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68 Cognitive Impairment in Schizophrenia. First-generation Long-acting Antipsychotics versus Aripiprazole Long-acting Injectable
- Samuel-Leopoldo Romero Guillena, Beatriz-Oda Plasencia García de Diego
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- Journal:
- CNS Spectrums / Volume 24 / Issue 1 / February 2019
- Published online by Cambridge University Press:
- 12 March 2019, pp. 211-212
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Study Objectives
To assess differences in cognitive impairment in a group of patients with schizophrenia receiving first-generation long-acting antipsychotics (FG-LAI) versus Aripiprazole long-actinginjectable (ALAI).
MethodA descriptive, cross-sectional, multi-centerstudy.
Study sample: 28 outpatients with stable schizophrenia (18 men and 10 women) with ages ranging from 22 to 64years.
Inclusion criteria were: Clinically stable patients with a diagnosis of schizophrenia (according to DSM-5 criteria) and without any changes to their antipsychotic or antidepressant therapy in the last six months.
Simple stratified sampling was performed to collect data from patients with schizophrenia receiving FG-LAI (n=14) versus patients with schizophrenia receiving Aripiprazole long-acting injectable (ALAI) (n=14)
Groups were matched by age, gender, years of evolution of the disease, and years on formal education.
Functionality in the different cognitive domains was evaluated based on the Brief Assessment of cognition in Schizophrenia (BACS.), a hetero-applied instrument, which Spanish version has been validated. BACS evaluates the following cognitive domains:
Verbal memory (V.M): Word list test
Working memory (W.M): Digit sequencing task
Motor speed (M.S): Token motor task
Verbal fluency (V.F): Semantic or category fluency
Attention (A): Symbol coding
Executive function (E.F): Tower of London
The data obtained were analyzed using the SPSS 22.0 statistical package Differences between the means of quantitative variables were assessed using the independent-sample Student-t test. Individual test scores were converted into standardized (T and Z) scores and composite scores that were corrected for age and gender.
Informed consent was obtained from all patients according to the Declaration of Helsinki (World Medical Association).
ResultsIn the group receiving ALAI, the most severely impaired cognitive domain was attention, whereas motor speed was barely affected. In contrast, verbal memory was most impaired, whereas motor speed was the least impaired cognitive domain in the group receiving FG-LAI.
Patients with schizophrenia taking ALAI showed a better cognitive function in all domains (except for motor speed and attention) than patients receiving FG-LAI.
Summarized results in Table1.
ConclusionsIn our study, patients with schizophrenia receiving Aripiprazole long-acting injectable have better cognitive function than patients receiving first-generation long-acting antipsychotics.
64 Aripiprazole Long-acting Injectable in Schizophrenia. An 18-month Follow-up and Mirror-image Study
- Beatriz-Oda Plasencia García de Diego, Samuel-Leopoldo Romero Guillena
-
- Journal:
- CNS Spectrums / Volume 24 / Issue 1 / February 2019
- Published online by Cambridge University Press:
- 12 March 2019, pp. 209-210
-
- Article
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- You have access Access
- Export citation
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Study Objectives
1. To assess the effectiveness, functionality and tolerability of Aripiprazole long-acting injectable (ALAI) in patients with stable schizophrenia
2. Compare hospitalizations and emergency assists during 18-month period before (retrospective period) and after (prospective period) switch to ALAI
MethodThe study sample involved 18 patients with stable schizophrenia (DSM 5 criteria) who started treatment with ALAI between January-December 2016.
Variables: age, gender, psychopharmacological treatment.
- Follow-up study: Prospective assessments were performed at baseline and at 3, 6, 9, 12, 15 and 18 months:
∙ Brief Psychiatric rating Scale (BPRS)
∙ Global Clinical Impression Scale (ICG-SI)
∙ Personal and social Performance (PSP)
∙ Side effects reported
- Mirror-image study: 18-month before and afters witch
∙ Number of hospitalizations and emergency assists
The study was performed in accordance with the Declaration of Helsinki and all the participants provided written consent for participation.
Student’s t-test and Chi-square test were used to assess differences between baseline evaluation and subsequent visits. For mirror-image analysis test Z and MacNemar was used.
Resultsa) Efficacy and functionality: At the end of the study we observed:
∙ A statistically significant: reduction in the total score of ICG-SI, and increase in the total score of PSP
∙ A reduction in the total score of BPRS.
There is an indirect correlation between age and changes in the score on: BPRS and ICG-SI (p<0.05) and PSP scale (p<0.05)
b) Tolerability: The most frequent side effect with an incidence of 22% was transient mild insomnia
c) Psychopharmacological treatment: The percentage of patients on monotherapy increased from 39.6% baseline to 66.6%, and treatment with Biperidene decreased from 27.5% to 5.5% at the end of the study
d) Number of hospitalizations and emergency assist:
∙ 12 hospital admission during 18-month period before switch to ALI, and 3 hospital admission 18-month after switch
∙ 24 emergency assist during 18-month period before switch to ALI, and 7 emergency assist 18-month afterswitch
e) Treatment compliance: shown in Table 1.
ConclusionsALAI can be effective therapy for the treatment of patients with schizophrenia: improves psychopathological symptoms, functionality and can prevent hospitalizations and emergency visits. In addition, ALAI is well tolerated, achieving a high percentage of patients in monotherapy.