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Utilization of Long-Acting Antipsychotic Medication in Patient Care

Published online by Cambridge University Press:  07 November 2014

John M. Kane
John M. Kane*
Affiliation:
Dr. Kane is chair of the Department of Psychiatry at the Zucker Hillside Hospital and professor of psychiatry, neurology, and neuroscience at Albert Einstein College of Medicine, both in New York.
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Abstract

Schizophrenia is a complex disorder characterized by a broad spectrum of psychopathology. Aggressive efforts to bring the patient into remission should begin immediately after the first episode. Consequences of non-remission include poor prognosis, psychiatric and general medical complications, treatment resistance, and death from medical comorbidities and suicide. Prevention of relapse following remission is critical to the well-being and optimal functioning of patients with schizophrenia.

The key to optimizing patients' outcomes is to ensure a patient's long-term continuation on medication. As treatment discontinuation can greatly impact the progression of the illness and the patient's ultimate outcome, selecting a treatment with maximum treatment effectiveness is optimal. Nonadherence to treatment is extremely prevalent among patients with schizophrenia, due to such factors as impaired cognition, lack of insight, and side effects associated with antipsychotic treatment.

Atypical antipsychotics have shown some advantages over conventional antipsychotics in terms of reducing positive and negative symptoms of schizophrenia, preventing relapse, and incidence of tardive dyskinesia. Injectables and long-acting formulations of antipsychotics offer additional benefits in terms of ensuring treatment adherence.

Type
Research Article
Information
CNS Spectrums , Volume 11 , Issue S14 , December 2006 , pp. 1 - 8
Copyright
Copyright © Cambridge University Press 2003

