Current and emerging long-acting antipsychotics for the treatment of schizophrenia

Filippis, Renato de; Fazio, Pasquale De; Gaetano, Raffaele; Steardo, Luca; Cedro, Clemente; Bruno, Antonio; Zoccali, Rocco Antonio; Muscatello, Maria Rosaria Anna

doi:10.1080/14740338.2021.1910674

Cited by 28 publications

(13 citation statements)

References 155 publications

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“…Although head-to-head comparison of LAIs did not show relevant differences between LAI treatments, aripiprazole, olanzapine, and paliperidone (1- and 3-monthly formulation) might be considered first-line choices, as they are supported by the highest certainty of evidence for both relapse prevention and acceptability ( 20 ). Furthermore, benefits of LAI over oral formulation include improved bioavailability, maintenance stable plasma levels and receptor occupancy avoiding daily peaks, reducing plasma fluctuation, and increasing safety and tolerability, higher relapse prevention, greater compliance and earlier detection of non-adherence, requirement of regular visits with a psychiatrist specialist ( 21 – 23 ).…”

Section: Introductionmentioning

confidence: 99%

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

et al. 2021

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Background: Long-acting injectable (LAI) antipsychotics are efficacious in managing psychotic symptoms in people affected by severe mental disorders, such as schizophrenia and bipolar disorder. The present study aimed to investigate whether attitude toward treatment and treatment adherence represent predictors of symptoms changes over time.Methods: The STAR Network “Depot Study” was a naturalistic, multicenter, observational, prospective study that enrolled people initiating a LAI without restrictions on diagnosis, clinical severity or setting. Participants from 32 Italian centers were assessed at three time points: baseline, 6-month, and 12-month follow-up. Psychopathological symptoms, attitude toward medication and treatment adherence were measured using the Brief Psychiatric Rating Scale (BPRS), the Drug Attitude Inventory (DAI-10) and the Kemp's 7-point scale, respectively. Linear mixed-effects models were used to evaluate whether attitude toward medication and treatment adherence independently predicted symptoms changes over time. Analyses were conducted on the overall sample and then stratified according to the baseline severity (BPRS < 41 or BPRS ≥ 41).Results: We included 461 participants of which 276 were males. The majority of participants had received a primary diagnosis of a schizophrenia spectrum disorder (71.80%) and initiated a treatment with a second-generation LAI (69.63%). BPRS, DAI-10, and Kemp's scale scores improved over time. Six linear regressions—conducted considering the outcome and predictors at baseline, 6-month, and 12-month follow-up independently—showed that both DAI-10 and Kemp's scale negatively associated with BPRS scores at the three considered time points. Linear mixed-effects models conducted on the overall sample did not show any significant association between attitude toward medication or treatment adherence and changes in psychiatric symptoms over time. However, after stratification according to baseline severity, we found that both DAI-10 and Kemp's scale negatively predicted changes in BPRS scores at 12-month follow-up regardless of baseline severity. The association at 6-month follow-up was confirmed only in the group with moderate or severe symptoms at baseline.Conclusion: Our findings corroborate the importance of improving the quality of relationship between clinicians and patients. Shared decision making and thorough discussions about benefits and side effects may improve the outcome in patients with severe mental disorders.

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Section: Introductionmentioning

confidence: 99%

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

et al. 2021

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“…5,20 Research has shown that LAIs maintain steady levels and avoid plasma fluctuations of the drug, which results in improved functional outcomes, lowered risk of adverse effects, reduced relapse rates, and decreased hospitalizations. 5,20 The decrease in relapse and hospitalizations ultimately reduces the cost of managing the disease. 21 New guidelines from the American Psychiatric Association suggest that a LAI should be prescribed to any patient who prefers this formulation as an alternative to daily oral antipsychotic treatment or if they have a history of poor or uncertain adherence.…”

Section: Place In Therapymentioning

confidence: 99%

“…To address the issue of treatment adherence, several long-acting injectable (LAI) antipsychotics are available. 5,7 In this article, we focus on paliperidone palmitate once in 6 months formulation (PP6M). PP6M is a LAI and marketed as Invega Hafyera.…”

Section: Introductionmentioning

confidence: 99%

Invega Hafyera (Paliperidone Palmitate): Extended-Release Injectable Suspension for Patients With Schizophrenia

Peters

Dyer

Schroeder

et al. 2023

Journal of Pharmacy Technology

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Objective: The objective of this study was to describe the safety, efficacy, and potential role in therapy of once in 6 months paliperidone palmitate formulation (PP6M; Invega Hafyera). PP6M is a long-acting injectable antipsychotic recently approved by the Food and Drug Administration (FDA) for the treatment of schizophrenia. Data Sources: A PubMed literature search was conducted using the following terms: paliperidone palmitate and long-acting antipsychotic injections (January 1, 2017, to November 1, 2022). FDA product labeling was also reviewed for pertinent data. Study Selection and Data Extraction: All relevant English-language articles focused on the efficacy and safety of PP6M were considered for inclusion. Data Synthesis: A multicenter, randomized, active controlled relapse prevention noninferiority study showed that PP6M is comparable to paliperidone palmitate once in 3 months formulation (PP3M) in terms of efficacy and safety in clinically stable schizophrenia patients. Place in Therapy: PP6M is indicated in the treatment of adult patients with schizophrenia, who need treatment over a prolonged period. It improves adherence and decreases the rate of relapse and hospitalizations among patients with schizophrenia. It is useful for patients who may have difficulty accessing health care or would prefer the convenience of less frequent injections. Conclusion: PP6M with its long duration of action and lowered frequency of administration (once every 6 months) expands the therapeutic choices available to patients with schizophrenia. More studies in patients with schizophrenia with PP6M, and perhaps other mental illnesses (eg, schizoaffective disorder), are required to fully elucidate the therapeutic potential of PP6M.

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“…In the last few decades psychopharmacology has witnessed an incredible development in terms of efficacy, safety and number of options available for the treatment and management of major mental disorders ( 1 , 2 ). The change of perspective from a therapy mainly centered on experience to the evidence-based medicine has represented a true Copernicus revolution in mental health, with the implication of providing concrete improvements on disease prognosis and patients' quality of life ( 3 ).…”

mentioning

confidence: 99%

Editorial: Safety and side effects of psychotropic medications

Filippis

Solerdelcoll²,

Shalbafan³

2023

Front. Psychiatry

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Current and emerging long-acting antipsychotics for the treatment of schizophrenia

Cited by 28 publications

References 155 publications

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

The Role of Attitudes Toward Medication and Treatment Adherence in the Clinical Response to LAIs: Findings From the STAR Network Depot Study

Invega Hafyera (Paliperidone Palmitate): Extended-Release Injectable Suspension for Patients With Schizophrenia

Editorial: Safety and side effects of psychotropic medications

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