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CNS Drugs

Published in:

01-06-2007 | Current Opinion

Long-Acting Formulations of Atypical Antipsychotics

Time to Reconsider When to Introduce Depot Antipsychotics

Authors: Dr Pierre Chue, Robin Emsley

Published in: CNS Drugs | Issue 6/2007

Abstract

The current availability of a long-acting injectable formulation of risperidone and the potential future availability of long-acting formulations of other atypical antipsychotics (such as paliperidone) should prompt a reconsideration of at what stage in the treatment of schizophrenia such long-acting agents should be introduced. At present, long-acting formulations, particularly of conventional antipsychotics (depots), are usually reserved for patients with chronic schizophrenia who are at high-risk of noncompliance. Recent and increasing data from other patient groups, such as those with first-episode psychosis, suggest that long-acting risperidone is associated with good efficacy and tolerability leading to high patient acceptance, and treatment continuation rates that are greater than with oral antipsychotics. The benefits of an atypical antipsychotic coupled with the assurance of medication delivery in the form of a long-acting injection imply that these novel formulations should be considered in first-episode patients, for whom optimal outcome is frequently compromised by early treatment discontinuation and poor adherence.

Menezes NM, Arenovich T, Zipursky RB. A systematic review of longitudinal outcome studies of first-episode psychosis. Psychol Med 2006; 36(10): 1349–62PubMedCrossRef

Crespo-Facorro B, Pelayo-Teran JM, Perez-Iglesias R, et al. Predictors of acute treatment response in patients with a first episode of non-affective psychosis: sociodemographics, premorbid and clinical variables. J Psych Res 2007; 41(8): 659–66CrossRef

Emsley R, Rabinowitz J, Medori R. Time course for antipsychotic treatment response in first-episode schizophrenia. Am J Psychiatry 2006; 163(4): 743–5PubMedCrossRef

Robinson DG, Woerner MG, Delman HM, et al. Pharmacological treatments for first-episode schizophrenia. Schizophr Bull 2005; 31(3): 705–22PubMedCrossRef

Bradford DW, Perkins DO, Lieberman JA. Pharmacological management of first-episode schizophrenia and related nonaffective psychoses. Drugs 2003; 63(21): 2265–83PubMedCrossRef

Malla A, Norman R, Schmitz N, et al. Predictors of rate and time to remission in first-episode psychosis: a two-year outcome study. Psychol Med 2006; 36(5): 649–58PubMedCrossRef

McEvoy JP, Johnson J, Perkins D, et al. Insight in first-episode psychosis. Psychol Med 2006; 36(10): 1385–93PubMedCrossRef

Robinson DG, Woerner MG, Alvir JM, et al. Predictors of medication discontinuation by patients with first-episode schizophrenia and schizoaffective disorder. Schizophr Res 2002; 57(2–3): 209–19PubMedCrossRef

Davis JM, Chen N. Choice of maintenance medication for schizophrenia. J Clin Psych 2003; 64: 24–33

10.

Schooler N. Relapse and rehospitalization: comparing oral and depot antipsychotics. J Clin Psychiatry 2003; 64: 14–7PubMedCrossRef

11.

Davis JM, Matalon L, Watanabe MD, et al. Depot antipsychotic drugs: place in therapy. Drugs 1994; 47(5): 741–73PubMedCrossRef

12.

McEvoy JP. Risks versus benefits of different types of longacting injectable antipsychotics. J Clin Psychiatry 2006; 67(5): 15–8PubMed

13.

Canadian Psychiatric Association. Clinical practice guidelines: treatment of schizophrenia. Can J Psychiatry 2005; 50: 7–57S

14.

Royal Australian and New Zealand College of Psychiatrists Clinical Practice Guidelines Team for the Treatment of Schizophrenia and Related Disorders. Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of schizophrenia and related disorders. Aust N Z J Psychiatry 2005; 39 (1–2): 1–30CrossRef

15.

American Psychiatric Association. Practice guidelines for the treatment of patients with schizophrenia. 2nd ed. Arlington (VA): American Psychiatric Association, 2004

16.

Miller AL, Hall CS, Buchanan RW, et al. The Texas Medication Algorithm Project antipsychotic algorithm for schizophrenia: 2003 update. J Clin Psychiatry 2004; 65(4): 500–8PubMedCrossRef

17.

Kane JM, Leucht S, Carpenter D, et al. The expert consensus guideline series: optimizing pharmacologic treatment of psychotic disorders. Introduction: methods, commentary, and summary. J Clin Psychiatry 2003; 64: 5–19

18.

