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García-Carmona JA, García-Pérez A, Isidro García G, Forcen-Muñoz LA, Ovejero García S, Sáez Povedano R, González-Galdámez AL, Mata Iturralde L, Hernández-Sánchez F, Ramirez Bonilla M, Fuentes-Pérez P, Ovejas-Catalán C, Suárez-Pinilla P, Valdivia-Muñoz F, Fernández Abascal B, Omaña Colmenares M, de Lourdes Martín-Pérez Á, Campos-Navarro MP, Baca-García E, Benavente-López S, Raya Platero A, Barberán Navalón M, Sánchez-Alonso S, Vázquez-Bourgon J, Pappa S. Preliminary data from a 4-year mirror-image and multicentre study of patients initiating paliperidone palmitate 6-monthly long-acting injectable antipsychotic: the Paliperidone 2 per Year study. Ther Adv Psychopharmacol 2023; 13:20451253231220907. [PMID: 38152569 PMCID: PMC10752040 DOI: 10.1177/20451253231220907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Accepted: 11/22/2023] [Indexed: 12/29/2023] Open
Abstract
Background Paliperidone palmitate 6-monthly (PP6M) is the first long-acting antipsychotic injectable (LAI) to allow for only two medication administrations per year, though there is presently limited insight into its effectiveness and potential added value in real clinical practice conditions. Objectives To present our ongoing study and draw its preliminary data on patient characteristics initiating PP6M and adherence during the first year of treatment. Methods The paliperidone 2 per year (P2Y) study is a 4-year, multicentre, prospective mirror-image pragmatic study taking place at over 20 different sites in Europe. The mirror period covers 2 years either side of the PP6M LAI initiation. Retrospective data for the previous 2 years are collected for each patient from the electronic health records. Prospective data are recorded at baseline, 6, 12, 18 and 24 months of drug administration and also cover information on concomitant psychiatric medication, relapses, hospital admissions, side effects, discontinuation and its reasons. Meanwhile, here we present preliminary data from the P2Y study at basal and 6-month period (first and second PP6M administration). Results At the point of PP6M initiation, the most frequent diagnosis was schizophrenia (69%), the clinical global impression scale mean score was 3.5 (moderately markedly ill) and the rate of previous hospital admissions per patient and year was 0.21. PP6M was initiated after a median of 3-4 years on previous treatment: 146 (73%) from paliperidone palmitate 3-monthly, 37 (19%) from paliperidone palmitate 1-monthly and 17 (9%) from other antipsychotics. The mean dose of the first PP6M was 1098.9 mg. The retention rate at 6 months and 1 year of treatment on PP6M in our cohort was 94%. Conclusion Patient and clinician preference for LAIs with longer dosing intervals was the main reason for PP6M initiation/switching resulting in high treatment persistence. Future data are needed to evaluate the full impact of PP6M in clinical practice.
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Affiliation(s)
- Juan Antonio García-Carmona
- Department of Neurology, Santa Lucía University Hospital, C/Mezquita s/n 30202, Cartagena, Murcia 30202, Spain
- Group of Clinical and Experimental Pharmacology, Institute for Biomedical Research of Murcia (IMIB), Murcia, Spain
- Faculty of Pharmacy and Nutrition, San Antonio Catholic University of Murcia (UCAM), Murcia, Spain
| | - Alba García-Pérez
- Centre of Mental Health Molina de Segura, Molina de Segura, Murcia, Spain
| | - Guillermo Isidro García
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Universidad de Cantabria, Santander, Spain
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | | | | | - Rocío Sáez Povedano
- Department of Psychiatry, General Hospital of Villarrobledo, Villarrobledo, Albacete, Spain
| | | | | | | | - Mariluz Ramirez Bonilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Universidad de Cantabria, Santander, Spain
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - Paloma Fuentes-Pérez
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - Claudia Ovejas-Catalán
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - Paula Suárez-Pinilla
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Universidad de Cantabria, Santander, Spain
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | - Francisco Valdivia-Muñoz
- Department of Psychiatry, Santa Lucía University Hospital, Cartagena, Murcia, Spain
- Unit of Assertive Community Treatment, Centre Mental Health Cartagena, Cartagena, Murcia, Spain
