Sociodemographic and clinical factors associated with prescription of first- versus second-generation long-acting antipsychotics in incarcerated adult males

Abstract

Information on patterns of prescription of long-acting injection (LAI) antipsychotics among people who are incarcerated is lacking. Therefore, we aimed to evaluate prescribing rates for first-generation antipsychotic (FGA)-LAI versus second-generation antipsychotic (SGA)-LAI and to identify the factors associated with the prescription of one of the two classes of LAI. A cross-sectional study was conducted among incarcerated adult males hosted in Monza detention center between January 2013 and April 2023. Socio-demographic and clinical data were retrospectively collected. Descriptive and univariate statistics as well as logistic regression analyses were performed. Data were available for 135 consecutive incarcerated adult males with different mental disorders who received a LAI as part of their treatment. 75.6% of our sample was treated with FGA-LAIs, with haloperidol as the most commonly prescribed drug, followed by zuclopentixol and aripiprazole. Diagnosis of bipolar disorder and concomitant administration of antidepressants were statistically significant predictors of SGA-LAI prescription. Some patients’ characteristics may influence prescription patterns in prison. Further longitudinal studies with larger samples should confirm these findings.

The impact of efficacy of long-acting injectable antipsychotics on caregivers’ burden of patients with schizophrenia

“…In addition, an asymptomatic subject who achieved stable remission may not realize the necessity to maintain the therapy and there is no clear evidence of a better patients' adherence to LAI-SGAs than LAI first-generation antipsychotics (LAI-FGAs). Similarly, clinicians do not currently show a clear preference in prescribing LAI-SGAs versus LAI-FGAs (Capuzzi et al, 2023), although SGAs may be the best choice for their action on a broader group of symptoms and a potential neuroprotective effect (Capuzzi et al, 2021b). Also in the article of this commentary, there was a wider use of SGAs without the possibility for sample reasons of a comparison with FGAs.…”

Focus on neurodevelopmental conditions and antipsychotics prescription patterns

“…Two articles in this issue contribute to increasing our knowledge on this issue. One of the two articles examine factors that may be associated with the prescription of first-generation and second-generation long-acting antipsychotics in incarcerated adult males (Capuzzi et al, 2023). An interesting finding is that only about half of the prescriptions were for subjects with schizophrenia and about 25% were for personality disorders.…”