Kane JM, Aguglia E, Altamura AC, et al. Guidelines for depot antipsychotic treatment in schizophrenia. European Neuropsychopharmacology Consensus Conference in Siena, Italy. Eur Neuropsychopharmacol 1998; 8(1): 55–66

19.

Altamura AC, Sassella F, Santini A, et al. Intramuscular preparations of antipsychotics: uses and relevance in clinical practice. Drugs 2003; 63(5): 493–512PubMedCrossRef

20.

Moller HJ. Antipsychotic agents: gradually improving treatment from the traditional oral neuroleptics to the first atypical depot. Eur Psychiatry 2005; 20(5–6): 379–85PubMedCrossRef

21.

Kane JM. Strategies for improving compliance in treatment of schizophrenia by using a long-acting formulation of an antipsychotic: clinical studies. J Clin Psychiatry 2003; 64: 34–40PubMed

22.

Dursun SJ. An atypical long-acting injectable antipsychotic: implications for pharmacotherapy of schizophrenia. J Psychopharmacol 2005; 19(5): 3–4CrossRef

23.

Keith SJ, et al. Academic highlights: guidelines for the use of long-acting injectable atypical antipsychotics. J Clin Psychiatry 2004; 65(1): 120–31PubMedCrossRef

24.

Jarboe KS, Littrell K, Tugrul K. Long-acting injectable risperidone: an emerging tool in schizophrenia treatment. J Psychosoc Nurs Ment Health Serv 2005; 43(12): 25–33PubMed

25.

Bhanji NH, Chouinard G, Margolese HC. A review of compliance, depot intramuscular antipsychotics and the new longacting injectable atypical antipsychotic risperidone in schizophrenia. Eur Neuropsychopharmacol 2004; 14(2): 87–92PubMedCrossRef

26.

Love RC. Strategies for increasing treatment compliance: the role of long-acting antipsychotics. Am J Health Syst Pharm 2002; 59: S10–5PubMed

27.

Chen EY, Harrison G, Standen PJ. Management of first episode psychotic illness in Afro-Caribbean patients. Br J Psychiatry 1991; 158: 517–22PubMedCrossRef

28.

Valenstein M, Copeland LA, Owen R, et al. Adherence assessments and the use of depot antipsychotics in patients with schizophrenia. J Clin Psychiatry 2001; 62(7): 545–51PubMedCrossRef

29.

Tiihonen J, Walhbeck K, Lonnqvist J, et al. 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): 224–7PubMedCrossRef

30.

Kane JM, Rifkin A, Quitkin F, et al. Fluphenazine vs placebo in patients with remitted, acute first-episode schizophrenia. Arch Gen Psychiatry 1982; 39: 70–3PubMedCrossRef

31.

Harrison TS, Goa LA. Long-acting risperidone: a review of its use in schizophrenia. CNS Drugs 2004; 18(2): 113–32PubMedCrossRef

32.

Chue P. Risperidone long-acting injection. Expert Rev Neurotherapeutics 2003; 3(4): 89–100CrossRef

33.

Thompson S, Rey JA. Risperdal consta: the first long-acting atypical antipsychotic agent. P&T 2004; 29(9): 555–62

34.

Faludi G. The first long-acting atypical antipsychotic: new milestone in the treatment of schizophrenia [in Hungarian]. Neuropsychopharmacol Hung 2005; 7(1): 22–7PubMed

35.

Knox ED, Stimmel GL. Clinical review of a long-acting, injectable formulation of risperidone. Clin Ther 2004; 26(12): 1994–2002PubMedCrossRef

36.

Lemon M. Risperidone long-acting injection: a brief overview. S D J Med 2004; 57(5): 171–2PubMed

37.

Love RC, Conley RJ. Long-acting risperidone injection. Am J Health Syst Pharm 2004; 61(17): 1792–800PubMed

38.

Ehret MJ, Fuller MA. Long-acting injectable risperidone. Ann Pharmacother 2004; 38(12): 2122–7PubMedCrossRef

39.

Curran MP. Long-acting injectable risperidone. Int J Clinical Psychopharmacology 2006; 14(2): 107–25

40.

Parellada E. Clinical experience and management considerations with long-acting risperidone. Curr Med Res Opin 2006; 22(2): 241–55PubMedCrossRef

41.

Martin SD, Libretto SE, Pratt DJ, et al. Clinical experience with the long-acting injectable formulation of the atypical antipsychotic, risperidone. Curr Med Res Opin 2003; 19(4): 298–305PubMedCrossRef

42.