| | - Blanca Fernández Abascal
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Universidad de Cantabria, Santander, Spain
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
| | | | | | | | | | | | | | | | | | - Javier Vázquez-Bourgon
- Department of Psychiatry, Marqués de Valdecilla University Hospital, Universidad de Cantabria, Santander, Spain
- Psychiatry and Mental Health Research Group, Instituto Investigación Sanitaria Valdecilla (IDIVAL), Santander, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Sevilla, Spain
| | - Sofia Pappa
- West London National Health System (NHS) Trust, London, UK
- Department of Brain Sciences, Imperial College of London, London, UK
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García-Carmona JA, Pappa S. Cumulative Clinical Experience of the Use of Paliperidone Palmitate 3-Monthly Long-Acting Injection in the Treatment of Schizophrenia: A Critical Appraisal. Drug Healthc Patient Saf 2023; 15:113-123. [PMID: 37720806 PMCID: PMC10504906 DOI: 10.2147/dhps.s339170] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/06/2023] [Indexed: 09/19/2023] Open
Abstract
Paliperidone palmitate 3-monthly (PP3M), an approved maintenance treatment for patients with schizophrenia, was the first long-acting antipsychotic injectable (LAI) to require only four administrations per year. Here, we aimed to review the available evidence about its use in the management of schizophrenia to date and highlight key study findings in order to provide a balanced overview of current experience in clinical practice. For that purpose, an extensive search of available literature from PubMed, Embase, and Web of Science was conducted in March 2023. Emerging data from real-world studies appear to signal that the benefits of the use of PP3M may well extent beyond the obvious convenience for patients and resource efficiency for services and may be actually associated with improved effectiveness and patient satisfaction. Large naturalistic studies from Australia, Europe and the US comparing treatment continuation between newer LAIs and/or oral antipsychotics showed that patients treated with PP3M had higher compliance rates and a longer period of continuous use. The risk of relapse, re-hospitalization and number of bed days was also lower with PP3M compared to PP1M and other LAIs as demonstrated by several cohort studies. Furthermore, patients treated with PP3M were using lower doses of benzodiazepines and concomitant oral antipsychotics compared with other LAIs. What is more, PP3M appears to positively impact patients' satisfaction and quality of life, facilitating long-term goals. In fact, recent studies recorded better quality-adjusted life years and decreased stigma, with improved social acceptability and promotion of rehabilitation for patients transitioning to PP3M. The rates of general satisfaction rates with PP3M were also higher among psychiatrists and caregivers who reported overall less concerns. In conclusion, clinical exposure and a growing body of evidence thus far, reinforce the use of PP3M in an effort to enhance patient outcomes alongside individual experience and treatment persistence.
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Affiliation(s)
- Juan Antonio García-Carmona
- Department of Neurology, Santa Lucia University Hospital, Cartagena, Murcia, Spain
- Unit of Acute Psychiatry, Reina Sofía University Hospital, Murcia, Spain
- Group of Clinical and Experimental Pharmacology, Institute for Biomedical Research of Murcia (IMIB), Murcia, Spain
| | - Sofia Pappa
- West London NHS Trust, London, UK
- Department of Brain Sciences, Imperial College London, London, UK
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Sanchez-Gistau V, Moreno MJ, Gómez-Lus S, Sicras-Mainar A, Crespo-Facorro B. Healthcare resource use and costs reduction with aripiprazole once-monthly in schizophrenia: AMBITION, a real-world study. Front Psychiatry 2023; 14:1207307. [PMID: 37599866 PMCID: PMC10437073 DOI: 10.3389/fpsyt.2023.1207307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/26/2023] [Indexed: 08/22/2023] Open
Abstract
