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With generic risperidone now approved, new trials of paliperidone, its proprietary offspring, were expected. This 6-week, randomized, controlled, double-blind, international study was industry-sponsored, -designed, and -reported. The 399 participants had chronic schizophrenia (mean illness duration, 10 years) and a recent exacerbation requiring rehospitalization. Patients with treatment-resistant disease were excluded.
One day after discontinuing other psychiatric medications, patients began extended-release paliperidone at 6 mg/day, quetiapine at 50 mg/day, or placebo. Target doses, achieved by day 5, were at the high end of recommended ranges (paliperidone, 9 mg/day; quetiapine, 600 mg/day); higher doses were optional. In the first 2 weeks…