Marder SR, Conley R, Ereshefsky L, et al. Clinical guidelines: dosing and switching strategies for long-acting risperidone. J Clin Psychiatry 2003; 64: 41–6PubMed

43.

Taylor DM, Young CL, Mace S, et al. Early clinical experience with risperidone long-acting injection: a prospective, 6-month follow-up of 100 patients. J Clin Psychiatry 2004; 65(8): 1076–83PubMedCrossRef

44.

Marsand P, Gupta S. Long-acting injectable antipsychotics in the elderly: guidelines for effective use. Drugs Aging 2003; 20(15): 1099–110CrossRef

45.

Chue P. Long-acting risperidone injection: efficacy, safety and cost-effectiveness of the first long-acting atypical antipsychotic. Neuropsychiatr Dis Treat 2007. E-pub

46.

Keith S, Nick B, Emsley R, et al. Practical application of pharmacotherapy with long-acting risperidone for patients with schizophrenia. Psychiatr Serv 2004; 55(9): 997–1005PubMedCrossRef

47.

Parellada E, Andrezina R, Milanova V, et al. Patients in the early phases of schizophrenia and schizoaffective disorders effectively treated with risperidone long-acting injectable. J Psychopharmacol 2005; 19: 5–14PubMedCrossRef

48.

Saleem P, Firmino H, Parellada E, et al. Young patients (18–30 years) with schizophrenia and schizoaffective disorder: results of direct switching to long-acting injectable risperidone (StoRMi trial) [abstract]. 12th Biennial Winter Workshop on Schizophrenia; 2004 Feb 7–13: Davos

49.

Lasser R, Bossie CA, Zhu Y, et al. Long-acting risperidone in young adults with schizophrenia or schizoaffective disorder [abstract]. 157th American Psychiatric Association Annual Meeting; 2004 May 1–6: New York

50.

Emsley R, Oosthuizen P, Koem L, et al. A trial of risperidone long-acting injectable in first episode psychosis [abstract]. American Psychiatric Association Annual Meeting; 2005 May 21–26: Atlanta (GA)

51.

Emsley R, Oosthuizen P, Koem L, et al. Safety and efficacy of long-acting risperidone as a first-line treatment for first-episode psychosis: 6-month interim analysis [abstract]. XIIIth Biennial Winter Workshop of Schizophrenia Research; 2006 Feb 4–10: Davos

52.

Möller H, Llorca PM, Sachetti E, et al. Efficacy and safety of direct transition to risperidone long-acting injectable in patients treated with various antipsychotic therapies. Int Clin Psychopharmacol 2005; 20: 121–30PubMedCrossRef

53.

Fleischhacker WW, Eerdekens M, Karcher K, et al. Treatment of schizophrenia with long-acting injectable risperidone: a 12-month open-label trial of the first long-acting second generation antipsychotic. J Clin Psychiatry 2003; 64: 1250–7PubMedCrossRef

54.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC. American Psychiatric Association, 1994

55.

Malla A, Binder C, Chue P. Comparison of long-acting injectable risperidone and oral novel antipsychotic drugs for treatment in early phase of schizophrenia spectrum psychosis [abstract]. 61st Annual Convention Society of Biological Psychiatry; 2006 May 18–20: Toronto (ON)

56.

Rummel C, Hamann J, Kissling W, et al. New generation antipsychotics for first episode schizophrenia. Cochrane Database Syst Rev 2003; (4): CD004410

57.

Bradford DW, Perkins DO, Lieberman JA. Pharmacological management of first-episode schizophrenia and related nonaffective psychoses. Drugs 2003; 63(21): 2265–83PubMedCrossRef

58.

Lambert M, Conus P, Lambert T, et al. Pharmacotherapy of first-episode psychosis. Expert Opin Pharmacother 2003; 4(5): 717–50PubMedCrossRef

59.

Ohlsen RI, O’Toole MS, Purvis RG, et al. Clinical effectiveness in first-episode patients. Eur Neuropsychopharmacol 2004; 14(4): S445–51PubMedCrossRef

60.

Kelly DL, Conley RR, Carpenter WT. First-episode schizophrenia: a focus on pharmacological treatment and safety considerations. Drugs 2005; 65(8): 1113–38PubMedCrossRef

61.

Lieberman JA, Tollefson G, Tohen M, et al. Comparative efficacy and safety of atypical and conventional antipsychotic drugs in first-episode psychosis: a randomized, double-blind trial of olanzapine versus haloperidol. HGDH Study Group. Am J Psychiatry 2003; 160(8): 1396–404

62.

