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Long-Acting Antipsychotic Medication and the Outcome of Schizophrenia

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Advances in Schizophrenia Research 2009

Abstract

Long-acting injectable antipsychotic medication or depots are an important element in the treatment of schizophrenia. Before assessing the pros and cons of such treatment and determining whether it has a significant impact on outcome over and above oral medication, it may be useful to consider where the idea of depot injections came from. There is surely a history behind this idea though it appears that a full account of this has yet to be written.

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References

  • Adams, C.E., Fenton, M.K.P., Quraishi, S., & David, A.S. (2001) Systemic meta-review of depot antipsychotic drugs for people with schizophrenia. British Journal of Psychiatry 179: 290–299

    Article  CAS  PubMed  Google Scholar 

  • Appelbaum, P.S., Robbins, P.C., & Monahan, J. (2000). Violence and delusions: data from the MacArthur violence risk assessment study. American Journal of Psychiatry 157: 566–572

    Article  CAS  PubMed  Google Scholar 

  • Arango, C., Barba, A.C., Gonzalez-Salvador, T., & Ordonez, A.C. (1999). Violence in inpatients with schizophrenia: a prospective study. Schizophrenia Bulletin 25: 493–503

    CAS  PubMed  Google Scholar 

  • Arango, C., Bombin, I., Gonzalez-Salvador, T., Garcia-Cabeza, I., & Bobes, J. (2006). Randomised clinical trial comparing oral versus depot formulations of zuclopenthixol in patients with schizophrenia and previous violence. European Psychiatry 21: 34–40

    Article  CAS  PubMed  Google Scholar 

  • Arseneault, L., Moffitt, T.E., Caspi, A., Taylor, P.J., & Silva, P.A. (2000). Mental disorders and violence in a total birth cohort: results from the Dunedin study. Archives of General Psychiatry 57: 979–986

    Article  CAS  PubMed  Google Scholar 

  • Barnes, T.R. & Curson, D.A. (1994). Long-term depot antipsychotics: a risk-benefit assessment. Drug Safety 10: 464–479

    Article  CAS  PubMed  Google Scholar 

  • Buckley, P.F., Bartell, J., Donenwirth, K., Lee, S., Torigoe, F., & Schulz, S. (1995). Violence and schizophrenia: clozapine as a specific anti-aggressive agent. Bulletin of the American Academy of Psychiatry and the Law 23: 607–611

    CAS  PubMed  Google Scholar 

  • Buckley, P.F., Hrouda, D.R., Friedman, L., Noffsinger, S.G., Resnick, P.J., & Camlin-Shingler, K. (2004). Insight and its relationship to violent behavior in patients with schizophrenia. American Journal of Psychiatry 161: 1712–1714

    Article  PubMed  Google Scholar 

  • Buckley, P.F., Ibrahim, Z.Y., Singer, B., Orr, B., Donenwirth, K., & Brar, P.S. (1997). Aggression and schizophrenia: efficacy of risperidone. Journal of the American Academy of Psychiatry and Law 25: 173–181

    CAS  Google Scholar 

  • Chue, P., Eerdekens, M., Augustyns, I., Lachaux, B., Molcan, P., Eriksson, L., Pretorius, H., & David, A.S. (2005). Comparative efficacy and safety of long-acting risperidone and risperidone oral tablets. European Neuropsychopharmacology 15: 111–117

    Article  CAS  PubMed  Google Scholar 

  • Davis, J.M., Matalon, L., Watanabe, M.D., & Blake, L. (1994). Depot antipsychotic drugs. Place in therapy. Drugs 47: 741–773

    Article  CAS  PubMed  Google Scholar 

  • Dencker, S.J. & Axelsson, R. (1996). Optimising the use of depot antipsychotics. CNS Drugs 6: 367–381

    Article  CAS  Google Scholar 

  • Fleischhacker, W.W., Eerdekens, M., Karcher, K., Remington, G., Llorca, P.-M., Chrzanowski, W., Martin, S., & Gefert, O. (2003). Treatment of schizophrenia with long-acting injectable risperidone: a 12-month open-label trial of the first long-acting second-generation antipsychotic. Journal of Clinical Psychiatry 64: 1250–1257

