Schizophrenia Bulletin Advance Access published online on April 29, 2007
Schizophrenia Bulletin, doi:10.1093/schbul/sbm033
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Treatment of Schizophrenia With Long-Acting Fluphenazine, Haloperidol, or Risperidone
2 Division of Clinical and Genetic Epidemiology, New York State Psychiatric Institute, New York, NY
3 Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, 1050 Riverside Drive, Unit 24, New York, NY 10032
4 School of Social Policy and Practice, University of Pennsylvania, Philadelphia, PA
5 Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN
1 To whom correspondence should be addressed; tel: 212-543-5293, e-mail: mo49{at}columbia.edu.
Objective: This study compares 3 cohorts of patients with schizophrenia before, during, and after initiating treatment with fluphenazine decanoate (FD), haloperidol decanoate (HD), or long-acting injectable risperidone (LAR). Methods: Administrative data are analyzed from California Medicaid (Medi-Cal) beneficiaries with schizophrenia who initiated FD, HD, or LAR treatment. Patients were required to have been continuously enrolled in Medi-Cal for 180 days before and 180 days after the start of the new episode of long-acting antipsychotic therapy. Results: There were few demographic and clinical differences among patients initiating FD, HD, and LAR. During the 180 days before starting long-acting injections, most patients initiating FD (53.5%), HD (58.5%), and LAR (61.2%) received oral antipsychotic medications for <80% of the days in this period (medication possession ratio: <0.80). The mean duration of depot treatment episodes was 58.3 days (SD = 53.6) for FD, 71.7 days (SD = 56.4) for HD, and 60.6 days (SD = 48.8) for LAR (F = 18.3, df = 2, 2694, P < .0001, HD > FD). Few patients who started on FD (5.4%), HD (9.7%), or LAR (2.6%) continued for at least 180 days. Most patients in each group (FD [77.4%], HD [78.9%], and LAR [75.5%]) received oral antipsychotic medications during the 45 days after discontinuing long-acting injections. Coprescription with antidepressants, mood stabilizers, and benzodiazepines was common. Conclusions: Patients treated with long-acting antipsychotic injections tend to have complex pharmacological regimens and recent medication nonadherence. A great majority of patients initiating long-acting antipsychotic medications discontinue use within the first few months of treatment.
Keywords: schizophrenia / depot antipsychotic medications / community treatment
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  W. W. Fleischhacker Second-generation antipsychotic long-acting injections: systematic review The British Journal of Psychiatry, November 1, 2009; 195(52): S29 - S36. [Abstract] [Full Text] [PDF]
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