Three-Year Naturalistic Study On Early Use Of Long-Acting Injectable Antipsychotics In First Episode Psychosis

Overview

Journal Psychopharmacol Bull

Specialty Pharmacology

Date 2019 Jan 9

PMID 30618474

Citations 8

Authors

Sofia Medrano

Amal Abdel-Baki

Emmanuel Stip

Stephane Potvin

Affiliations

Soon will be listed here.

Abstract

Abstract: Poor adherence to antipsychotics, which affects outcome, is frequent in first episode psychosis (FEP). Most randomized studies demonstrate no superiority of long-acting injectable antipsychotics (LAI-AP) over oral antipsychotics (OAP). However, participants in these studies represent a minority of patients who may benefit from LAI-AP. Mirror and naturalistic studies generally demonstrate efficacy of LAI-AP on more representative samples, but studies on FEP are scarce.

Aim: To describe LAI-AP's utilization and impact on FEP outcome in a naturalistic setting.

Methods: A 3-year longitudinal prospective and retrospective descriptive study of all consecutive admissions from two Early Intervention Services for psychosis (EIS) in Montréal, Canada, compared the characteristics and evolution of patients who received LAI-AP for at least 12 months to those who received OAP only.

Results: From 375 FEP patients included, 26,7% received LAI-AP during their follow-up. They were more likely to have poor prognostic factors (male gender, lower premorbid functioning, homelessness, substance use disorder and schizophrenia spectrum diagnoses). Despite a more severe illness and lower functioning in the LAI-AP group, at admission and study endpoint, clinical and functional improvements were observed.

Conclusion: Early prescription of LAI-AP seems beneficial in FEP with poor prognostic factors.

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References

Emsley R, Oosthuizen P, Koen L, Niehaus D, Medori R, Rabinowitz J . Oral versus injectable antipsychotic treatment in early psychosis: post hoc comparison of two studies. Clin Ther. 2009; 30(12):2378-86. DOI: 10.1016/j.clinthera.2008.12.020. View

Schreiner A, Aadamsoo K, Altamura A, Franco M, Gorwood P, Neznanov N . Paliperidone palmitate versus oral antipsychotics in recently diagnosed schizophrenia. Schizophr Res. 2015; 169(1-3):393-399. DOI: 10.1016/j.schres.2015.08.015. View

Lachaine J, Lapierre M, Abdalla N, Rouleau A, Stip E . Impact of switching to long-acting injectable antipsychotics on health services use in the treatment of schizophrenia. Can J Psychiatry. 2015; 60(3 Suppl 2):S40-7. PMC: 4418621. View

Bradford D, Perkins D, Lieberman J . Pharmacological management of first-episode schizophrenia and related nonaffective psychoses. Drugs. 2003; 63(21):2265-83. DOI: 10.2165/00003495-200363210-00001. View

Correll C, Citrome L, Haddad P, Lauriello J, Olfson M, Calloway S . The Use of Long-Acting Injectable Antipsychotics in Schizophrenia: Evaluating the Evidence. J Clin Psychiatry. 2016; 77(suppl 3):1-24. DOI: 10.4088/JCP.15032su1. View

Leclerc E, Noto C, Bressan R, Brietzke E . Determinants of adherence to treatment in first-episode psychosis: a comprehensive review. Braz J Psychiatry. 2015; 37(2):168-76. DOI: 10.1590/1516-4446-2014-1539. View

Brissos S, Ruiz Veguilla M, Taylor D, Balanza-Martinez V . The role of long-acting injectable antipsychotics in schizophrenia: a critical appraisal. Ther Adv Psychopharmacol. 2014; 4(5):198-219. PMC: 4212490. DOI: 10.1177/2045125314540297. View

Fenton W, Blyler C, Heinssen R . Determinants of medication compliance in schizophrenia: empirical and clinical findings. Schizophr Bull. 1997; 23(4):637-51. DOI: 10.1093/schbul/23.4.637. View

Peuskens J, Olivares J, Pecenak J, Tuma I, Bij de Weg H, Eriksson L . Treatment retention with risperidone long-acting injection: 24-month results from the Electronic Schizophrenia Treatment Adherence Registry (e-STAR) in six countries. Curr Med Res Opin. 2009; 26(3):501-9. DOI: 10.1185/03007990903488670. View

10.

Roy M, Lanctot G, Merette C, Cliche D, Fournier J, Boutin P . Clinical and methodological factors related to reliability of the best-estimate diagnostic procedure. Am J Psychiatry. 1997; 154(12):1726-33. DOI: 10.1176/ajp.154.12.1726. View

11.

Addington D, Addington J, Schissel B . A depression rating scale for schizophrenics. Schizophr Res. 1990; 3(4):247-51. DOI: 10.1016/0920-9964(90)90005-r. View

12.

Galletly C, Castle D, Dark F, Humberstone V, Jablensky A, Killackey E . Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the management of schizophrenia and related disorders. Aust N Z J Psychiatry. 2016; 50(5):410-72. DOI: 10.1177/0004867416641195. View

13.

Bret P, Heil M, Queuille E, Bret M . [Evaluation of prescription practices of long acting injectable risperidone in French hospitals]. Encephale. 2011; 37 Suppl 1:S58-65. DOI: 10.1016/j.encep.2010.04.001. View

14.

Kishi T, Oya K, Iwata N . Long-acting injectable antipsychotics for the prevention of relapse in patients with recent-onset psychotic disorders: A systematic review and meta-analysis of randomized controlled trials. Psychiatry Res. 2016; 246:750-755. DOI: 10.1016/j.psychres.2016.10.053. View

15.

Verdoux H, Lengronne J, Liraud F, Gonzales B, Assens F, Abalan F . Medication adherence in psychosis: predictors and impact on outcome. A 2-year follow-up of first-admitted subjects. Acta Psychiatr Scand. 2000; 102(3):203-10. DOI: 10.1034/j.1600-0447.2000.102003203.x. View

16.

Amminger G, Henry L, Harrigan S, Harris M, Alvarez-Jimenez M, Herrman H . Outcome in early-onset schizophrenia revisited: findings from the Early Psychosis Prevention and Intervention Centre long-term follow-up study. Schizophr Res. 2011; 131(1-3):112-9. DOI: 10.1016/j.schres.2011.06.009. View

17.

Strous R, Alvir J, Robinson D, Gal G, Sheitman B, Chakos M . Premorbid functioning in schizophrenia: relation to baseline symptoms, treatment response, and medication side effects. Schizophr Bull. 2004; 30(2):265-78. DOI: 10.1093/oxfordjournals.schbul.a007077. View

18.

Tiihonen J, Wahlbeck K, Lonnqvist J, Klaukka T, Ioannidis J, Volavka J . Effectiveness of antipsychotic treatments in a nationwide cohort of patients in community care after first hospitalisation due to schizophrenia and schizoaffective disorder: observational follow-up study. BMJ. 2006; 333(7561):224. PMC: 1523484. DOI: 10.1136/bmj.38881.382755.2F. View

19.

Abdel-Baki A, Ouellet-Plamondon C, Salvat E, Grar K, Potvin S . Symptomatic and functional outcomes of substance use disorder persistence 2 years after admission to a first-episode psychosis program. Psychiatry Res. 2016; 247:113-119. DOI: 10.1016/j.psychres.2016.11.007. View

20.

Ouellet-Plamondon C, Abdel-Baki A, Salvat E, Potvin S . Specific impact of stimulant, alcohol and cannabis use disorders on first-episode psychosis: 2-year functional and symptomatic outcomes. Psychol Med. 2017; 47(14):2461-2471. DOI: 10.1017/S0033291717000976. View