Iloperidone - A novel atypical antipsychotic for the treatment of schizophrenia

Iloperidone, a new-generation atypical antipsychotic, is currently under investigation for the treatment of schizophrenia. In 4 separate phase 3 trials, iloperidone has demonstrated efficacy in treating schizophrenia, with total Positive and Negative Symptom Scale (PANSS) scores decreasing by a range of 8 to 14 points depending on the iloperidone dose. The most common adverse events associated with iloperidone treatment include dizziness, dry mouth, dyspepsia, sedation, orthostatic hypotension, and weight gain. Studies have also demonstrated that, similar to ziprasidone, iloperidone is associated with a risk of corrected QT (QTc) prolongation. Currently, iloperidone does not appear to offer any unique chemical properties that separate it from the other atypical antipsychotics. The manufacturer is hoping to determine specific reliable genetic markers for predictive response to this medication. Six polymorphisms demonstrating an association with iloperidone response have been identified. However, until genotyping patients becomes cost effective, iloperidone is not likely to drastically affect current clinical practice.