookout for serotonin syndrome symptoms which include agitation hallucinations fever excessive sweating shivering accelerated heart rate muscle stiffness twitching loss of coordination nausea vomiting diarrhea.
If any such adverse events are experienced while on Invega or Aristada it's essential to reach out to healthcare providers promptly.
What are the most common side effects for Aristada?
While using Aristada, patients may experience:
- Injection site reactions (pain, redness, or swelling)
- Dizziness and lightheadedness
- Nausea and upset stomach
- Restlessness or feeling agitated
- Weight gain
- Insomnia or other sleep disturbances
- Uncontrollable movements of the face, tongue, or other parts of the body
- Muscle stiffness
- Rash These side effects can be mild to severe. It's also possible for some individuals to have an allergic reaction to Aristada. Always consult with your healthcare provider about potential side effects when starting a new medication.
Are there any potential serious side effects for Aristada?
Aristada, while considered safe for most patients, can occasionally lead to serious side effects. Pay close attention to the following reactions:
- Signs of an allergic reaction such as hives, difficulty breathing or swallowing, and swelling in your face or throat
- Increased thoughts about suicide or self-harm
- Seizures (convulsions)
- New or worsening mood changes including severe agitation, aggression, anxiety
- Blurred vision or eye pain
- Rapid heartbeat; irregular heart rhythm; palpitations
- Symptoms associated with neuroleptic malignant syndrome like fever, muscle stiffness/pain/tenderness/weakness, severe fatigue
Remember that immediate medical help is needed if any of these symptoms occur.
Contraindications for Invega and Aristada?
Both Invega and Aristada, as with most other antipsychotic medications, may exacerbate symptoms of depression in some individuals. If you notice your depression worsening or an increase in suicidal thoughts or behavior, please seek immediate medical attention.
Neither Invega nor Aristada should be taken if you are taking, or have recently been on treatment with dopamine agonists (medications that stimulate dopamine receptors). Always inform your physician about all the medications you're currently taking; discontinuing a dopamine agonist will require a period of roughly two weeks to prevent dangerous interactions with Invega and Aristada. Furthermore, these drugs should not be used by patients suffering from certain conditions such as heart disease without close monitoring due to their potential cardiovascular side effects.
How much do Invega and Aristada cost?
For the brand name versions of these drugs:
- The monthly cost for Invega (also known as paliperidone), which is commonly used in a 6 mg dose, averages around $1,300. This works out to approximately $43/day.
- The cost of Aristada (aripiprazole lauroxil) varies depending on the dosing interval. For example, the price for a single injection which lasts 2 months (882 mg) averages about $1,500—working out to approximately $25/day.
Therefore, if you are taking Invega daily at a common dosage (i.e., 6 mg/day), then brand-name Aristada is less expensive on an averaged per-day treatment basis – although please note that Aristada is administered via injection every four to eight weeks rather than being taken daily. As always though, it’s important to understand that cost should not be the primary consideration when deciding between these two medications.
As yet there are no generic versions of either Invega or Aristada available in most countries including USA due to patent restrictions; thus their costs remain quite high compared with many other medications.
Popularity of Invega and Aristada
Invega, known generically as paliperidone, is an antipsychotic used primarily in the treatment of schizophrenia. In 2020, it was estimated that about 1 million prescriptions for Invega were filled in the United States. Accounting for just over 5% of all antipsychotic prescriptions in the U.S., Invega continues to be a significant player within its class.
Aristada (aripiprazole lauroxil) on the other hand, had fewer than a half-million total prescription fills during that same year. Belonging to a similar class of medication as Invega and utilized mainly for treating schizophrenia or bipolar disorder, Aristada accounted for roughly 2% of overall antipsychotic prescriptions in the US by volume. Both medications have seen relatively steady usage rates over recent years despite being part of an increasingly competitive therapeutic area.
Conclusion
Both Invega (paliperidone) and Aristada (aripiprazole lauroxil) are antipsychotic medications used primarily in the treatment of schizophrenia, with a robust body of clinical studies and meta-analyses showing their efficacy compared to placebo treatments. At times, these drugs might be co-administered under careful physician oversight as they can have interactive effects. They operate through different mechanisms: Invega acts by blocking dopamine D2 receptors and serotonin 5-HT2A receptors while Aristada works mainly as a partial agonist at dopamine D2 receptors and serotonin 5-HT1A receptors.
Invega is often chosen as an initial therapy option due to its once-daily oral dosing or monthly injection options. Comparatively, Aristada is typically considered for patients not responding optimally to other antipsychotics or those who require less frequent administration schedules since it offers extended-release injections that last from one month up to two months.
Both medications also come in generic forms, offering substantial cost savings for those paying out-of-pocket. A period of adjustment may be necessary with both Invega and Aristada - immediate results should not necessarily be anticipated.
The side effect profiles for both drugs share similarities; however, specific side effects can vary between individuals. Both medicines are generally well-tolerated but carry potential risks such as weight gain or movement disorders (extrapyramidal symptoms). Patients must monitor their condition closely when initiating treatment on either drug – anyone noticing worsening symptoms or onset of suicidal ideation should seek medical help immediately.
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Refrences
- Younis, I. R., Laughren, T. P., Wang, Y., Mathis, M., & Gobburu, J. V. (2013, April). An Integrated Approach for Establishing Dosing Recommendations. Journal of Clinical Psychopharmacology. Ovid Technologies (Wolters Kluwer Health).http://doi.org/10.1097/jcp.0b013e31828393a8
- Hard, M. L., Wehr, A. Y., Sadler, B. M., Mills, R. J., & von Moltke, L. (2018, June 11). Population Pharmacokinetic Analysis and Model-Based Simulations of Aripiprazole for a 1-Day Initiation Regimen for the Long-Acting Antipsychotic Aripiprazole Lauroxil. European Journal of Drug Metabolism and Pharmacokinetics. Springer Science and Business Media LLC.http://doi.org/10.1007/s13318-018-0488-4