skip to main content

Depot Switching — MRCPsych Paper B MCQ

Instant feedback + full explanation. One question, done properly.

HardSchizophrenia & PsychosisDepot SwitchingMRCPsych Paper B

A patient with schizophrenia on depot zuclopenthixol decanoate 400mg every 2 weeks is being switched to paliperidone palmitate. According to the Maudsley Guidelines, when should the first paliperidone palmitate injection be given?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — At least one dosing interval after the last depot, to allow washout

When switching between depot antipsychotics, the timing should account for the pharmacokinetics of both preparations. The first injection of the new depot should be given at or around the time the next injection of the old depot would have been due. For zuclopenthixol decanoate to paliperidone palmitate, the paliperidone loading regimen should commence approximately one dosing interval after the last zuclopenthixol injection.

Reference: Maudsley Prescribing Guidelines 15th Edition 2024