Chue PS, D’Hoore P, Ramstack JM. Sustained drug delivery optimizes long-term treatment of patients with schizophrenia. Acta Neuropsychiatrica 2004; 16(6): 319–26CrossRef

63.

Chue P. Compliance and convenience: do physicians and patients see depot medication differently? Acta Neuropsychiatrica 2004; 16: 314–38CrossRef

64.

Leal A, Rosillon D, Mehnert A, et al. Healthcare resource utilization during 1-year treatment with long-acting, injectable risperidone. Pharmacoepidemiol Drug Saf 2004; 13: 811–6PubMedCrossRef

65.

Patel MX, De Zoysa N, Baker D, et al. Antipsychotic depot medication and attitudes of community psychiatric nurses. J Psychiatr Ment Health Nurs 2005; 12(2): 237–44PubMedCrossRef

66.

Patel MX, Nikolaou V, David AS. Psychiatrists’ attitudes to maintenance medication for patients with schizophrenia. Psychol Med 2003; 33: 83–9PubMedCrossRef

67.

Chue P, Llorca P, Duchesne I, et al. Hospitalization rates in patients during long-term treatment with long-acting risperidone injection. J Appl Res 2005; 5: 266–74

68.

Walburn J, Gray R, Gournay K, et al. Systematic review of patient and nurse attitudes to depot antipsychotic medication. Br J Psychiatry 2001; 179: 300–7PubMedCrossRef

69.

Svedberg B, Backenroth-Ohsako G, Lutzen K. On the path to recovery: patients’ experiences of treatment with long-acting injections of antipsychotic medication. Int J Ment Health Nurs 2003; 12(2): 110–8PubMedCrossRef

70.

Fleischhacker WW, Lasser R, Mehnert A. Perceived functioning and well-being and association with psychiatric symptomatology in clinically stable schizophrenia patients treated with long-acting risperidone for 1 year. Br J Psychiatry 2005; 187: 131–6PubMedCrossRef

71.

Nasrallah HA, Duchesne I, Mehnert A, et al. Health-related quality of life in patients with schizophrenia during treatment with long-acting, injectable risperidone. J Clin Psychiatry 2004; 65: 531–6PubMedCrossRef

72.

Lindenmayer JP, Jarboe K, Bossie CA, et al. Minimal injection site pain and high patient satisfaction during treatment with long-acting risperidone. Int Clin Psychopharmacol 2005; 20(4): 213–21PubMedCrossRef

73.

Mannaert E, Vermeulen A, Remmerie B, et al. Pharmacokinetic profile of long-acting injectable risperidone at steady-state: comparison with oral administration. Encephale 2005; 31(5): 609–15PubMedCrossRef

74.

Ereshefsky L, Mascarenas CA. Comparison of the effects of different routes of antipsychotic administration on pharmacokinetics and pharmacodynamics. J Clin Psychiatry 2003; 64(16): 18–23PubMed

75.

Ereshefsky L, Mannaert E. Pharmacokinetic profile and clinical efficacy of long-acting risperidone: potential benefits of combining an atypical antipsychotic and a new delivery system. Drugs R D 2005; 6(3): 129–37PubMedCrossRef

76.

Schooler N, Rabinowitz J, Davidson M, et al. Risperidone and haloperidol in first-episode psychosis: a long-term randomised trial. Early Psychosis Global Working Group. Am J Psychiatry 2005; 162(5): 947–53

77.

Emsley RA. Risperidone in the treatment of first-episode psychotic patients: a double-blind multicenter study. Risperidone Working Group. Schizophr Bull 1999; 25: 721–9CrossRef

78.

Lambert T. Selecting patients for novel long-acting antipsychotic therapy. Australas Psychiatry 2006; 14(1): 38–42PubMed

79.

Fraser R, Berger G, Killackey E, et al. Emerging psychosis in young people: part 3. Key issues for prolonged recovery. Australian Family Physician 2006; 35(5): 329–33

Title: Long-Acting Formulations of Atypical Antipsychotics
Time to Reconsider When to Introduce Depot Antipsychotics
Authors: Dr Pierre Chue
Robin Emsley
Publication date: 01-06-2007
Publisher: Springer International Publishing
Published in: CNS Drugs / Issue 6/2007
Print ISSN: 1172-7047
Electronic ISSN: 1179-1934
DOI: https://doi.org/10.2165/00023210-200721060-00001

ACC 2024 Congress

Springer Medicine

Long-Acting Formulations of Atypical Antipsychotics

Time to Reconsider When to Introduce Depot Antipsychotics

Abstract

ACC 2024 Congress

Springer Medicine

Abstract

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