Treatment Adherence with Early Prescription of Long-Acting Injectable Antipsychotics in Recent-Onset Schizophrenia

Abstract

Although response to treatment for the first episode of schizophrenia is generally favourable, nonadherence with the treatment is the first cause of relapse and rehospitalisation within the next few years. Long-acting injectable antipsychotics (LAIAs) combine the advantages of the newer antipsychotics and the long-acting formulation. The evaluation concerns 25 schizophrenic patients hospitalised for the first time, treated with risperidone long-acting injectable (RLAI) associated with reintegration methods, and followed up for at least 18 months. Clinical observation was completed using Clinical Global Impression (CGI) scale and Global Assessment of Functioning (GAF). Clinical improvement was coupled with a good reintegration rate, very few relapse, or rehospitalisation. Bimonthly injection combined with psychosocial methods improved interactive followup, and therefore patients' compliance with the treatment. Treating with LAIA as early as possible, from the first episode if possible, can reduce relapse, number and duration of rehospitalisation, and cognitive symptoms and improve the quality of life and prognosis.

The Use of Continuous Treatment Versus Placebo or Intermittent Treatment Strategies in Stabilized Patients with Schizophrenia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials with First- and Second-Generation Antipsychotics

“…Current guidelines and recommendations on schizophrenia consider LAAPs as drugs of choice for the treatment of schizophrenia patients with recurrent relapses related to non-adherence with antipsychotic medication [11,65,[152][153][154][155][156]. Recent reviews have never been more vocal about their use in early-episode patients for similar reasons (provided schizophrenia has been diagnosed or clinically highly suspected), as these patients ''have more to lose'' [134,[157][158][159][160][161][162][163][164][165][166][167][168][169][170]. LAAPs may, if presented correctly, be more effective for maintaining medication continuity, preventing relapse, reducing the number and duration of rehospitalizations and, when achieving remission, holding this status [161,166,168,169,[171][172][173][174][175].…”

Stress and burden faced by family caregivers of people with schizophrenia and early psychosis in Hong Kong

“…Among people with schizophrenia, poor medication adherence is a major issue that brings about negative clinical impacts and relapses , which subsequently intensify caregiver burden . Current evidence has indicated that the use of long‐acting injectable antipsychotics (LAIs) can enhance treatment adherence, reduce relapse rates and improve prognosis in people with schizophrenia . Moreover, a recent post hoc analysis revealed that, for people on prior oral antipsychotics after switching to LAIs, caregiver burden was significantly alleviated, with reductions in workdays missed, leisure time affected and time spent in caregiving .…”

“…19 Current evidence has indicated that the use of long-acting injectable antipsychotics (LAIs) can enhance treatment adherence, reduce relapse rates and improve prognosis in people with schizophrenia. 20,21 Moreover, a recent post hoc analysis revealed that, for people on prior oral antipsychotics after switching to LAIs, caregiver burden was significantly alleviated, with reductions in workdays missed, leisure time affected and time spent in caregiving. 22 Nevertheless, about one-third of the caregivers in our survey were unsure whether having their ill relative on injectable antipsychotics instead of oral antipsychotics could help improve their own stress ( Table 6).…”

Clinical benefits and impact of early use of long‐acting injectable antipsychotics for schizophrenia

“…5,[44][45][46][47] A growing body of literature demonstrates that LAIs also are effective for early intervention or when used for first-episode treatment of schizophrenia rather than delaying treatment. [48][49][50][51][52] A higher response rate is associated with initial AP treatment in first episode with significantly less response to subsequent AP treatment. 22,53 Although LAIs may have advantages compared with oral APs, especially with respect to more convenient monitoring of adherence, LAI use often is limited by negative attitudes of health-care professionals, specifically regarding earlier use in the course of therapy.…”

“…Twenty-five schizophrenic patients hospitalized for the first time were treated with a LAI and subsequently followed for up to 18 months. 52 Patients were assessed with CGI and GAF scales. Clinical improvement was associated with fewer relapses and a lower rate of rehospitalization.…”