Discontinuation, read missions and polytherapy with long-acting antipsychotics: An observational study

Abstract

Introduction and aim

Long-acting antipsychotics (LAIs) provide certain advantages over oral medications. The aim of our study is to determine whether there are differences between the various long-acting injectable antipsychotics available in our environment.

Methods

A retrospective observational study with psychotic patients discharged with LAIs was designed. Data on discontinuation, relapses and associated drugs in the discharge and in a year follow-up were collected. Fifty-seven patients were included: 21 risperidone (RLAI), 20 paliperidone palmitate (PP) and 16 first-generation LAIs (FG). Odds ratio was used to compare discontinuation, χ² test for categorical variables and Kruskal-Wallis test for independent samples.

Results

Discontinuation was lower with PP: OR_RLAI/PP = 2.74 and OR_FGLAI/PP = 3.09. There were significant differences in readmissions: rehospitalizations (χ² = 7.072, P = 0.029) and days of stay (χ² = 8.251; P = 0.016), both lower in the PP group. We found less use of psychoactive drugs with PP, with significant differences in the discharge (χ² = 11.518; P = 0.003) and in the follow-up (χ² = 7.097; P = 0.029). There were also significant differences in the use of oral antipsychotics in the discharge (χ² = 27.049, P = 0.000); anticholinergic drugs in the discharge (χ² = 7.001, P = 0.03) and in the follow-up (χ² = 11.699, P = 0.003) and benzodiazepines in the follow-up (χ² = 8.493, P = 0.014), always lower in the group of patients treated with PP.

Conclusions

Treatment with paliperidone palmitate may be more suitable than other long acting antipsychotics when it starts during the acute episode.

Disclosure of interest

The authors have not supplied their declaration of competing interest.