    Article  CAS  PubMed  Google Scholar 

  • Gerlach, J. (1995). Depot neuroleptics in relapse prevention: advantages and disadvantages. International Clinical Psychopharmacology 9(Suppl. 5): 17–20

    Article  PubMed  Google Scholar 

  • Glazer, W.M. & Kane, J.M. (1992). Depot neuroleptic therapy: an underutilized treatment option. Journal of Clinical Psychiatry 53: 426–433

    CAS  PubMed  Google Scholar 

  • Gray, R., Leese, M., Bindman, J., Becker, T., Burti, L., David, A., Gournay, K., Kikkert, M., Koeter, M., Puscher, B., Schene, A., Thornicroft, G., & Tansella, M. (2006). Adherence therapy for people with schizophrenia: European multicentre randomised controlled trial. British Journal of Psychiatry 189: 508–514

    Article  PubMed  Google Scholar 

  • Haider, I. (1968). A controlled trial of fluphenazine enanthate in hospitalized chronic schizophrenics. British Journal of Psychiatry 114: 837–841

    Article  CAS  PubMed  Google Scholar 

  • Healy, D. (2000). The birth of psychopharmacotherapy: explorations’ in a new world 1952–1968. In: The Psychopharmacologists III. Interviews by Dr David Healy. Arnold, London, pp. 1–53

    Google Scholar 

  • Heres, S., Hamann, J., Kissling, W., & Leucht, S. (2006). Attitudes of psychiatrists toward antipsychotic depot medication. Journal of Clinical Psychiatry 67: 1948–1953

    Article  PubMed  Google Scholar 

  • Heres, S., Schmitz, F.S., Leucht, S., & Pajonk, F.G. (2007). The attitude of patients towards antipsychotic depot treatment. International Clinical Psychopharmacology 22: 275–282

    Article  PubMed  Google Scholar 

  • Heysue, B.E., Levin, G.M., & Merrick, J.P. (1998). Compliance with depot antipsychotic medication by patients attending outpatient clinics. Psychiatric Services 49: 1232–1234

    Google Scholar 

  • Hicks, R. & Ovenstone, I.M.K. (1996). Fluphenazine enanthate in the maintenance treatment of schizophrenia. British Medical Journal 29th Oct, 1071

    Google Scholar 

  • Hirsch, S.R., Gaind, R., Rohde, P.D., Stevens, B.C., & Wing, J. (1973). Outpatient maintenance of chronic schizophrenic patients with long-acting fluphenazine: double-blind placebo controlled trial. British Medical Journal i: 633 –637

    Article  Google Scholar 

  • Hodgins, S. (1992). Mental disorder, intellectual deficiency and crime: evidence from a Danish birth cohort. Archives of General Psychiatry 49: 476–483

    CAS  PubMed  Google Scholar 

  • Hodgins, S., Hiscoke, U., & Freese, R., (2003). The antecedents of aggressive behavior among men with schizophrenia: a prospective investigation of patients in community treatment. Behavioral Sciences and the Law 21: 523

    Article  PubMed  Google Scholar 

  • Hogarty, G.E, Schooler, N.R, Ulrich, R., Mussare, I., Ferro, P., & Herron, E. (1979). Fluphenazine and social therapy in the aftercare of schizophrenic patients. Archives of General Psychiatry 36: 1283–1294

    CAS  PubMed  Google Scholar 

  • Hosalli, P. & Davis, J.M. (2003). Depot risperidone for schizophrenia. Cochrane Database of Systematic Reviews, Issue 4. Art. No.: CD004161. DOI: 10.1002/14651858.CD004161

    Google Scholar 

  • Ioannidis J.P.A., Haidich, A.B., & Lau, J. (2001). Any casualties in the clash of randomised and observational evidence? British Medical Journal 322: 879–880

    Article  CAS  PubMed  Google Scholar 

  • Jones, P.B., Barnes, T.R.E., Davies, L., Dunn, G., Lloyd, H., Hayhurst, K.P., Murray, R.M., Markwick, A., & Lewis, S.W. (2006). Randomized controlled trial of the effect on quality of life of second- vs. first-generation antipsychotic drugs in schizophrenia: Cost Utility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Archives of General Psychiatry 63: 1079–1087

    Article  CAS  PubMed  Google Scholar 

  • Junginger, J., Parks-Levy, J., & Mcguire, L. (1998). Delusions and Symptom-Consistent Violence. Psychiatric Services 49: 218–220

    CAS  PubMed  Google Scholar 

  • Kane, J.M., Aguglia, E., Altamura, A.C., Ayuso Gutierrez, J.L., Brunello, N., Fleischhacker, W.W., Gaebel, W., Gerlach, J., Guelfi, J.D., Kissling, W., Lapierre, Y.D., Lindstrom, E., Mendlewicz, J., Racagni, G., Carulla, L.S., & Schooler, N.R. (1998). Guidelines for depot antipsychotic treatment in schizophrenia. European Neuropsychopharmacology 8: 55–66

    Article  CAS  PubMed  Google Scholar 

  • Kane, J.M., Eerdekens, M., Lindenmayer, J.P., Keith, S.J., Lesem, M., & Karcher, K. (2003). Long-acting injectable risperidone: efficacy and safety of the first long-acting atypical antipsychotic. American Journal of Psychiatry 160: 1125–1132

    Article  PubMed  Google Scholar 

  • Kinross-Wright, J., Vogt, A.H., & Charalampous, K.D. (2003). A new method of drug therapy. American Journal of Psychiatry 119: 779–780

    Google Scholar 

  • Kemp, R., Hayward, P., Applewhaite, G., Everitt, B., & David, A. (1996). Compliance therapy in psychotic patients: randomised controlled trial. British Medical Journal 312: 345–349

    CAS  PubMed  Google Scholar 

  • Kemp, R., Kirov, G., Everitt, B., Hayward, P., & David, A. (1998). Randomised controlled trial of compliance therapy. 18-month follow-up. British Journal of Psychiatry 172: 413–419

    Article  CAS  PubMed  Google Scholar 

  • Kissling, W. (1994). Compliance, quality assurance and standards for relapse prevention in schizophrenia. Acta Psychiatrica Scandinavica Supplement 382: 16–24

    Article  CAS  Google Scholar 

  • Kissling, W. (1997). Compliance, quality management and standards in the treatment of schizophrenia. Neuropsychobiology 35: 70–72

    Article  CAS  PubMed  Google Scholar 

  • Lauriello, J., Lambert, T., Andersen, S., Lin, D., Taylor, C.C., & Mcdonnell, D. (2008). An 8-week, double-blind, randomized, placebo-controlled study of olanzapine long-acting injection in acutely ill patients with schizophrenia. Journal of Clinical Psychiatry 69: 790–799

    Article  CAS  PubMed  Google Scholar 

  • Leff, J.P. & Wing, J.K. (1971). Trial of maintenance therapy in schizophrenia. British Medical Journal 11: 599–604

    Article  Google Scholar 

  • Lieberman, J.A., Stroup, T.S., Mcevoy, J.P., Swartz, M.S., Rosenheck, R.A., Perkins, D.O., Keefe, R.S.E., Davis, S.M., Davis, C.E., Lebowitz,B.D., Severe, J., & Hsiao, J.K. (2005). And the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) Investigators, Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine 353: 1209–1223

    Article  CAS  PubMed  Google Scholar 

  • Link, B.G., Stueve, A., & Phelan, J. (1998). Psychotic symptoms and violent behavior: probing the components of “threat/control-override” symptoms. Social Psychiatry and Epidemiology 33: 55–60

    Article  Google Scholar 

  • Nose, M., Barbui, C., Gray, R., & Tansella, M. (2003). Clinical interventions for treatment non-adherence in psychosis: meta-analysis. British Journal of Psychiatry 183:197–206

