Tajima-Pozo Kazuhiro, Reinoso Barragán Sergio, Pozuelo Ruiz Mónica, Pérez Elia, Montañes-Rada Francisco
Servicio de Psiquiatría, Hospital Universitario Fundación Alcorcón, España.
Vertex. 2019 Jan-Feb;XXX(143):46-51.
Schizophrenia is a chronic mental disorder that affects young patients in which antipsychotic treatment is essential for sympto- matic control and preventing progression. The high rate of relapse in these patients (10%) is mainly due to the abandonment of the medication. It is necessary to find tools to increase adherence. The long acting injectable antipsychotics (depot antipsychotics) represent a useful alternative in the recent years, since there is great evidence that they improve therapeutic compliance.
To evaluate the effectiveness and adherence to pharmacological treatment with depot antipsychotics in patients with psychotic disorders.
A retrospective longitudinal observational study was performed on a population of 89 subjects from Hospital Universitario Fundación Alcorcón (HUFA) with psychotic disorders, who received depot antipsychotics since September 2015 until June 2017. The incidences of new symptomatic episodes (assessed as visits to Emergency Department, general hospital admissions and psychiatric admissions) were compared at 6, 12, 24 months before and 6, 12, 14 months after the start of the depot treatment.
There is a significant reduction in the relative risk of general and psychiatric admissions with all depot antipsychotics. Paliperidone Palmitate is superior to the others, being the only one that reduces the number of visits to general Emergencies. Aripiprazole only decreased the relative risk of psychiatric admissions. The depot antipsychotics used had a high adherence (73%). Among the causes of non-adherence to treatment (23%), the most important is non-compliance with the prescribed regimen.
Depot antipsychotics are an effective alternative to improve therapeutic adherence in patients with psychotic disorders, which means a lower incidence of symptoms and lower hospital requirements.
精神分裂症是一种影响年轻患者的慢性精神障碍，其中抗精神病药物治疗对于症状控制和预防病情进展至关重要。这些患者的高复发率（10%）主要是由于停药。有必要找到提高依从性的方法。长效注射用抗精神病药物（长效抗精神病药物）近年来是一种有用的替代选择，因为有大量证据表明它们可提高治疗依从性。
评估长效抗精神病药物治疗精神病性障碍患者的有效性和药物治疗依从性。
对阿尔科孔基金会大学医院（HUFA）的89名患有精神病性障碍的受试者进行了一项回顾性纵向观察研究，这些受试者自2015年9月至2017年6月接受长效抗精神病药物治疗。比较长效治疗开始前6、12、24个月以及开始后6、12、14个月新症状发作的发生率（通过急诊科就诊、综合医院住院和精神科住院评估）。
所有长效抗精神病药物在综合医院和精神科住院的相对风险均显著降低。棕榈酸帕利哌酮优于其他药物，是唯一能减少综合急诊科就诊次数的药物。阿立哌唑仅降低了精神科住院的相对风险。所使用的长效抗精神病药物具有较高的依从性（73%）。在不依从治疗的原因（23%）中，最重要的是未遵守规定的治疗方案。
长效抗精神病药物是提高精神病性障碍患者治疗依从性的有效替代方法，这意味着症状发生率降低且住院需求减少。
