Risperidone long-acting injection (RLAI) is the first atypical antipsychotic drug to be available in a ‘depot’ formulation. The evidence base underpinning its use is small. We sought to evaluate its early use in clinical practice by a naturalistic follow-up study of the first 50 patients to be prescribed RLAI in one National Health Service Trust.
At 6 months, 54% of patients had achieved at least minimal improvement, 4% were unchanged, 24% failed to comply, and 18% fared poorly and were switched to alternative antipsychotics. The attrition rate at 6 months was 42%. Supplementation with oral antipsychotics was often required for longer than 3 weeks. Only half of those who had a good clinical outcome at 6 months had achieved this by 3 months.
Some patients responded well to RLAI, but the overall attrition rate was high. Although RLAI provides additional choice in the range of treatments available for people with schizophrenia, we have much to learn about how to optimise its use in practice.
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