Patients' acceptance of the deltoid application of risperidone long-acting injection

Heres, Stephan; Froböse, Teresa; Hamann, Johannes; Leucht, Stefan; Maino, Katja; Reichhart, Tatjana; Stiegler, Michaela; Kissling, Werner

doi:10.1016/j.euroneuro.2012.04.014

Cited by 7 publications

(10 citation statements)

References 19 publications

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“…Future studies should also focus on site of injection (deltoid vs . gluteal) ( Heres et al, 2012 ) and timing of administration (twice vs . once-monthly vs .…”

Section: Article In Pressmentioning

confidence: 99%

Long-acting injectable antipsychotics (LAIs) for maintenance treatment of bipolar and schizoaffective disorders: A systematic review

Pacchiarotti

Tiihonen

Kotzalidis

et al. 2019

European Neuropsychopharmacology

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Long-Acting Injectable Antipsychotics (LAIs) are used to overcome non-compliance in psychoses, mainly schizophrenia spectrum disorders. We aimed to summarize available evidence of studies comparing the efficacy of LAIs to placebo or oral medications for Bipolar Disorder JID: NEUPSY [m6+; February 12, 2019;11:45 ] Long-acting injectable antipsychotic treatment; Risperidone long-acting; Paliperidone palmitate long-acting injectable; Aripiprazole monohydrate long-acting injectable (BD) and/or Schizoaffective Disorder (SAD). We searched six databases from inception to 28-March-2018, using the strategy: long-acting antipsychotics AND (bipolar disorder OR schizoaffective disorder OR mania OR manic OR bipolar depression). We included peer-reviewed double-blind comparisons of LAIs for any clinical outcome occurrence in BD, or open mirror studies with same prospective as retrospective assessment periods. We excluded studies reporting on mixed schizophrenia/SAD populations without reporting results separately. The pooled records amounted to 642. After duplicate removal and inclusion/exclusion criteria application, we included 15 studies, 6 double-blind and 9 open, 13 assessing BD and 2 SAD. Depot neuroleptics prevented manic, but not depressive recurrences and may worsen depressive symptoms. Risperidone long-acting injectable was found to be effective in protecting from any mood/manic symptom compared to placebo, but not from depressive recurrences. Add-on or monotherapy paliperidone palmitate in SAD patients protected from psychotic, depressive, and manic symptoms. In patients with BD-I with a manic episode at study enrolment, aripiprazole monohydrate significantly delayed time to recurrence of manic episodes without inducing depressive episodes. LAIs are effective and well-tolerated maintenance treatments for BD and SAD. They showed better efficacy in preventing mania than depression. LAIs may be first-line for BD-I and SAD patients with a manic predominant polarity and with non-adherence problems.

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“…Future studies should also focus on site of injection (deltoid vs . gluteal) ( Heres et al, 2012 ) and timing of administration (twice vs . once-monthly vs .…”

Section: Article In Pressmentioning

confidence: 99%

Long-acting injectable antipsychotics (LAIs) for maintenance treatment of bipolar and schizoaffective disorders: A systematic review

Pacchiarotti

Tiihonen

Kotzalidis

et al. 2019

European Neuropsychopharmacology

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“…In a previous study regarding acceptance for risperidone LAI administration into the deltoid muscle [14], 57% of patients responding to a questionnaire wished to switch to deltoid muscle administration. A survey after 3 months showed that deltoid muscle administration had been continued in 60% of patients in the switching group, whereas it was again switched to gluteal muscle administration in 40%.…”

Section: Discussionmentioning

confidence: 99%

“…1). Furthermore, the study design and questionnaire items were established based on a previous study [14], regarding acceptance for risperidone LAI administration into the deltoid muscle.…”

Section: Methodsmentioning

confidence: 99%

“…Pariperidone LAI is available in Japan as same as Europe and USA for both gluteal or deltoid muscle injection [13], although the deltoid administration of risperidone LAI is not available in Japan. According to a previous study regarding acceptance for risperidone LAI administration into the deltoid muscle [14], 57% of patients responding to a questionnaire wished to switch to deltoid muscle administration. A survey after 3 months showed that deltoid muscle administration had been continued in 60% of patients in the switching group, whereas it was again switched to gluteal muscle administration in 40%, suggesting that resistance to the administration site influences LAI acceptance.…”