Objective This study aims to compare the hospitalization rate in individuals with schizophrenia who started their treatment with aripiprazole once monthly (AOM400) or atypical oral antipsychotics (OA) in Spain. Methods This is an observational and retrospective study based on the electronic medical records from the BIG-PAC database. The study population consisted of individuals diagnosed with schizophrenia who initiated their treatment with AOM400 (AOM cohort) or atypical OA (OA cohort) from 01/01/2017 to 31/12/2019. A 1:1 propensity score matching (PSM) procedure was conducted to match individuals of both cohorts. The number and duration of hospitalizations, persistence to treatment, healthcare resources use, and costs were analyzed after 12 months. Results After the PSM, 1,017 individuals were included in each cohort [age: 41.4 years (SD: 10.6); males: 54.6%]. During the follow-up period, the AOM cohort had a 40% lower risk of hospitalization than the OA group [HR: 0.60 (95% confidence interval, CI: 0.49-0.74)]. The median time to the first hospitalization was longer in individuals with AOM400 compared to those with OA (197 days compared to 174 days; p < 0.004), whereas hospital admissions were shorter (AOM400: 6 compared to OA: 11 days; p < 0.001). After 12 months, individuals receiving AOM400 were more persistent than those with OA (64.9% compared to 53.7%; p < 0.001). The OA cohort required more healthcare resources, mainly visits to primary care physicians, specialists, and emergency rooms than those receiving AOM400 (p ≤ 0.005 in all comparisons). AOM400 reduced the costs of hospitalizations, and emergency room, specialist and primary care visits by 50.4, 36.7, 16.1, and 10.9%, respectively, in comparison to the treatment with atypical OA. AOM400 led to annual cost savings of €1,717.9 per individual, from the societal perspective. Conclusion Aripiprazole once monthly reduces the number and duration of hospitalizations, together with the treatment costs of schizophrenia, as it reduces the use of healthcare resources and productivity losses in these individuals.
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Affiliation(s)
- Vanessa Sanchez-Gistau
- Early Intervention in Psychosis Service, Hospital Universitari Institut Pere Mata, IISPV-CERCA, CIBERSAM, ISCIII, Universitat Rovira i Virgili (URV), Reus, Spain
| | | | | | - Antoni Sicras-Mainar
- Health Economics and Outcomes Research Department, Atrys Health, Barcelona, Spain
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, University Hospital Virgen del Rocio, IBiS, CSIC, CIBERSAM, ISCIII, School of Medicine, University of Sevilla, Sevilla, Spain
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Pae CU, Han C, Bahk WM, Lee SJ, Patkar AA, Masand PS. Consideration of Long-Acting Injectable Antipsychotics for Polypharmacy Regimen in the Treatment of Schizophrenia: Put It on the Table or Not? CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:434-448. [PMID: 34294613 PMCID: PMC8316655 DOI: 10.9758/cpn.2021.19.3.434] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/11/2020] [Accepted: 11/16/2020] [Indexed: 12/11/2022]
Abstract
Antipsychotic monotherapy (APM) is considered best-acceptable treatment option regardless of antipsychotic class and formulation types for treating schizophrenia. However, antipsychotic polypharmacy (APP) has been also widely utilized in routine clinical practice. Despite APP has some clinical benefits it has also numerous pitfalls in relation with increased total number and doses of APs leading to adverse events as well as decrease of treatment adherence and persistence resulting in poor clinical outcomes. Recent introduction of long-acting injectable antipsychotics (LAIs) to the market has offered a chance for better medication adherence/persistence and also provided a simplification of treatment regime leading to more stabilized treatment for schizophrenia patients. When we cannot stay away from APP in the treatment of schizophrenia, clinicians need to find more proper APP regimens and thereby utilization of APP in efficient way should be a practical strategy to benefit schizophrenia patient in a real world treatment setting. With this regard, LAIs can be one of available APP regimen for treatment of schizophrenia in routine practice since their clinical utility and pharmacokinetic stability over oral APs have been well-elaborated today. However, when we have to commence LAIs as a part of APP with oral APs or other LAIs, every effort should be made before doing so whether or not validated and available treatment options or other clinical factors were not done or evaluated yet. Any treatment guidelines do not support APP regardless of the formulation of APP regimen or address two or more LAIs for treatment of schizophrenia till today.