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References

1.AF, Lehman, et al.APA practice guideline for the treatment of patients with schizophrenia. Am J Psychiatry. 2004;161(suppl 2):1–56.Google Scholar
2.Leucht, S, Kane, JM, Kissling, W, Hamann, J, Etschel, E, RR, Engel. What does the PANSS mean? SchizophrRes. 2005;79(2–3):231–238.CrossRefGoogle ScholarPubMed
3.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.Google Scholar
4.Andreasen, NC, WT, Carpenter Jr, Kane, JM, et al.Remission in schizophrenia: proposed criteria and rationale for consensus. Am J Psychiatry. 2005;162(3):441–449.CrossRefGoogle ScholarPubMed
5.Lieberman, JA, Stroup, TS, McEvoy, JP, et al.Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med. 2005;353(12):1209–1223.CrossRefGoogle ScholarPubMed
6.Liberman, RP, Kopelowicz, A. Recovery from schizophrenia: a concept in search of research. Psychiatr Serv. 2005;56(6):735–742.CrossRefGoogle ScholarPubMed
7.Robinson, DG, Woerner, MG, McMeniman, M, et al.Symptomatic and functional recovery from a first episode of schizophrenia or schizoaffective disorder. Am J Psychiatry. 2004;161:473–479.CrossRefGoogle ScholarPubMed
8.Correll, CU, Leucht, S, Kane, JM. Lower risk for tardive dyskinesia associated with second-generation antipsychotics: a systematic review of 1-year studies. Am J Psychiatry. 2004;161:414–425.CrossRefGoogle ScholarPubMed
9.Cramer, JA, Rosenheck, R. Compliance with medication regimens for mental and physical disorders. Psychiatr Serv. 1998;49(2):196–201.CrossRefGoogle ScholarPubMed
10.Mahmoud, RA, et al.Poster presented at: the 36th Annual Meeting of the American College of Neuropsychopharmacology; December 8–12, 1997; Kamuela, Hawaii.Google Scholar
11.Dolder, CR, Lacro, JP, Dunn, LB, Jeste, DV. Antipsychotic medicine adherence: Is there a difference between typical and atypical agents? Am J Psychiatry. 2002;159:103–108.CrossRefGoogle Scholar
12.Byerly, M, Fisher, R, Rush, AJ, et al. Comparison of Clinical vs. Electronic monitoring of antipsychotic adherence in schizophrenia. Poster presented at: 41st Annual Meeting of the American College of Neuropsychopharmacology; December 8–12, 2002; San Juan, Puerto Rico.Google Scholar
13.Weiden, PJ, Kozma, C, Grogg, A, Locklear, J. Partial compliance and risk of rehospit Kane, JM, Leucht, S, Carpenter, D, Docherty, JP. Expert consensus guideline series. Optimizing pharmacologic treatment of psychotic disorders. Introduction: methods, commentary, and summary. J Clin Psychiatry. 2003;64(suppl 12):5–19.Google Scholar
15.Robinson, D, Woerner, MG, Alvir, JM, et al.Predictors of relapse following response from a first episode of schizophrenia or schizoaffective disorder. Arch Gen Psychiatry. 1999;56:241–247.CrossRefGoogle ScholarPubMed
16.Schooler, NR. Reducing dosage in maintenance treatment of schizophrenia. Review and prognosis. Br J Psychiatry Suppl. 1993; (22):58–65.CrossRefGoogle ScholarPubMed
17.Gaebel, W, Frick, U, Kopcke, W. Early neuroleptic intervention in schizophrenia: are prodromal symptoms valid predictors of relapse? Br J Psychiatry Suppl. 1993;(21):8–12.CrossRefGoogle ScholarPubMed
18.Jolley, AG, Hirsch, SR, McRink, A, Manchanda, R. Trial of brief intermittent neuroleptic prophylaxis for selected schizophrenic outpatients: clinical outcome at one year. BMJ. 1989;298(6679):985–90.CrossRefGoogle ScholarPubMed
19.Herz, MI, Glazer, WM, Mostert, MA. Intermittent vs maintenance medication in schizophrenia. Two-year results. Arch Gen Psychiatry. 1991;48(4):333–339.CrossRefGoogle ScholarPubMed
20.WT, Carpenter Jr, Hanlon, TE, Heinrichs, DW, et al.Continuous versus targeted medication in schizophrenic outpatients: outcome results. Am J Psychiatry. 1990;147(9):1138–1148.Google Scholar
21.Leucht, S, Barnes, TR, Kissling, W, et al.Relapse prevention in schizophrenia with new-generation antipsychotics: a systematic review and exploratory meta-analysis of randomized, controlled trials. Am J Psychiatry. 2003;160(7):1209–1222.CrossRefGoogle ScholarPubMed
22.Barnes, TR, Milavic, G, Curson, DA, Platt, SD. Use of the Social Behaviour Assessment Schedule (SBAS) in a trial of maintenance antipsychotic therapy in schizophrenia. Social Psychiatry. 1983;18(4):193–199.CrossRefGoogle Scholar
23.Falloon, I, Watt, DC, Shepherd, M. A comparative controlled trial of pimozide and fluphenazine decanoate in the continuation therapy of schizophrenia. Psychol Med. 1978;8(1):59–70.CrossRefGoogle ScholarPubMed
24.Hogarty, GE, Schooler, NR, Ulrich, R, et al.Fluphenazine and social therapy in the aftercare of schizophrenic patients. Relapse analyses of a two-year controlled study of fluphenazine decanoate and fluphenazine hydrochloride. Arch Gen Psychiatry. 1979;36 (12):1283–1294.CrossRefGoogle ScholarPubMed
25.Quitkin, F, Rifkin, A, Kane, J, Ramos-Lorenzi, JR, Klein, DF. Long-acting oral vs injectable antipsychotic drugs in schizophrenics: a one-year double-blind comparison in multiple episode schizophrenics. Arch Gen Psychiatry. 1978;35(7):889–892.CrossRefGoogle ScholarPubMed
26.Rifkin, A, Quitkin, F, Rabiner, CJ, Klein, DF. Fluphenazine decanoate, fluphenazine hydrochloride given orally, and placebo in remitted schizophrenics. I. Relapse rates after one year. Arch Gen Psychiatry. 1977;34(1):43- Crawford, Forrest A. Controlled trial of depot fluphenazine in out-patient schizophrenics. Br J Psychiatry. 1974;124(0):385–391.CrossRefGoogle ScholarPubMed
28.Del Giudice, J, Clark, WG, Gocka, EF. Prevention of recidivism of schizophrenics treated with fluphenazine enanthate. Psychosomatics. 1975;16:32–36.CrossRefGoogle ScholarPubMed
29.Schooler, NR, Levine, J, Severe, JB, et al.Prevention of relapse in schizophrenia. An evaluation of fluphenazine decanoate. Arch Gen Psychiatry. 1980;37(1):16–24.CrossRefGoogle ScholarPubMed
30.Kane, JM, Eerdekens, M, Lindenmayer, JP, et al.Long-acting injectable risperidone: efficacy and safety of the first long-acting atypical antipsychotic. Am J Psychiatry. 2003;160:1125–1132.CrossRefGoogle ScholarPubMed