Section: Introductionmentioning

confidence: 99%

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Acceptance of the Deltoid Muscle Injection of Aripiprazole Long-acting Injectable in the Patients with Schizophrenia

Kamei

Homma

Takeuchi³

et al. 2020

Clin Psychopharmacol Neurosci

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Objective: To improve poor medication adherence in schizophrenic patients, long-acting injectable (LAI) antipsychotics are used. However, it has not yet become common in Japan. Recently, aripiprazole LAI was approved for alternative injection into the deltoid muscle in addition to the gluteal muscle. The acceptance for the proposal to switch from gluteal to deltoid injections of aripiprazole LAI was investigated. Methods: The subjects were 32 outpatients with schizophrenia who had continuously received aripiprazole LAI administration into the gluteal muscle for ≥ 6 months. In the patients who had continued deltoid injection for 3 months after switching, the changes in the pain and shame in comparison with gluteal injections were evaluated. Results: Switching to the deltoid injection was chosen by 17 out of 32 patients. Three months later, 9 patients were still receiving deltoid injections with highly rated satisfaction. The main reasons for switching to deltoid injections included the pain and shame associated with gluteal injections. The main reason for returning to the gluteal injection was the pain experienced from the injection in the deltoid. Conclusion: The option to select the injected area was based on the amount of pain in the deltoid and gluteal sites, leading to the widespread use of aripiprazole LAI.

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“…Patients may also value the opportunity to select or alternate the administration site. In a survey of 60 patients with schizophrenia who were stabilized on an LAI antipsychotic administered at the gluteal site, 57% (n=34/60) of patients chose to switch to the deltoid injection site when given the choice in administration site (Heres et al, 2012). Common reasons noted for switching included less burden from undressing and being able to receive the injection while standing, whereas common reasons for not switching included fear of increased pain and potential dermal injection site reactions in a visible area of the body (Heres et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Aripiprazole Once-Monthly 400 mg: Comparison of Pharmacokinetics, Tolerability, and Safety of Deltoid Versus Gluteal Administration

Raoufinia

Peters-Strickland

Nylander

et al. 2017

International Journal of Neuropsychopharmacology

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Background:Two open-label, randomized, parallel-arm studies compared pharmacokinetics, safety, and tolerability of aripiprazole once-monthly 400 mg following deltoid vs gluteal injection in patients with schizophrenia.Methods:In the single-dose study, 1 injection of aripiprazole once-monthly 400 mg in the deltoid (n=17) or gluteal (n=18) muscle (NCT01646827) was administered. In the multiple-dose study, the first aripiprazole once-monthly 400 mg injection was administered in either the deltoid (n=71) or gluteal (n=67) muscle followed by 4 once-monthly deltoid injections (NCT01909466).Results:After single-dose administration, aripiprazole exposure (area under the concentration-time curve) was similar between deltoid and gluteal administrations, whereas median time to maximum plasma concentration was shorter (7.1 [deltoid] vs 24.1 days [gluteal]) and maximum concentration was 31% higher after deltoid administration. In the multiple-dose study, median time to maximum plasma concentration for deltoid administration was shorter (3.95 vs 7.1 days), whereas aripiprazole mean trough concentrations, maximum concentration, and area under the concentration-time curve were comparable between deltoid and gluteal muscles (historical data comparison). Multiple-dose pharmacokinetic results for the major metabolite, dehydro-aripiprazole, followed a similar pattern to that of the parent drug for both deltoid and gluteal injection sites. Safety and tolerability profiles were similar after gluteal or deltoid injections. Based on observed data, minimum aripiprazole concentrations achieved by aripiprazole once-monthly 400 mg are comparable with those of oral aripiprazole 15 to 20 mg/d.Conclusions:The deltoid muscle is a safe alternative injection site for aripiprazole once-monthly 400 mg in patients with schizophrenia.

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Patients' acceptance of the deltoid application of risperidone long-acting injection

Cited by 7 publications

References 19 publications

Long-acting injectable antipsychotics (LAIs) for maintenance treatment of bipolar and schizoaffective disorders: A systematic review

Long-acting injectable antipsychotics (LAIs) for maintenance treatment of bipolar and schizoaffective disorders: A systematic review

Acceptance of the Deltoid Muscle Injection of Aripiprazole Long-acting Injectable in the Patients with Schizophrenia

Aripiprazole Once-Monthly 400 mg: Comparison of Pharmacokinetics, Tolerability, and Safety of Deltoid Versus Gluteal Administration

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