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Comparison of the effectiveness of depot antipsychotics in routine clinical practice

  • Polash Shajahan (a1) (a2), Elizabeth Spence (a3), Mark Taylor (a2) (a4), Darlington Daniel (a1) and Anthony Pelosi (a1) (a2)...
Abstract
Aims and method

To compare effectiveness of long-acting injections in schizophrenia and related psychoses in Lanarkshire, Scotland, from 2002 to 2008. We retrospectively assigned Clinical Global Impression (CGI) scores and examined discontinuation and hospitalisation rates.

Results

Risperidone, zuclopenthixol and flupentixol were associated with CGI improvement in 72-74% of individuals. Zuclopenthixol was associated with lower rates of discontinuation as a result of inefficacy compared with risperidone (hazard ratio (HR) = 0.11, 95% CI 0.05-0.27) and flupenthixol (HR = 0.14, 95% CI 0.05-0.39), and lower rates of hospitalisation compared with risperidone (HR = 0.32, 95% CI 0.17-0.56) and flupentixol (HR = 0.34, 95% CI 0.16-0.71). ‘Very much improved’ or ‘much improved’ on the CGI was seen in risperidone (29%), zuclopenthixol (16%) and flupentixol (37%), P<0.001.

Clinical implications

No long-acting injection was clearly superior in all our outcome measures, supporting the continued need for a variety of long-acting depot antipsychotics to optimise the treatment of the range of patients seen in clinical practice.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Corresponding author
Polash Shajahan (polash.shajahan@lanarkshire.scot.nhs.uk)
Footnotes
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Declaration of interest

P.S., M.T. and A.P. have received honoraria and hospitality and E.S. and D.D. have received hospitality from various pharmaceutical firms including Bristol-Myers Squibb, AstraZeneca, Lilly and Janssen.

Footnotes
References
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Comparison of the effectiveness of depot antipsychotics in routine clinical practice

  • Polash Shajahan (a1) (a2), Elizabeth Spence (a3), Mark Taylor (a2) (a4), Darlington Daniel (a1) and Anthony Pelosi (a1) (a2)...
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