Does formulation matter? A systematic review and meta-analysis of oral versus long-acting antipsychotic studies

Ostuzzi, Giovanni; Bighelli, Irene; So, Ryuhei; Furukawa, Toshi A; Barbui, Corrado

doi:10.1016/j.schres.2016.11.010

Cited by 69 publications

(57 citation statements)

References 62 publications

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“…The reduction seen in the total number of MH ER visits (~48.6%) is consistent with other studies which have previously documented decreases between ~36% and 73% (Su et al, 2009;Denham & Adamson, 1971;Schooler, 2003). However, in contrast to our results, randomized controlled trials (RCTs) have generally not found statistically significant differences between the efficacy of OA and LAI regimens (Kishimoto et al, 2012;Ostuzzi et al, 2017). Although meta-analyses of both standard study-designs clearly contradict each other, there is no evidence of OA to LAI superiority.…”

Section: Discussioncontrasting

confidence: 99%

Effectiveness of Oral Antipsychotic versus Long-Acting-Injectable Antipsychotics: A Comparison of Suicidality, Relapse, and Recidivism

Ward¹,

Parmar²,

Sandhu³

et al. 2017

Int J Emerg Ment Health

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Section: Discussioncontrasting

confidence: 99%

Effectiveness of Oral Antipsychotic versus Long-Acting-Injectable Antipsychotics: A Comparison of Suicidality, Relapse, and Recidivism

Ward¹,

Parmar²,

Sandhu³

et al. 2017

Int J Emerg Ment Health

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“…However, seven independent metaanalyses of available randomized controlled trials, including one conducted in recent-onset psychosis (including only three trials enrolling patients with a diagnosis of psychosis within 1-5 years) 123 , found no evidence that LAIs are associated with better efficacy on relapse prevention, compared to oral antipsychotics [124][125][126][127][128][129] .…”

Section: Should We Use Long-acting Injectable Antipsychotics Earlier?mentioning

confidence: 99%

Improving outcomes of first‐episode psychosis: an overview

2017

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Outcomes of psychotic disorders are associated with high personal, familiar, societal and clinical burden. There is thus an urgent clinical and societal need for improving those outcomes. Recent advances in research knowledge have opened new opportunities for ameliorating outcomes of psychosis during its early clinical stages. This paper critically reviews these opportunities, summarizing the state-of-the-art knowledge and focusing on recent discoveries and future avenues for first episode research and clinical interventions. Candidate targets for primary universal prevention of psychosis at the population level are discussed. Potentials offered by primary selective prevention in asymptomatic subgroups (stage 0) are presented. Achievements of primary selected prevention in individuals at clinical high risk for psychosis (stage 1) are summarized, along with challenges and limitations of its implementation in clinical practice. Early intervention and secondary prevention strategies at the time of a first episode of psychosis (stage 2) are critically discussed, with a particular focus on minimizing the duration of untreated psychosis, improving treatment response, increasing patients' satisfaction with treatment, reducing illicit substance abuse and preventing relapses. Early intervention and tertiary prevention strategies at the time of an incomplete recovery (stage 3) are further discussed, in particular with respect to addressing treatment resistance, improving well-being and social skills with reduction of burden on the family, treatment of comorbid substance use, and prevention of multiple relapses and disease progression. In conclusion, to improve outcomes of a complex, heterogeneous syndrome such as psychosis, it is necessary to globally adopt complex models integrating a clinical staging framework and coordinated specialty care programmes that offer pre-emptive interventions to high-risk groups identified across the early stages of the disorder. Only a systematic implementation of these models of care in the national health care systems will render these strategies accessible to the 23 million people worldwide suffering from the most severe psychiatric disorders.

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“…The inclusion of control groups, consisting of patients on typical depot antipsychotics or the corresponding oral formulations of ARI and PAL, would have produced stronger results, as would a prospective, double‐blind, placebo‐controlled design. However, even without testing in our study the two LAIs against their oral counterparts or placebo, we may rely on previous studies showing overlap of clinical effects and functioning between oral formulations and LAI (Misawa, Kishimoto, Hagi, Kane, & Correll, ; Patel et al, ) and even slight advantages for the latter in meta‐analyses, when quality of studies is taken into account (Ostuzzi, Bighelli, So, Furukawa, & Barbui, ). In addition, placebo‐controlled studies showed the superiority of both medications over placebo (Fu et al, ; Kane et al, ; Kramer et al, ; Meltzer et al, ).…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of overall functioning improvement in patients with chronic schizophrenia and schizoaffective disorder treated with paliperidone palmitate and aripiprazole monohydrate

Girardi

Casale

Rapinesi

et al. 2018

Human Psychopharmacology

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Does formulation matter? A systematic review and meta-analysis of oral versus long-acting antipsychotic studies

Cited by 69 publications

References 62 publications

Effectiveness of Oral Antipsychotic versus Long-Acting-Injectable Antipsychotics: A Comparison of Suicidality, Relapse, and Recidivism

Effectiveness of Oral Antipsychotic versus Long-Acting-Injectable Antipsychotics: A Comparison of Suicidality, Relapse, and Recidivism

Improving outcomes of first‐episode psychosis: an overview

Predictive factors of overall functioning improvement in patients with chronic schizophrenia and schizoaffective disorder treated with paliperidone palmitate and aripiprazole monohydrate

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