Department of Neurology, Santa Lucia University Hospital, Cartagena.
Unit of Acute Psychiatry, Reina Sofía University Hospital.
Int Clin Psychopharmacol. 2021 Jan;36(1):18-24. doi: 10.1097/YIC.0000000000000339.
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.
迄今为止,仅有少数研究比较了一些长效抗精神病药(LAIs),结果显示它们在改善症状、复发率和治疗依从性方面相似。我们评估了长效抗精神病药[阿立哌唑 1 个月(A1M);帕利哌酮 1 个月和 3 个月(PP1M 和 PP3M)和双周(2w)-LAIs]及其相应的口服制剂的使用情况,通过(1)住院再入院次数,(2)记录的自杀行为/企图次数和(3)苯二氮䓬类药物、口服抗精神病药和比哌立登的使用情况。共有 277 名年龄≥18 岁的患者,如果在至少 12 个月内接受了相应的口服或 LAI 抗精神病药治疗,且之前被诊断为精神分裂症,则被纳入研究。我们的结果表明,与口服抗精神病药相比,LAIs 与较低的自杀行为相关,降低了住院次数,降低了地西泮和氟哌啶醇等效物的数量以及比哌立登的日平均剂量。此外,LAIs 之间也存在显著差异。具体来说,PP3M 与 A1M 相比,住院次数较少;PP1M 和 PP3M 与 2w-LAIs 相比,地西泮等效物剂量较低,最后,PP1M 与 2w-LAIs 相比,抗精神病药剂量较低。总之,LAIs 通过减少对合并治疗和住院的需求改善了临床结果,优于口服抗精神病药。PP1M 和 PP3M 与 A1M 和双周 LAIs 相比,具有更好的结果。