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Affiliation(s)
- Chi-Un Pae
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea.,Cell Death Disease Research Center, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Changsu Han
- Department of Psychiatry, Korea University College of Medicine, Seoul, Korea
| | - Won-Myong Bahk
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Soo-Jung Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ashwin A Patkar
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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Simashkova NV, Makushkin EV, Ivanov MV, Balakireva EE, Kulikov AV, Koval-Zaytsev AA, Luss LA. [Models of clinical and social management of patients with autism spectrum disorders]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:13-20. [PMID: 34283524 DOI: 10.17116/jnevro202112106113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To develop clinical and social models and management routes for patients with autism spectrum disorders (ASD). MATERIAL AND METHODS A clinical follow-up study was performed for 254 patients, aged 4-17 years (average age 7.3 years), who represented the main forms of ASD. Psychopathological, clinical-follow-up, psychological and statistical methods were used. RESULTS AND CONCLUSION Five management models for patients with different forms of ASD are described; differentiation of routes for interagency monitoring of patients is proposed. The effectiveness of the integrated use of drug and non-drug therapeutic approaches for the management of patients with ASD in the clinical-age aspect is shown. Timely diagnosis of ASD makes it possible to develop differentiated routes of patient management within the framework of interdepartmental interaction and achieve positive results in the clinical and age aspect.
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Affiliation(s)
| | - E V Makushkin
- Serbsky National Medical Research Center of Psychiatry and Narcology, Moscow, Russia
| | - M V Ivanov
- Mental Health Research Center, Moscow, Russia
| | | | - A V Kulikov
- Mental Health Research Center, Moscow, Russia
| | | | - L A Luss
- Mental Health Research Center, Moscow, Russia
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Off-label use of second-generation antipsychotics in borderline personality disorder: a comparative real-world study among oral and long-acting injectables in Spain. Int Clin Psychopharmacol 2021; 36:201-207. [PMID: 33853106 DOI: 10.1097/yic.0000000000000357] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of the present study was to evaluate the use of oral vs. long-acting injectables (LAIs) antipsychotics, as well as, to compare the effectiveness of different LAI antipsychotics [aripiprazole-1-month, paliperidone-1-month (PP1M), paliperidone-3-month (PP3M) and risperidone long-acting injectable (RLAI)] in patients diagnosed with borderline personality disorder (BPD), by evaluating the following clinical outcomes: (1) the number of hospital admissions; (2) the number of documented suicidal behaviour/attempts; and (3) the use of concomitant treatments, including benzodiazepines, oral antipsychotics and biperiden. We included a total of 116 patients diagnosed with BPD and treated with antipsychotic medication: 50 using a LAI antipsychotic formulation and 66 using the equivalent main oral antipsychotic. Patients treated with LAIs showed a decreased ratio of visits to emergency compared with the oral treatment group, and between LAIs, PP3M vs. aripiprazole-1-month group. Furthermore, patients treated with LAIs used lower number and dose of concomitant antipsychotics compared with patients treated with oral antipsychotics. Moreover, PP1M and PP3M used lower daily dose of diazepam equivalents compared with the aripiprazole-1-month and RLAI treatment groups. In conclusion, the use of LAIs may play a role in the management of BPD.
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Kotzalidis GD, Rapinesi C, Chetoni C, De Filippis S. Aripiprazole IM depot as an option for the treatment of bipolar disorder. Expert Opin Pharmacother 2021; 22:1407-1416. [PMID: 33847183 DOI: 10.1080/14656566.2021.1910236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Introduction: Long-acting injectable (LAI) antipsychotic drugs are developed to reduce daily intake need and to overcome treatment non-adherence. Aripiprazole IM depot refers to two long-acting aripiprazole formulations, once monthly monohydrate (AOM) and aripiprazole lauroxil. AOM has been approved for schizophrenia since 2012 and for bipolar disorder since 2017. Aripiprazole lauroxil is approved for schizophrenia, not for bipolar disorder.Areas covered: To assess the effect of AOM in bipolar disorder, the authors searched PubMed and ClinicalTrials.gov for randomized trials using AOM in patients with bipolar disorder. Included were four studies covering efficacy, functioning, quality of life, and safety/tolerability. Studies lasted 12 months.Expert opinion: AOM reduced symptoms of patients with bipolar disorder and a manic episode, increased functioning and quality of life, and protected from recurrence of manic episodes. It proved to be safe/tolerable, with only akathisia occurring in ≥10% of cases and more frequently than with placebo. However, there were only 143 patients receiving AOM in the considered studies. Included studies were backed in their conclusions by other literature, but they come from 2017-2018. No studies are expected or planned in the near future. Aripiprazole lauroxil has not applied for approval in bipolar disorder and there is no sign it will.
