J Nerv Ment Dis. 2021 May 1;209(5):330-335. doi: 10.1097/NMD.0000000000001299.
The objective here is to compare the effectiveness of long-acting injectable antipsychotics (LAI-APs) and oral ones (OAPs) in patients with severe (Global Clinical Impression-Severity ≥ 5) schizophrenia (N = 688). A 5-year follow-up study has been conducted in patients undergoing standard treatment in mental health units (MHUs) or on a severe mental illness program (SMIP). A total of 8.7% of the patients on the SMIP discontinued treatment, whereas 43.6% did so in MHUs (p < 0.0001). In both cases, treatment retention was significantly higher in patients on LAI-APs (p < 0.001). Also, hospital admissions were in both cases fewer among those on LAI-APs (p < 0.001). There was a significant link between suicide attempts and OAP treatment (p < 0.01). Given the relationship between the use of LAI-APs versus oral treatments in achieving higher adherence and less relapses and suicide attempts, the use of second-generation antipsychotics LAIs should be considered more suitable for people with severe schizophrenia.
本研究旨在比较长效注射抗精神病药（LAI-APs）和口服抗精神病药（OAPs）在重度精神分裂症患者（N=688）中的疗效。在接受精神卫生单位（MHUs）或严重精神疾病计划（SMIP）标准治疗的患者中进行了为期 5 年的随访研究。共有 8.7%的 SMIP 患者停止治疗，而 MHUs 中则有 43.6%的患者停止治疗（p<0.0001）。在这两种情况下，接受 LAI-AP 治疗的患者的治疗保留率显著更高（p<0.001）。此外，接受 LAI-AP 治疗的患者住院治疗也明显减少（p<0.001）。自杀企图与 OAP 治疗之间存在显著关联（p<0.01）。鉴于 LAI-APs 与口服治疗在提高依从性、减少复发和自杀企图方面的关系，第二代抗精神病药 LAI 的使用应被视为更适合重度精神分裂症患者。
