1360 – Long acting second generation antipsychotic therapy, from compliance to improving quality of life: the florence depot clinic preliminary report

2013 ◽  
Vol 28 ◽  
pp. 1
Author(s):  
G. Talamba ◽  
S. Arcabasso ◽  
M. Spadafora ◽  
A. Ballerini
2018 ◽  
Vol 52 ◽  
pp. 85-94 ◽  
Author(s):  
Pierre-Michel Llorca ◽  
Julio Bobes ◽  
W. Wolfgang Fleischhacker ◽  
Stephan Heres ◽  
Nicholas Moore ◽  
...  

AbstractBackground:The Antipsychotic Long-acTing injection in schizOphrenia (ALTO) study was a non-interventional study across several European countries examining prescription of long-acting injectable (LAI) antipsychotics to identify sociodemographic and clinical characteristics of patients receiving and physicians prescribing LAIs. ALTO was also the first large-scale study in Europe to report on the use of both first- or second-generation antipsychotic (FGA- or SGA-) LAIs.Methods:Patients with schizophrenia receiving a FGA- or SGA-LAI were enrolled between June 2013 and July 2014 and categorized as incident or prevalent users. Assessments included measures of disease severity, functioning, insight, well-being, attitudes towards antipsychotics, and quality of life.Results:For the 572 patients, disease severity was generally mild-to-moderate and the majority were unemployed and/or socially withdrawn. 331/572 were prevalent LAI antipsychotic users; of whom 209 were prescribed FGA-LAI. Paliperidone was the most commonly prescribed SGA-LAI (56% of incident users, 21% of prevalent users). 337/572 (58.9%) were considered at risk of non-adherence. Prevalent LAI users had a tendency towards better insight levels (PANSS G12 item). Incident FGA-LAI users had more severe disease, poorer global functioning, lower quality of life, higher rates of non-adherence, and were more likely to have physician-reported lack of insight.Conclusions:These results indicate a lower pattern of FGA-LAI usage, reserved by prescribers for seemingly more difficult-to-treat patients and those least likely to adhere to oral medication.


CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 221-222 ◽  
Author(s):  
S Arques-Egea ◽  
E Ros-Cucurull ◽  
C Iranzo-Tatay ◽  
C Parro-Torres ◽  
RF Palma-Álvarez ◽  
...  

AbstractAIMThe objective of the study is to evaluate the differences in health outcomes as well as treatment satisfaction and functionality, focusing particularly in cognitive deficits and perceived disability among stable psychotic patients with therapeutic adherence treated with oral antipsychotics (OA) vs Aripiprazole Long Acting Inyectable (A-LAI).METHODNaturalistic study, descriptive and transversal. Inclusion criteria: Schizophrenia; 18-65 years old; CGI≤3; treatment OA or A-LAI; no changes antipsychotic therapy in last 3months. Sociodemographic and clinical variables were recorded using self-applied scales (TSQM;EQ-5;SDI;PDQ) and heteroaplied (PSP;CGI;UKU). A mirror analysis was performed in the A-LAI group comparing number of psychiatric drugs and antipsychotic used, previous admissions and emergency care visits.RESULTS50 patients (25 OA, 25 A-LAI), 62% male, age 43,9±11,1, psychotic illness evolution 15,9±9,9. In comparison with OA, A-LAI patients present greater functionality scores (PSP) 75±11,5 vs 61,8,±10,5 (p.001) and better results in quality of life (EQ-5D), both quantitatively, 69±18,6 vs 48,3±22,1 (p.005), and qualitatively (particularly in everyday tasks, OR 0,15 (p.009), and better health during the last year OR 0,16 (p.011). Additionally A-LAI patients showed less disability compared to OA, particularly in work areas (4,7 vs 6,8,p.017), social life (4,5 vs 6,6,p.006), overall disability (13 vs 18,p.022) and perceived stress (4,2 vs 6,2,p.020). Perceived cognitive deficits were lower in the A-LAI group, particularly in attention and concentration. There were significant differences in weight gained OR 0,22 (p.082) and sexual disfunction OR 0,078 (p.000) in favor of A-LAI. Prolactin levels are higher for the OA group, 41,7±30,8 vs 8,6±11,67ng/ml (p.003). Treatment satisfaction (TSQM) was significantly higher in A-LAI patients in all 4 dimensions. The factor that most influences the improvement in the functionality is the treatment with A-LAI instead of OA (–10,9±4,1,p.0117). A-LAI patients required a lower number of psychiatric drugs than OA. In A-LAI patients group was observed a statistical significant difference in the number of hospitalizations (1,8 vs 0,08,p.002), the number of admission days to the hospital (45,4 vs 1,5,p.010) and the number of emergency care needed (3,96 vs 0,6,p.000); furthermore, the number of antipsychotics was significantly reduced (2±1,3 vs 0,2±0,4) as well as the number of overall psychotic drugs (4,5±2,1 vs 2,2±1,4).CONCLUSIONSAccording to the data from our study patients with schizophrenia that are treated with A-LAI show better results in quality of life, functionality, less perceived disability and cognitive deficits compare to those that received OA, as well as more levels of treatment satisfaction. Tolerance of A-LAI has been better than OA, particularly in the sexual and weight areas, being prolactin levels also lower. The change to A-LAI has allowed a reduced use of health resources.


