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European Archives of Psychiatry and Clinical Neuroscience

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27-11-2022 | Antipsychotics | Original Paper

Effect of long-acting injectable antipsychotics on 1-year hospitalization in bipolar disorder: a mirror-image study

Authors: Francesco Bartoli, Tommaso Callovini, Daniele Cavaleri, Cristina Crocamo, Ilaria Riboldi, Andrea Aguglia, Pasquale De Fazio, Giovanni Martinotti, Armando D’Agostino, Giovanni Ostuzzi, Corrado Barbui, Giuseppe Carrà, STAR Network Depot Investigators

Published in: European Archives of Psychiatry and Clinical Neuroscience | Issue 7/2023

Abstract

Long-acting injectable (LAI) antipsychotics are often used for the long-term management also of bipolar disorder (BD). Nonetheless, evidence on their effect on pragmatic outcomes such as hospitalization risk in BD is inconsistent. We carried out a mirror-image study comparing rates and number of days of hospitalization, one year before and after the initiation of LAI treatment, in a sample of subjects with BD. Participants were selected from the STAR Network Depot Study, a pragmatic, observational, multicenter research involving a cohort of inpatients and outpatients consecutively started on LAI treatment. Variations in rates and in total number of days of hospitalization between the 12 months before and those after treatment initiation were analyzed. Among 461 individuals screened for eligibility, we included 71 adults with BD, initiated either on first- (FGA) or second-generation (SGA) LAIs. We found a significant decrease in terms of 12-month hospitalization rates (p < 0.001) and number of days (p < 0.001) after LAI initiation, without any effect by age, gender, alcohol/substance use disorders, and symptom severity. Subgroup analyses based on antipsychotic class, history of LAI treatment, and concomitant oral medications, confirmed the decreasing trend on both hospitalization rates and number of days. However, these reductions were not significant among participants who continued this treatment for less than 6 months. Comprehensively, this study supports the role of LAIs as effective maintenance treatment options for BD. Further research is needed to identify clinical characteristics of people with BD who would most benefit from long-acting formulations of antipsychotics.

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Title: Effect of long-acting injectable antipsychotics on 1-year hospitalization in bipolar disorder: a mirror-image study
Authors: Francesco Bartoli
Tommaso Callovini
Daniele Cavaleri
Cristina Crocamo
Ilaria Riboldi
Andrea Aguglia
Pasquale De Fazio
Giovanni Martinotti
Armando D’Agostino
Giovanni Ostuzzi
Corrado Barbui
Giuseppe Carrà
STAR Network Depot Investigators
Publication date: 27-11-2022
Publisher: Springer Berlin Heidelberg
Keywords: Antipsychotics
Antipsychotics
Published in: European Archives of Psychiatry and Clinical Neuroscience / Issue 7/2023
Print ISSN: 0940-1334
Electronic ISSN: 1433-8491
DOI: https://doi.org/10.1007/s00406-022-01522-5

At a glance: The STEP trials

Springer Medicine

Effect of long-acting injectable antipsychotics on 1-year hospitalization in bipolar disorder: a mirror-image study

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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