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Schizophrenia Bulletin Advance Access published online on December 18, 2007
Schizophrenia Bulletin, doi:10.1093/schbul/sbm137
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© The Author 2007. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Use of Depot Antipsychotic Medications for Medication Nonadherence in Schizophrenia

Joyce C. West2, Steven C. Marcus3, Joshua Wilk2, Lisa M. Countis2, Darrel A. Regier2 and Mark Olfson1
2 American Psychiatric Institute for Research and Education, 1000 Wilson Boulevard, Suite 1825, Arlington, VA
3 University of Pennsylvania School of Social Policy and Practice, Philadelphia, PA

1 To whom correspondence should be addressed; New York State Psychiatric Institute/Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, New York, NY 10032; tel: 212-543-5293, fax: 212-568-3534, e-mail: mo49{at}columbia.edu.

Objectives: To describe factors associated with initiation of depot antipsychotic medications in psychiatric outpatients with schizophrenia and recent medication nonadherence. Methods: A national sample of psychiatrists reported on adult outpatients with schizophrenia who were nonadherent with oral antipsychotic medications in the last year. Results: In total, 17.6% of psychiatrists initiated depot antipsychotic injections. Initiation was significantly and positively associated with public insurance, prior inpatient admission, proportion of time nonadherent, average or above average intellectual functioning, and living in a mental health residence. Use was inversely associated with using second-generation antipsychotics and other oral psychotropic medications prior to medication nonadherence. Psychiatrists who were male, nonwhite, and more optimistic about managing nonadherence were more likely to initiate depot injections. Conclusions: Initiation of depot injections is a joint function of patient, physician, treatment, and setting factors. Use of long-acting preparations in this population is uncommon despite clinical recommendations urging their use.

Keywords: nonadherence / depot / antipsychotics


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[Abstract] [Full Text] [PDF]


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