The switch strategies of long-term antipsychotic treatment (on the example of risperidone long acting injectable)

Abstract

On the example of risperidone long-acting injectable (RLAI) the advantages and the limitations of long-term treatment of chronic schizophrenia by prolonged antipsychotics were discussed. The main purpose of this treatment is achieving and maintaining remission by assurance of better compliance and adherence. Special attention should be paid to the adequate dosing. In original cohort pharmacotherapeutic study all stable patients form two care services of the one regular city outpatient clinic were assessed monthly by International remission criteria (IRC) in period of 12 months prospective observation. 35 patients of one care service received naturalistic treatment with conventional antipsychotics including 13 patients on long- acting injectable ones, and 42 patients from the other care setting were switched to RLAI. In both groups the patients with chronic paranoid schizophrenia were dominated, the mean illness duration was 16,8 ± 11,7 and 15,7 ± 12,3 years respectively. In 12 months the number of patients, who met the IRC, was greater in RLAI group (19 %) than in control group (5,7 %) (p < 0,001), and the reduction of total PANSS score was 16,8 ± 11,7 vs 15,7 ± 12,3 respectively (p < 0,01). In RLAI group there were also greater improvement in social functioning by PSP scale (15,6 % vs 4,5%, p < 0,01), and less level of non-compliance was revealed by ROMI (10,5 % vs 2,4 % respectively, p < 0,001).