Devrımcı Özgüven Halise, Kir Yağmur
Ankara University School of Medicine, Department of Psychiatry, Ankara University Institute of Health Sciences Department of Neuroscience, Ankara University Brain Research Center, Ankara, Türkiye.
Amasya University Sabuncuoğlu Şerefeddin Training and Research Hospital, Department of Mental Health and Diseases, Amasya, Turkey.
Noro Psikiyatr Ars. 2021 Sep 20;58(Suppl 1):S47-S52. doi: 10.29399/npa.27480. eCollection 2021.
Schizophrenia and bipolar disorder (BD) are psychiatric disorders with economic and social effects that cause disability. Treatment non-compliance is one of the major problems faced by clinicians in both schizophrenia and BD. Treatment non-compliance is associated with recurrence and impaired functionality. Treatment compliance increases with long-acting injectable antipsychotics (LAIAs) and recurrence times are prolonged, hospitalization rates decrease compared to those who use an equivalent oral form of the same drug. The use of LAIAs in the maintenance treatment of schizophrenia has also been associated with a low mortality rate, decrease in caregiver burden, and increase in patient satisfaction. Studies show that LAIAs are cost-effective compared to their oral forms. Data on the use of LAIAs in first-episode schizophrenia and BD are relatively limited. The results of studies on the use of LAIAs in patients with first-episode schizophrenia indicate that LAIAs have advantageous in preventing relapse and re-hospitalization compared to oral antipsychotics. In BD, with the use of LAIAs, the rate of hospitalization due to mood episodes and the frequency of manic episodes have been decreased. LAIAs have not been found to be as effective in preventing depressive episodes in BD as manic episodes. Although there are many studies supporting the use of LAIAs in maintenance treatment of schizophrenia and BD, more studies are needed on this issue. In this article, studies on the use of LAIAs in schizophrenia, first episode schizophrenia and BD are reviewed and the place of LAIAs in treatment was discussed.
精神分裂症和双相情感障碍(BD)是具有经济和社会影响并导致残疾的精神疾病。治疗不依从是精神分裂症和双相情感障碍临床医生面临的主要问题之一。治疗不依从与复发和功能受损有关。长效注射用抗精神病药物(LAIA)可提高治疗依从性,延长复发时间,与使用同等剂量口服药物的患者相比,住院率降低。在精神分裂症维持治疗中使用LAIA还与低死亡率、照顾者负担减轻和患者满意度提高有关。研究表明,与口服药物相比,LAIA具有成本效益。关于LAIA在首发精神分裂症和双相情感障碍中应用的数据相对有限。关于LAIA在首发精神分裂症患者中应用的研究结果表明,与口服抗精神病药物相比,LAIA在预防复发和再次住院方面具有优势。在双相情感障碍中,使用LAIA后,因情绪发作导致的住院率和躁狂发作频率均有所降低。尚未发现LAIA在预防双相情感障碍抑郁发作方面与预防躁狂发作一样有效。尽管有许多研究支持在精神分裂症和双相情感障碍维持治疗中使用LAIA,但在这个问题上还需要更多的研究。本文回顾了关于LAIA在精神分裂症、首发精神分裂症和双相情感障碍中应用的研究,并讨论了LAIA在治疗中的地位。