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?