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Affiliation(s)
- Georgios D Kotzalidis
- NESMOS Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy.,Department of Neuropsychiatry, Villa Von Siebenthal Neuropsychiatric Hospital, Genzano Di Roma, Italy
| | - Chiara Rapinesi
- NESMOS Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - Chiara Chetoni
- NESMOS Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Sant'Andrea Hospital, Rome, Italy
| | - Sergio De Filippis
- Department of Neuropsychiatry, Villa Von Siebenthal Neuropsychiatric Hospital, Genzano Di Roma, Italy
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Simal-Aguado J, Campos-Navarro MP, Valdivia-Muñoz F, Galindo-Tovar A, García-Carmona JA. Evaluation of Risk Factors Associated to Prescription of Benzodiazepines and its Patterns in a Cohort of Patients from Mental Health: A Real World Study in Spain. PSYCHOPHARMACOLOGY BULLETIN 2021; 51:81-93. [PMID: 33897065 PMCID: PMC8063129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PURPOSE we aimed 1) to evaluate the risk factors associated to the benzodiazepines intake; 2) to assess the impact about the use of long acting injectables antipsychotics (LAIs); 3) to assess the risk in severe and affective disorders and 4) to identify the prescription patterns of use in mental health in a cohort of patients from Spain. METHODS 735 outpatients from Mental Health were included. Demographic and clinical data were collected. In order to compare the use of benzodiazepines we calculated the daily dose equivalents (mg/day) to diazepam as standard. RESULTS The most commonly prescribed benzodiazepine was clonazepam (33%) and the mean daily dose of diazepam equivalents was 24.9 mg. It was higher in affective disorders (40.35 ± 3.36) and lower in patients using LAIs antipsychotics (17.50 ± 1.39; p = 0.001). Multivariate analysis showed that to be women (OR = 1.559, 95% CI = 1.059-2.295, p = 0.024), the use of drugs (OR = 1.671, 95% CI = 1.127-2.477, p = 0.011) and suffering any affective disorder (OR = 1.542, 95% CI = 1.355-1.826, p = 0.040) increased the risk of benzodiazepine intake. In contrast, the use of LAIs antipsychotics significantly reduced it versus oral antipsychotics (OR = 5.226, 95% CI = 3.185-8.575, p = 0.001). CONCLUSIONS benzodiazepines are widely prescribed, mainly clonazepam followed by lorazepam and diazepam. Most of patients used at least one benzodiazepine and the mean daily intake was 25 mg diazepam equivalents. Therefore, benzodiazepines are extensively prescribed and used at higher doses than desirable. These, findings could be useful for clinicians and their practice.
