Comparative Effectiveness of Risperidone Long-Acting Injectable vs First-Generation Antipsychotic Long-Acting Injectables in Schizophrenia: Results From a Nationwide, Retrospective Inception Cohort Study

Nielsen, Jimmi; Jensen, Sigmund; Friis, Rasmus Blechingberg; Valentin, Jan Brink; Correll, Christoph U.

doi:10.1093/schbul/sbu128

Cited by 43 publications

(40 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…On the other hand, in the previously cited cohort study in Finland, the authors found a significantly lower risk of rehospitalization on depots than on oral drugs [13], while in yet another nationwide retrospective inception cohort study in Denmark, RLAI and FGA LAIs did not differ regarding time to hospitalization, all-cause discontinuation, or duration of hospitalization in patients with schizophrenia [23]. However, this study did not evaluate psychopathology, functional outcomes, quality of life (QOL), or side effects.…”

Section: Specific Agentsmentioning

confidence: 99%

The Use of Long-Acting Injectable Antipsychotics in Schizophrenia

Miyamoto

Fleischhacker

2017

Curr Treat Options Psych

View full text Add to dashboard Cite

Opinion StatementSchizophrenia is a mostly chronic mental disorder, and symptomatic relapse is frequently observed. It is often associated with social and/or occupational decline that can be difficult to reverse. Most patients with the illness need long-term pharmacological treatment, and antipsychotic drugs represent the mainstay of clinical care. Long-acting injectable antipsychotics (LAIs) are an important alternative to oral medication, particularly advantageous in the context of compliance management. Several new-generation antipsychotics (NGAs), including risperidone, olanzapine, paliperidone, and aripiprazole, have become available as long-acting formulations, and new evidence has been accumulating. To date, all of the NGA LAIs have demonstrated a statistically and clinically significant decrease of relapse rates over placebo. The results of clinical trials comparing NGA LAIs with oral antipsychotics (OAPs) are not consistent, as being influenced considerably by study design. Superiority of LAIs to OAPs in efficacy is most evident in mirror image and cohort studies. New-generation LAIs are comparable to their oral mother compounds regarding safety and tolerability if one disregards potential injection site complications. There is little evidence of efficacy differences between the available LAIs, but they have different characteristics in terms of pharmacodynamic and pharmacokinetic profiles, injection interval, cost, requirements for oral supplementation, as well as adverse events. Considering these differences is useful for selecting LAIs for the treatment of individual patients. There is increasing evidence suggesting the use of LAIs in special patient groups, such as first-episode or forensic schizophrenia patients. This article reviews data on the use of NGA LAIs in schizophrenia and discusses current issues from clinical and methodological perspectives.

show abstract

Section: Specific Agentsmentioning

confidence: 99%

The Use of Long-Acting Injectable Antipsychotics in Schizophrenia

Miyamoto

Fleischhacker

2017

Curr Treat Options Psych

View full text Add to dashboard Cite

show abstract

“…In contrast, haloperidol has a clear advantage with respect to placebo in terms of amelioration of positive symptoms, but it can worsen motor and negative symptoms (King, ). Despite these speculations, a number of studies reported equal (Peuskens et al, ; Crespo‐Facorro et al, ; McEvoy et al, ; Nielsen et al, ;) or even less effectiveness of second‐generation antipsychotics than first‐generation antipsychotics in long‐term treatment of schizophrenia (Kennedy et al, ). In contrast, in 2011 preliminary results by the group investigators from the University of Milan showed a clear advantage of olanzapine and risperidone compared to haloperidol (Altamura et al, ).…”

Section: Introductionmentioning

confidence: 99%

Haloperidol versus second-generation antipsychotics in the long-term treatment of schizophrenia

Buoli

Kahn

Serati

et al. 2016

Hum. Psychopharmacol Clin Exp

View full text Add to dashboard Cite

Patients treated with atypical antipsychotics appear to continue pharmacotherapy longer than patients treated with haloperidol. In addition, atypical antipsychotics seem to be more protective against recurrences than haloperidol. However, these results should be cautiously interpreted in the light of potential confounder factors such as duration of illness. Copyright © 2016 John Wiley & Sons, Ltd.

show abstract

“…In fact, patients have to return for injections and, thus, clinicians and family members are certain when a medication dose has been received or missed, allowing immediate action. Moreover, as antipsychotic LAI release the medication slowly, missing an injection will not lead to a precipitous drop in the blood level like after stopping oral antipsychotics, increasing the window of protection during which nonadherence can be addressed . For these reasons, LAI are considered an important treatment option for nonadherence …”

Section: Discussionmentioning

confidence: 99%

Discontinuation rates during long‐term, second‐generation antipsychotic long‐acting injection treatment: A systematic review

Gentile

2019

Psychiatry Clin Neurosci

View full text Add to dashboard Cite

Aim The aim of this review was to analyze the discontinuation rates during long‐term treatment with second‐generation antipsychotic long‐acting injection (SGA‐LAI) in adults with either schizophrenia spectrum or bipolar disorders. Methods A systematic search (PubMed, Scopus, and the Cochrane Library) of studies published in English (1 January 2001–12 October 2018) identified 1214 abstracts, which were analyzed independently by the author and two colleagues. Studies were retrieved and reviewed if they reported primary data on the discontinuation rate before the study end during treatment lasting ≥36 weeks. Data were extracted from 51 articles meeting the inclusion criteria. Results In all head‐to‐head comparisons, and studies on patients with schizophrenia spectrum or bipolar disorders, the discontinuation rate before the study end in patients treated with SGA‐LAI was, at best, similar to that recorded in patients treated with first‐generation antipsychotics in either oral or LAI formulations or with oral SGA. In particular, in most of the SGA‐LAI long‐term studies, the rate of premature dropout was higher than 50%. Conclusion Reviewed data suggest that SGA‐LAI show no clear superiority over less expensive drugs (including first‐generation antipsychotic LAI and oral antipsychotic formulations) in reducing the risk of premature antipsychotic discontinuation. Thus, alternative strategies should be considered to improve medication persistence and lower discontinuation rates in patients with severe psychiatric disorders. Planning tailored, individualized, and integrated approaches (including frequent clinical evaluations, and behavioral or other flexible techniques adaptable to different settings and patients) may be an effective intervention for improving patient adherence in long‐term pharmacological treatment regimens.

show abstract

Comparative Effectiveness of Risperidone Long-Acting Injectable vs First-Generation Antipsychotic Long-Acting Injectables in Schizophrenia: Results From a Nationwide, Retrospective Inception Cohort Study

Cited by 43 publications

References 33 publications

The Use of Long-Acting Injectable Antipsychotics in Schizophrenia

The Use of Long-Acting Injectable Antipsychotics in Schizophrenia

Haloperidol versus second-generation antipsychotics in the long-term treatment of schizophrenia

Discontinuation rates during long‐term, second‐generation antipsychotic long‐acting injection treatment: A systematic review

Contact Info

Product

Resources

About