CNS Spectrums ◽  
2019 ◽  
Vol 24 (1) ◽  
pp. 199-200 ◽  
Author(s):  
Marcos Gómez-Revuelta ◽  
José María Pelayo-Terán ◽  
María Juncal-Ruiz ◽  
María Fernández-Rodríguez ◽  
Javier Vázquez-Bourgon ◽  
...  

AbstractRationaleLong-acting injectable antipsychotic therapies may offer benefits over oral antipsychotics in patients with schizophrenia. However, there is still a lack of real-world studies assessing the effectiveness of these therapies.ObjectiveThis study aimed to explore the safety, tolerability, and treatment response of aripiprazole monohydrate (AOM) once monthly in non-acute but symptomatic adult patients switched from previous therapy with frequently used oral or injectable atypical antipsychotics.MethodsThis was a post hoc analysis of a prospective, interventional, single-arm, open-label, 6-month study.ResultsThe patients (N=54) were switched to aripiprazole monohydrate once-monthly (AOM) from daily oral treatment or monthly injectable treatment with either aripiprazole (n=25), olanzapine (n=7), paliperidone extended-release (PP1M) (n=10), quetiapine (n=4), or risperidone (n=8). In all groups, mean Positive and Negative Syndrome Scale total (p=0.0001) and Clinical Global Impression-Severity scores improved significantly (p=0.0001). A reduction of ≥50% reduction of BPRS total-score and a CGI severity-score ≤4 in the Positive and Negative Syndrome Scale total score were observed in 16.7% (aripiprazole), 21.2% (olanzapine), 35.1% (PP1M), 27.3% (quetiapine), and 37.2% (risperidone) of patients. The patients showed significant improvements involving safety features as they experienced significant overall weight loss (p=0.0001) and prolactine decrease (risperidone p=0.0001, paliperidone extended-release p=0.0001). AOM once-monthly was well tolerated, presenting no new safety signals. Patient also reported an overall significant improvement on their quality of life measured with the Quality of Life Rating Scale (QLS) (p=0.0004) as well as in sexual functioning PRSexDQ-SALSEX (p=0.0001). In addition, the all cause treatment discontinuation rate after6-month follow-up was small (n=3; 5,55%)ConclusionsThese data illustrate that stable, non-acute but symptomatic patients either on oral antipsychotic therapy or under monthly antipsychotic treatment may show clinically meaningful improvement of psychotic symptoms, tolerability involving relevant side effects and quality of life perception. The findings are limited by the naturalistic study design; thus, further studies are required to confirm the current findings.Keywords: Long-acting injectable antipsychotic therapy. Oral antipsychotic. Effectiveness- Tolerability-Quality oflife.


2016 ◽  
Vol 33 (S1) ◽  
pp. S582-S582
Author(s):  
M.F. Molina López ◽  
M.C. Cancino Botello ◽  
A. Peña Serrano ◽  
M.D.L.A. Canseco Navarro

Introductionlong acting injectable formulations of antipsychotics are a valuable option for patients with schizophrenia, offering continuous medication delivery and stable dosage levels. Aripiprazole once-monthly is the first dopamine partial agonist available in long acting formulation approved in Europe for Schizophrenia with excellent results so far.Aimsto conduct a current review of articles related to the use and efficacy of Aripiprazole once monthly in patients with Schizophrenia.Methodssystematic review of the literature in English using the following keywords: “aripiprazole once-monthly”, “aripiprazole long acting formulation”, “schizophrenia”. PubMed database.ResultsAripiprazole once-monthly (AOM) formulation efficacy has been proven in many studies. The importance of maintaining an oral overlap during 14 days is highlighted in all studies that have been reviewed in order to reach therapeutic level; therefore, it can be used in patients with acute decompensations. Recent studies comparing AOM versus Paliperidone Palmitate once monthly (PP) have shown that patients with AOM had greater clinical improvement and, even though both drugs were well tolerated, when Quality of Life Style Scale was analyzed an important improvement in empathy, sense of purpose, emotional interaction and curiosity in the AOM group was observed.Conclusionslong acting injectable antipsychotics increase long-term adherence treatment and reduce risk of relapse. Because of its unique mechanism of action, Aripiprazole once-monthly improves positive and negative symptoms, giving the patient an opportunity to have a better quality of life.Disclosure of interestThe authors have not supplied their declaration of competing interest.


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