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Affiliation(s)
- Jorge Simal-Aguado
- Simal-Aguado, Galindo-Tovar, Department of Pharmacy, Health Sciences Faculty, San Antonio Catholic University of Murcia, UCAM, Murcia; Spain. Campos-Navarro, Unit of Acute Psychiatry, Santa Lucia University Hospital, Cartagena; Spain. Valdivia-Muñoz, Center of Mental Health Infante, Murcia; Spain, Center of Mental Health Cartagena, Cartagena, Murcia; Spain. Garcia-Carmona, Department of Neurology, Santa Lucia University Hospital, Cartagena; Spain, Unit of Acute Psychiatry, Reina Sofia University Hospital, Murcia; Spain
| | - María-Pilar Campos-Navarro
- Simal-Aguado, Galindo-Tovar, Department of Pharmacy, Health Sciences Faculty, San Antonio Catholic University of Murcia, UCAM, Murcia; Spain. Campos-Navarro, Unit of Acute Psychiatry, Santa Lucia University Hospital, Cartagena; Spain. Valdivia-Muñoz, Center of Mental Health Infante, Murcia; Spain, Center of Mental Health Cartagena, Cartagena, Murcia; Spain. Garcia-Carmona, Department of Neurology, Santa Lucia University Hospital, Cartagena; Spain, Unit of Acute Psychiatry, Reina Sofia University Hospital, Murcia; Spain
| | - Francisco Valdivia-Muñoz
- Simal-Aguado, Galindo-Tovar, Department of Pharmacy, Health Sciences Faculty, San Antonio Catholic University of Murcia, UCAM, Murcia; Spain. Campos-Navarro, Unit of Acute Psychiatry, Santa Lucia University Hospital, Cartagena; Spain. Valdivia-Muñoz, Center of Mental Health Infante, Murcia; Spain, Center of Mental Health Cartagena, Cartagena, Murcia; Spain. Garcia-Carmona, Department of Neurology, Santa Lucia University Hospital, Cartagena; Spain, Unit of Acute Psychiatry, Reina Sofia University Hospital, Murcia; Spain
| | - Alejandro Galindo-Tovar
- Simal-Aguado, Galindo-Tovar, Department of Pharmacy, Health Sciences Faculty, San Antonio Catholic University of Murcia, UCAM, Murcia; Spain. Campos-Navarro, Unit of Acute Psychiatry, Santa Lucia University Hospital, Cartagena; Spain. Valdivia-Muñoz, Center of Mental Health Infante, Murcia; Spain, Center of Mental Health Cartagena, Cartagena, Murcia; Spain. Garcia-Carmona, Department of Neurology, Santa Lucia University Hospital, Cartagena; Spain, Unit of Acute Psychiatry, Reina Sofia University Hospital, Murcia; Spain
| | - Juan Antonio García-Carmona
- Simal-Aguado, Galindo-Tovar, Department of Pharmacy, Health Sciences Faculty, San Antonio Catholic University of Murcia, UCAM, Murcia; Spain. Campos-Navarro, Unit of Acute Psychiatry, Santa Lucia University Hospital, Cartagena; Spain. Valdivia-Muñoz, Center of Mental Health Infante, Murcia; Spain, Center of Mental Health Cartagena, Cartagena, Murcia; Spain. Garcia-Carmona, Department of Neurology, Santa Lucia University Hospital, Cartagena; Spain, Unit of Acute Psychiatry, Reina Sofia University Hospital, Murcia; Spain
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García-Carmona JA, Simal-Aguado J, Campos-Navarro MP, Valdivia-Muñoz F, Galindo-Tovar A. Evaluation of long-acting injectable antipsychotics with the corresponding oral formulation in a cohort of patients with schizophrenia: a real-world study in Spain. Int Clin Psychopharmacol 2021; 36:18-24. [PMID: 33086252 DOI: 10.1097/yic.0000000000000339] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
To date, only a few studies compared some long-acting injectables (LAIs) antipsychotics showing similar symptom improvement, relapse rates and adherence to treatment. We evaluated the use of LAIs antipsychotics [aripiprazole-1-month (A1M); paliperidone-1-month and 3-month (PP1M and PP3M) and biweekly (2w)-LAIs] and their corresponding oral formulations through (1) the number of hospital re-admissions, (2) the number of documented suicidal behaviour/attempts and (3) the use of concomitant benzodiazepines, oral antipsychotics and biperiden. A total of 277 patients, ≥18 years old, were included if were treated with the corresponding oral or LAI antipsychotic during at least 12 months and were previously diagnosed with schizophrenia. Our results showed that LAIs associated significantly lower suicidal behaviour, reduced the number of hospital admissions, lower diazepam and haloperidol equivalents and mean daily dose of biperiden intake versus oral antipsychotics. Furthermore, significant differences were found between LAIs. Specifically, PP3M was associated to lower hospital admissions versus A1M; PP1M and PP3M lower doses of diazepam equivalents versus 2w-LAIs and finally, PP1M lower antipsychotic intake versus 2w-LAIs. In conclusion, LAIs improved clinical outcomes by reducing the need for concomitant treatments and hospital admissions over oral antipsychotics. PP1M and PP3M showed better outcomes versus A1M and biweekly LAIs.
