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Trevicta Prerequisite — MRCPsych Paper B MCQ

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ModerateSchizophrenia & PsychosisTrevicta PrerequisiteMRCPsych Paper B

An adult with schizophrenia is being considered for a switch to 3-monthly paliperidone palmitate (Trevicta). According to the UK Summary of Product Characteristics, which prerequisite best supports initiation?

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Reveal the answer and explanation

Correct answer: A — Stability on 1-monthly paliperidone palmitate, preferably for four months or more, without a need for dose adjustment

Explanation lettering: B = shown as A · E = shown as B · A = shown as E

The correct answer is B. Trevicta is a maintenance treatment for adults with schizophrenia who are clinically stable on 1-monthly paliperidone palmitate. The UK SmPC states that patients adequately treated with the monthly formulation, preferably for four months or more, who do not require dose adjustment may be switched. Oral paliperidone exposure or tolerability alone is insufficient, so A and E are incorrect. One month of monthly treatment does not establish the recommended period of stable treatment, making C inappropriate. Stability on another long-acting antipsychotic is also insufficient because patients should not be switched directly from other antipsychotics to Trevicta, excluding D. Four months is described as preferable rather than an absolute minimum in the prescribing instructions.

Reference: Electronic Medicines Compendium. TREVICTA 350 mg prolonged release suspension for injection, Summary of Product Characteristics, sections 4.1–4.2; revised 2023. https://www.medicines.org.uk/emc/product/7711/smpc