Cargando…

Effectiveness of oral versus long-acting antipsychotic treatment early-phase schizophrenia patients: an open-label randomized trial

INTRODUCTION: Schizophrenia is a chronic psychiatric illness with periods of remission and relapse. Patients vary in the frequency and severity of relapse, time until relapse and time in remission. Discontinuation of antipsychotic medication is by far the most important reason for relapse. A possibl...

Descripción completa

Detalles Bibliográficos
Autores principales: Winter, I., Davidson, M., Fleischhacker, W., Kahn, R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564751/
http://dx.doi.org/10.1192/j.eurpsy.2022.356
_version_ 1784808723141623808
author Winter, I.
Davidson, M.
Fleischhacker, W.
Kahn, R.
author_facet Winter, I.
Davidson, M.
Fleischhacker, W.
Kahn, R.
author_sort Winter, I.
collection PubMed
description INTRODUCTION: Schizophrenia is a chronic psychiatric illness with periods of remission and relapse. Patients vary in the frequency and severity of relapse, time until relapse and time in remission. Discontinuation of antipsychotic medication is by far the most important reason for relapse. A possible method to optimize medication adherence is to treat patients with long-term, depot medication rather than oral medication. OBJECTIVES: Primary objective is to compare all cause discontinuation rates in patients with schizophrenia randomized to either one of the two depot medications (aripiprazole depot or paliperidone palmitate) with patients randomized to either one of the two oral formulations of the same medication (aripiprazole or paliperidone) over an 19 month follow-up period. METHODS: Pragmatic, randomized, open label, multicenter, multinational comparative trial consisting of a 19 month treatment period. Patients aged 18 years or older, having experienced the first psychosis 1-7 years ago, currently meeting DSM-IV-R criteria for schizophrenia. Patients are randomized 1:1:1:1 to paliperidone palmitate, aripiprazole depot, oral aripiprazole or oral paliperidone. The primary outcome is all cause discontinuation. RESULTS: In the Intent to Treat sample (n=511), no difference was found in time to ACD between the combined oral and combined depot treatment arms, nor between the four individual treatment arms. CONCLUSIONS: Even though the scientific evidence comparing oral and depot medication has been inconsistent, most studies were conducted in rigorous clinical settings, which may have biased those results. In contract, given the pragmatic, open label design of the current trial, the results may be more representative of common daily practice. DISCLOSURE: No significant relationships.
format Online
Article
Text
id pubmed-9564751
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Cambridge University Press
record_format MEDLINE/PubMed
spelling pubmed-95647512022-10-17 Effectiveness of oral versus long-acting antipsychotic treatment early-phase schizophrenia patients: an open-label randomized trial Winter, I. Davidson, M. Fleischhacker, W. Kahn, R. Eur Psychiatry Abstract INTRODUCTION: Schizophrenia is a chronic psychiatric illness with periods of remission and relapse. Patients vary in the frequency and severity of relapse, time until relapse and time in remission. Discontinuation of antipsychotic medication is by far the most important reason for relapse. A possible method to optimize medication adherence is to treat patients with long-term, depot medication rather than oral medication. OBJECTIVES: Primary objective is to compare all cause discontinuation rates in patients with schizophrenia randomized to either one of the two depot medications (aripiprazole depot or paliperidone palmitate) with patients randomized to either one of the two oral formulations of the same medication (aripiprazole or paliperidone) over an 19 month follow-up period. METHODS: Pragmatic, randomized, open label, multicenter, multinational comparative trial consisting of a 19 month treatment period. Patients aged 18 years or older, having experienced the first psychosis 1-7 years ago, currently meeting DSM-IV-R criteria for schizophrenia. Patients are randomized 1:1:1:1 to paliperidone palmitate, aripiprazole depot, oral aripiprazole or oral paliperidone. The primary outcome is all cause discontinuation. RESULTS: In the Intent to Treat sample (n=511), no difference was found in time to ACD between the combined oral and combined depot treatment arms, nor between the four individual treatment arms. CONCLUSIONS: Even though the scientific evidence comparing oral and depot medication has been inconsistent, most studies were conducted in rigorous clinical settings, which may have biased those results. In contract, given the pragmatic, open label design of the current trial, the results may be more representative of common daily practice. DISCLOSURE: No significant relationships. Cambridge University Press 2022-09-01 /pmc/articles/PMC9564751/ http://dx.doi.org/10.1192/j.eurpsy.2022.356 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Winter, I.
Davidson, M.
Fleischhacker, W.
Kahn, R.
Effectiveness of oral versus long-acting antipsychotic treatment early-phase schizophrenia patients: an open-label randomized trial
title Effectiveness of oral versus long-acting antipsychotic treatment early-phase schizophrenia patients: an open-label randomized trial
title_full Effectiveness of oral versus long-acting antipsychotic treatment early-phase schizophrenia patients: an open-label randomized trial
title_fullStr Effectiveness of oral versus long-acting antipsychotic treatment early-phase schizophrenia patients: an open-label randomized trial
title_full_unstemmed Effectiveness of oral versus long-acting antipsychotic treatment early-phase schizophrenia patients: an open-label randomized trial
title_short Effectiveness of oral versus long-acting antipsychotic treatment early-phase schizophrenia patients: an open-label randomized trial
title_sort effectiveness of oral versus long-acting antipsychotic treatment early-phase schizophrenia patients: an open-label randomized trial
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564751/
http://dx.doi.org/10.1192/j.eurpsy.2022.356
work_keys_str_mv AT winteri effectivenessoforalversuslongactingantipsychotictreatmentearlyphaseschizophreniapatientsanopenlabelrandomizedtrial
AT davidsonm effectivenessoforalversuslongactingantipsychotictreatmentearlyphaseschizophreniapatientsanopenlabelrandomizedtrial
AT fleischhackerw effectivenessoforalversuslongactingantipsychotictreatmentearlyphaseschizophreniapatientsanopenlabelrandomizedtrial
AT kahnr effectivenessoforalversuslongactingantipsychotictreatmentearlyphaseschizophreniapatientsanopenlabelrandomizedtrial