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The role of long-acting antipsychotics in illness relapse: an observational study

Published online by Cambridge University Press:  27 August 2024

I. Berardelli
Affiliation:
1Neurosciences, Mental Health and Sensory Organs, Sant’ Andrea Hospital, Sapienza University of Rome
I. Mancinelli
Affiliation:
2Neurosciences, Mental Health and Sensory Organs, Sant’ Andrea Hospital
E. Rogante
Affiliation:
3Human Neuroscience, Sapienza University of Rome
D. Erbuto
Affiliation:
1Neurosciences, Mental Health and Sensory Organs, Sant’ Andrea Hospital, Sapienza University of Rome
M. A. Trocchia
Affiliation:
4Psychiatry Residency Training Program, