Long-acting drugs lead to better outcomes for schizophrenics

Patients with a first episode of psychosis should be offered an injection of a long-acting antipsychotic rather than just oral medication. In the image, a sad, depressed man and his reflection

Non-adherence to oral antipsychotic medication is common among people with schizophrenia and is associated with the return of symptoms. Long-acting injectable antipsychotics offer the potential of improved adherence and clinical outcomes but are rarely used in patients with first-episode psychosis.

Now, a randomised clinical trial involving 86 patients with a first schizophrenia episode has shown that treatment with the long-acting injectable risperidone is associated with a significantly lower rate of psychotic exacerbations or relapses than oral risperidone (5% versus 33%; P<0.001). The injectable formulation is also associated with better adherence and greater control of psychotic symptoms such as hallucinations.

These “notable advantages” presumably reflect the more consistent administration of the long-acting drug, say the researchers in JAMA Psychiatry (online, 24 June 2015)[1]
. The team conclude that such formulations should be offered earlier in the course of illness.

References

[1] Subotnik KL, Casaus LR, Ventura J et al . Long-acting injectable risperidone for relapse prevention and control of breakthrough symptoms after a recent first episode of schizophrenia: a randomized clinical trial. JAMA Psychiatry 2015. doi:10.1001/jamapsychiatry.2015.0270.

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Citation
The Pharmaceutical Journal, PJ, 18 July 2015, Vol 295, No 7871;295(7871):DOI:10.1211/PJ.2015.20068919