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Trevicta 3-Monthly Depot — MRCPsych Paper B MCQ

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ModerateSchizophrenia & PsychosisTrevicta 3-Monthly DepotMRCPsych Paper B

An adult with schizophrenia is receiving paliperidone palmitate 150 mg by 1-monthly injection. The clinical team is considering switching to 3-monthly paliperidone palmitate (Trevicta). According to the UK Summary of Product Characteristics, which treatment status should be established before switching?

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Correct answer: C — Clinical stability on 1-monthly paliperidone palmitate, with adequate treatment preferably for at least four months and no current need for dose adjustment

Trevicta is indicated for maintenance treatment in adults with schizophrenia who are clinically stable on 1-monthly paliperidone palmitate. The SmPC states that patients should be adequately treated with the monthly formulation, preferably for four months or more, and should not require dose adjustment before switching. Thus, C is correct. Oral paliperidone alone, a single monthly injection, or treatment with another depot does not meet the switching requirements. Trevicta has no loading regimen for paliperidone-naive patients and should not be started directly from another antipsychotic. Once eligible, a patient receiving 150 mg monthly would ordinarily switch to Trevicta 525 mg in place of the next scheduled monthly dose.

Reference: Electronic Medicines Compendium. TREVICTA 175 mg prolonged-release suspension for injection, Summary of Product Characteristics, sections 4.1–4.2. Text revised 4 August 2023. https://www.medicines.org.uk/emc/product/7230/smpc