Ambiguous findings concerning potential advantages of depot antipsychotics: in search of clinical relevance

Current Opinion in Psychiatry
Peter M HaddadJohn M Kane

Abstract

We review the recent literature on the comparative efficacy/effectiveness of antipsychotic long-acting injections (LAIs) vs. oral antipsychotics. Randomized controlled trials (RCTs), mirror-image studies and cohort studies are reviewed, and the strength and weaknesses of each design discussed. The data are conflicting and differ by trial design. RCTs tend to show equivalence for the two treatments, whereas mirror-image studies and cohort studies are more likely to show benefits for LAIs, although a prescribing/channelling bias in cohort studies suggests that LAIs are prescribed to more severely ill patients. Two recent, large RCTs, in a more real-world treatment setting, found a longer time to relapse or treatment failure with a LAI versus oral antipsychotics. Each of the three trial designs has strengths and weaknesses. The traditional RCT does not seem to be the gold standard to compare the effectiveness of oral antipsychotics and LAIs because of selective recruitment and altered ecology of the treatment. Conversely, weaknesses of observational studies include lack of blinding and difficulty disentangling the effect of treatment from prescribing bias and confounders. The best approach to determining comparative effectiveness ...Continue Reading

References

Apr 7, 2007·Psychiatric Services : a Journal of the American Psychiatric Association·Lizheng ShiStephen R Marder
May 28, 2010·The British Journal of Psychiatry. Supplement·Thomas R E BarnesCarol Paton
Mar 3, 2011·The American Journal of Psychiatry·Jari TiihonenPasi Korhonen
Mar 13, 2013·European Neuropsychopharmacology : the Journal of the European College of Neuropsychopharmacology·István BitterPál Czobor
Nov 16, 2013·The Journal of Clinical Psychiatry·Taishiro KishimotoChristoph U Correll
May 23, 2014·JAMA : the Journal of the American Medical Association·Joseph P McEvoyT Scott Stroup
May 30, 2014·Schizophrenia Bulletin·Peter F BuckleyUNKNOWN PROACTIVE Study
Jun 14, 2014·The British Journal of Psychiatry : the Journal of Mental Science·W Wolfgang FleischhackerJohn M Kane
Jul 26, 2014·Patient Related Outcome Measures·Peter M HaddadJan Scott
Oct 8, 2014·JAMA : the Journal of the American Medical Association·W Wolfgang Fleischhacker

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Citations

Nov 23, 2017·International Journal of Psychiatry in Clinical Practice·Eduard ParelladaUNKNOWN SHADOW Study Group
Oct 19, 2017·Journal of Psychopharmacology·David M TaylorCatrin Fischetti
Feb 3, 2016·Therapeutic Advances in Psychopharmacology·Robin EmsleyUNKNOWN EMEA ADHES group
Nov 2, 2019·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·So-Young OhMyung Hun Jung
Jun 17, 2016·Journal of Clinical Psychopharmacology·Saínza GarcíaAna González-Pinto
Nov 30, 2019·The Psychiatric Quarterly·Mary V Seeman
Jul 22, 2016·European Psychiatry : the Journal of the Association of European Psychiatrists·F PietriniA Ballerini
Jun 30, 2018·European Psychiatry : the Journal of the Association of European Psychiatrists·Francesco PietriniAndrea Ballerini
Jun 6, 2017·Current Treatment Options in Psychiatry·Seiya Miyamoto, W Wolfgang Fleischhacker
Mar 30, 2021·Expert Opinion on Drug Safety·Renato de FilippisMaria Rosaria Anna Muscatello
Jan 26, 2021·The Journal of Nervous and Mental Disease·Juan J Fernández-MirandaFrancisco López-Muñoz
Jul 6, 2021·Current Pharmaceutical Design·Juan J Fernández-MirandaFrancisco López-Muñoz

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