Invega sustenna question

I'm an ACT nurse and have a lot of clients on invega sustenna. There have been some dramatic improvements- people who went from nearly mute with flat affects to euthymic and speaking in full sentences, so delusional that hygiene was not possible to functional, able to live independently and taking showers, etc. They returned to wellness levels that I had not expected.

The earliest group started it mid to late September.

We are beginning to see decompensation in the ones who have been on it for 6 months. The ones with the most drastic improvements are sliding back to their previous states. It's sad and frustrating. I am wondering if they all will have this happen. These ones are on the 234mg dose. We managed to bump one up to q 3 weeks with results unknown as of yet.

Has anyone else seen this? How long have your patients been on it? Anyone who has people on it and has not seen this trend?

[TerpGal02, ASN]

My first nursing job was in ACT (loved and miss ACT actually) and we had a bunch on Sustenna. Most had been on it awhile when I started though. To be honest I didn't see a huge difference between the sustenna pts and pts on really anything else. We did have one woman that got so much better on Sustenna we graduated her from ACT........until she stopped going to her outpt provider for the injections and we ended up getting her right back.

[msteeleart]

I am a community health psych nurse and there are a couple of our patients in our group on the sustenna and they have made complete recoveries. They have been on it for over a year and they are having no problems. I am on the fence with the Risperdal even though we have a patient on that who is also doing great. These medications don't work for everyone but for a few, they are a miracle.

[Lareinamorena]

I'm in act too, and we've seen no change in our sustenna patients! At least, nothing dramatic. I wonder if it just happens to be the toughest cases that were placed on it, and we're not trying it on other patients because it hasn't helped those few, but no miracles here!

[Lareinamorena]

Terpgal, what kind of a job did you take after Act? I'm new to psych nursing, and I love act, but I always wonder where I might go from here. It's hard to picture moving from act to inpatient. I'm sure its very exciting/interesting in its own right, and I want that experience eventually, but i imagine the level of confinement (for the patients and myself!) would be hard to get used to -- especially coming from act which is so free.

[TerpGal02, ASN]

I work inpt now. It's definitely different and a huge learning curve, but I like it. Actually I have been mostly working c&a even though my background is with adults, obviously. And of course, there are always those pts that are admitted that I know from the community.

[ToothFairy(5)]

I think it depends on the person too. You'll have 3 people with the same dx, same everything and each one responds to a different medication. It is an individual thing in my opinion. I've seen good results with invega as well as risperdal and zyprexa.

[Orca, ADN, ASN, RN]

We only use Invega for people with impaired liver function who cannot take risperidone. Frankly, I haven't seen either drug make a profound difference for too many people.

[babynurse73]

Would someone please tell me what act is?

[Orca, ADN, ASN, RN]

Would someone please tell me what act is?

Assertive Community Treatment. Basically, the clients of this system have serious and persistent mental illness or personality disorders, with severe functional impairments. There is more information on it here from the Assertive Community Treatment Association.

ACTA - ACT Model

[Lareinamorena]

Act is team of various specialists (psychiatrist, nurse, Sa & voc specialists, peer, etc) who serve people with smi in their homes and in the community with the goal of helping them optimize function, be safe and stable, and reduce hospitalization. For the nurse, it's essentially psych home care.