    Article  PubMed  Google Scholar 

  • O’Donnell, C., Donohoe, G., & Sharkey, L. et al. (2003). Compliance therapy: a randomised controlled trial in schizophrenia. British Medical Journal 327: 834–838

    Article  PubMed  Google Scholar 

  • Patel, M.X., Dezoysa, N., Bernadt, M., Bindman, J., & David, A.S. (2007). Voluntary out-patients and coercion: depot versus oral antipsychotics. Schizophrenia Bulletin 33: 452

    Google Scholar 

  • Patel, M.X., & David, A.S. (2005). David AS. Why aren’t depot antipsychotics prescribed more often and what can be done about it? Advances in Psychiatric Treatment 11: 203–211

    Google Scholar 

  • Patel, M.X., Dezoysa, N., Baker, D., & David, A.S. (2005). Depot antipsychotic medication and attitudes of community psychiatric nurses. Journal of Psychiatric and Mental Health Nursing 12: 237–244

    Article  CAS  PubMed  Google Scholar 

  • Patel, M.X., Dezoysa, N., Bernadt, M., & David, A.S. (2008). Patients’ perspectives on adherence to antipsychotic medication: depots versus tablets. Journal of Clinical Psychiatry 69: 1548–1556

    Article  PubMed  Google Scholar 

  • Patel, M.X., Dezoysa, N., Bernadt, M., & David, A.S. (2009) Depot and oral antipsychotics: patient preferences and attitudes are not the same thing. Journal of Psychopharmacology 23(7), 789–796. (published online ahead of print 26 June 2008, doi: 10.1177/0269881108092124)

    Google Scholar 

  • Patel, M.X., Nikolaou, V., & David, A.S. (2003a). Psychiatrists’ attitudes to maintenance medication for patients with schizophrenia. Psychological Medicine 33: 83–89

    Google Scholar 

  • Patel, M.X., Nikolaou, V., & David, A.S. (2003b). Eliciting psychiatrists’ beliefs about side effects of typical and atypical antipsychotic drugs. International Journal of Psychiatry in Clinical Practice 7: 117–120

    Google Scholar 

  • Robinson, D., Woerner, M.G., Alvir, J.M. et al. (1999). Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Archives of General Psychiatry 56: 241–7

    Article  CAS  PubMed  Google Scholar 

  • Schanda, H., Knecht, G., Schreinzer, D., Stompe, T., Ortwein-Swoboda, G., & Waldhoer, T. (2004). Homicide and major mental disorders: a 25-year study. Acta Psychiatrica Scandinavica 110: 98–107

    Article  CAS  PubMed  Google Scholar 

  • Shi, L., Ascher-Svanum, H., Zhu, B., Faries, D., Montgomery, W., & Marder, S.R. (2007). Characteristics and use patterns of patients taking first-generation depot antipsychotics or oral antipsychotics for schizophrenia. Psychiatric Services 58: 482–488

    Article  PubMed  Google Scholar 

  • Simpson, G.M. (1974). A brief history of depot neuroleptics. Journal of Clinical Psychiatry 45: 3–4

    Google Scholar 

  • Steinert, T., Sippach, T., & Gebhardt, R. (2000). How common is violence in schizophrenia despite neuroleptic treatment? Pharmacopsychiatry 33: 98–102

    Article  CAS  PubMed  Google Scholar 

  • Swanson, J.W., Swartz, M.S., Van Dorn, R.A., Elbogen, E.B., Wagner, H.R., Rosenheck, R.A., Stroup, T.S., Mcevoy, J.P., & Lieberman, J.A. (2006). A national study of violent behavior in persons with schizophrenia. Archives of General Psychiatry 63: 490–499

    Article  PubMed  Google Scholar 

  • Swanson, J.W., Swartz, M.S., Van Dorn, R.A., Volavka, J., Monahan, J., Stroup, T.S., Mcevoy, J.P., Wagner, H.R., Elbogen, E.B., & Lieberman, J.A. (2008). Comparison of antipsychotic medication effects on reducing violence in people with schizophrenia. British Journal of Psychiatry 193: 37–43

