Japanese surveillance found little aggregate change in benzodiazepine prescribing after a switch to three-month paliperidone. The mean and median told different stories.
This post hoc analysis used surveillance data from 891 people with schizophrenia who transitioned from monthly to three-month paliperidone palmitate. The study recorded benzodiazepine prescribing in 19.1% at treatment start and 19.5% at the end. Those aggregate percentages do not show that the same individuals continued the same regimens. Starts, stops, and dose changes can offset one another in a group summary.
The mean diazepam-equivalent dose was 35.79 mg at the start and 35.94 mg at the end. At both points the median was 2 mg, with a reported range of 0.03 to 500 mg. The distance between the mean and median shows why the mean is a poor description of a typical prescription in this sample. A converted dose is a reporting measure, not a measured diazepam concentration or evidence that the person took diazepam itself.
Benzodiazepine use did not show a statistically clear association with discontinuation in the reported model: hazard ratio 1.15, with a 95% confidence interval of 0.73 to 1.80. The analysis was observational, with physician selection and potentially missing data. It does not prove that the switch caused stable benzodiazepine exposure or that concomitant use had no effect. For an individual review, reconstruct the named drug, prescribed and administered doses, dates, and conversion assumptions instead of assigning the group average to the patient.
Original analysis of the supplied journal article, identified as PMC13038911.