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Affiliation(s)
- Juan Antonio García-Carmona
- Department of Neurology, Santa Lucia University Hospital, Cartagena
- Unit of Acute Psychiatry, Reina Sofía University Hospital
| | - Jorge Simal-Aguado
- Department of Pharmacy, Health Sciences Faculty, San Antonio Catholic University of Murcia, UCAM
| | | | | | - Alejandro Galindo-Tovar
- Department of Pharmacy, Health Sciences Faculty, San Antonio Catholic University of Murcia, UCAM
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Petrova NN, Serazetdinova VS. Long-Acting Injectable Drugs in the Maintenance Therapy of Patients with Schizophrenia. CONSORTIUM PSYCHIATRICUM 2020; 1:53-62. [PMID: 39006895 PMCID: PMC11240131 DOI: 10.17650/2712-7672-2020-1-2-53-62] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 07/16/2024] Open
Abstract
This article discusses case reports of treatment with paliperidone palmitate in comparison with data from recent publications. Second-generation long-acting injectable antipsychotics have been shown to provide better control of psychiatric manifestations, reduce the severity of negative symptoms, improve social functioning and quality of life of patients and relatives, and reduce the burden of disease for both the healthcare system and the caregivers. The case reports presented in this article demonstrate better quality of remission in schizophrenia patients treated with one- monthly and three-monthly paliperidone palmitate formulations, due to higher effi in preventing relapses, better safety and good tolerability regardless of patient age.
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Stip E, Javaid S, Bayard-Diotte J, Abdel Aziz K, Arnone D. Use of long acting antipsychotics and relationship to newly diagnosed bipolar disorder: a pragmatic longitudinal study based on a Canadian health registry. Ther Adv Psychopharmacol 2020; 10:2045125320957118. [PMID: 32974000 PMCID: PMC7493262 DOI: 10.1177/2045125320957118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/18/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND There is limited data from large naturalistic studies to inform prescribing of long-acting injectable medication (LAIs). Guidance is particularly rare in the case of primary mood disorders. METHODS This study describes prescribing trends of LAIs in 3879 patients in Quebec, Canada, over a period of 4 years. Health register data from the Quebec provincial health plan were reviewed. RESULTS In this specific registry, 32% of patients who received LAIs drugs for schizophrenia had a confirmed diagnosis of bipolar disorder and 17% had a diagnosis of major depressive disorder. Non-schizophrenia syndromes were preferentially prescribed risperidone long-acting antipsychotic, whereas patients with schizophrenia were prescribed an excess of haloperidol decanoate. Patients with non-schizophrenia disorders prescribed long-acting antipsychotics were more frequently treated in primary care compared with patients with schizophrenia. CONCLUSION Data from a large number of patients treated naturalistically in Quebec with long-acting antipsychotics suggests that these compounds, prescribed to treat symptoms of schizophrenia and schizoaffective disorders, were maintained when mood symptoms emerged, even in cases when the diagnosis changed to bipolar disorder. This pragmatic study supports the need to explore this intervention as potential treatment for affective disorders.
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Affiliation(s)
- Emmanuel Stip
- Department of Psychiatry and Behavioural science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates; Centre Hospitalier Universitaire de Montreal (CHUM), Institute Universitaireen Santé Mentale de Montréal, Université de Montreal, Canada E-mail:
| | - Syed Javaid
- Department of Psychiatry and Behavioural science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Jonathan Bayard-Diotte
- Centre Hospitalier Universitaire de Montreal (CHUM), Université de Montréal, Montreal, Canada
| | - Karim Abdel Aziz
- Department of Psychiatry and Behavioural science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates
| | - Danilo Arnone
- Department of Psychiatry and Behavioural science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, Abu Dhabi, United Arab Emirates; Kings' College London, Institute of Psychiatry, Psychology, Neuroscience, Department of Psychological Medicine, Centre for Affective Disorders, London, UK
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