    Article  PubMed  Google Scholar 

  • Swartz, M.S., Swanson, J.W., Hiday, V.A., Borum, R., Wagner, H.R., & Burns, B.J., (1998a). Taking the wrong drugs: the role of substance abuse and medication noncompliance in violence among severely mentally ill individuals. Social Psychiatry and Epidemiology 33: S75–S80

    Google Scholar 

  • Swartz, M.S., Swanson, J.W., Hiday, V.A., Borum, R., Wagner, H.R., & Burns, B.J., (1998b).Violence and severe mental illness: the effects of substance abuse and nonadherence to medication. American Journal Psychiatry 155: 226–231

    Google Scholar 

  • Swartz, M.S., Swanson, J.W., Wagner, H.R., Burns, B.J., & Hiday, V.A., (2001). Effects of involuntary outpatient commitment and depot antipsychotics on treatment adherence in persons with severe mental illness. Journal of Nervous and Mental Disease 189: 592

    Article  Google Scholar 

  • Tattan, T.M.G. & Creed, F.H. (2001). Negative symptoms of schizophrenia and compliance with medication. Schizophrenia Bulletin 27: 149–155

    CAS  PubMed  Google Scholar 

  • Taylor, D., Mir, S., Mace, S., & Hogman, G. (1999). Is Cost a Factor – II? A Survey of Psychiatrists and Health Authorities to Determine the Factors Influencing the Prescribing and Funding of Atypical Antipsychotics. London: National Schizophrenia Fellowship

    Google Scholar 

  • Teasdale, B., Silver, E., & Monahan, J. (2006). Gender, threat/control-override delusions and violence. Law and Human Behavior 30: 649–658

    Article  PubMed  Google Scholar 

  • Tiihonen, J., Walhbeck, K., Lonnqvist, J., Klaukka, T., Ioannidis, J.P.A., Volavka, J., & Haukka, J. (2006). Effectiveness of antipsychotic treatments in a nationwide cohort of patients in community care after first hospitalisation due to schizophrenia and schizoaffective disorder: observational follow-up study. British Medical Journal 333: 224

    Article  PubMed  Google Scholar 

  • Valenstein, M., Copeland, L.A., Blow F.C., Mccarthy J.F., Zeber, J.E., Gillon, L., Bingham, C.R., & Stavanger, T. (2002). Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Medical Care 40:630–639

    Article  PubMed  Google Scholar 

  • Volavka, J. (1999). The effects of clozapine on aggression and substance abuse in schizophrenic patients. Journal of Clinical Psychiatry 60: 43–46

    CAS  PubMed  Google Scholar 

  • Walburn, J., Gray, R., Gournay, K., Quraishi, S., & David, A.S. (2001). A systematic review of patient and nurse attitudes to depot antipsychotic medication. British Journal of Psychiatry 179: 300–307

    Article  CAS  PubMed  Google Scholar 

  • Walsh, E., Buchanan, A., & Fahy, T., (2002). Violence and schizophrenia: examining the evidence. British Journal of Psychiatry 180: 490–495

    Article  PubMed  Google Scholar 

  • Weiden, P. & Glazer, W. (1997). Assessment and treatment selection for ‘revolving door’ inpatients with schizophrenia. The Psychiatric Quarterly 68: 377–392

    Article  CAS  PubMed  Google Scholar 

  • Zygmunt, A., Olfson, M., Boyer, C.A., & Mechanic, D. (2002). Interventions to improve medication adherence in schizophrenia. American Journal of Psychiatry 159: 1653–1664

    Article  PubMed  Google Scholar 

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David, A.S., Gibbs, A., Patel, M.X. (2010). Long-Acting Antipsychotic Medication and the Outcome of Schizophrenia. In: Gattaz, W., Busatto, G. (eds) Advances in Schizophrenia Research 2009. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-0913-8_23

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