Background and importance Long acting injectable antipsychotics have emerged to improve adherence and reduce the risk of relapse in patients with psychiatric disorders.
Aim and objectives The aim was to evaluate the maintenance rate of long acting injectable antipsychotics in real life.
Material and methods A retrospective observational study was conducted from April 2017 to April 2019 in outpatients in mental health units who initiated long acting injectable antipsychotic treatment (monthly aripiprazole 400 mg (MA), monthly paliperidone 150 mg (MP) or quarterly paliperidone 525 mg (QP)) between April and September 2017. Anthropometric data, injectable antipsychotic treatment and psychiatric diagnoses were collected. Active treatments, discontinuations and changes in drugs, formulations (monthly/quarterly) and doses were recorded in April 2018 and April 2019.
Results A total of 113 patients were included. Treatments were 46.0% (52) MA, 40.7% (46) MP and 13.3% (15) QP. Average ages (MA, MP, QP) were 41.75±12.8, 47.70±14.9 and 44.13±7.1 years, respectively, and the number of men were 56.69%, 76.09% and 93.33%, respectively. Diagnoses (MA, MP, QP) were paranoid schizophrenia in 55.77%, 54.35% and 53.33%, respectively; substance abuse related disorder in 7.69%, 4.35% and 6.67%, respectively; simple schizophrenia in 17.31%, 10.87% and 13.33%, respectively; intellectual disability in 3.85%, 4.35% and 0%, respectively; personality disorder in 1.92%, 4.35% and 0%, respectively; and other in 13.46%, 21.73% and 26.67%, respectively.
In April 2018, 90.38% (47) of MA patients maintained treatment, while 9.62% (5) discontinued treatment. A year later, 76.92% (40) maintained treatment, 5.77% (3) changed doses and 17.31% (9) had discontinued their treatment.
For MP, 58.70% (27) continued with treatment in the first year, 19.57% (9) changed to QP, 6.51% (3) changed doses but maintained the monthly administration and 15.22% (7) interrupted treatment. In the second year, 50.00% (23) maintained treatment, 17.39% (8) changed to QP and 10.87% (5) changed dose. Treatment was interrupted in 21.74% (10) of patients at the end of the study.
For the QP group, 53.33% (8) maintained treatment in the first year while 26.67% (4) required a change to MP and 20.00% (3) interrupted treatment. At the end of the study, 40.00% (6) maintained treatment, 26.67% (4) continued with MP, 6.66% (1) changed to MA and 26.67% (4) discontinued treatment.
Conclusion and relevance A good maintenance rate was observed with MA and MP over 2 years. In contrast, half of the patients receiving QP had to interrupt their treatment during the first year due to a short acting duration. Almost a third of QP patients had to restart treatment with MP. In conclusion, the maintenance rate was higher in monthly presentations than in the quarterly presentation.
References and/or acknowledgements N/A
No conflict of interest.
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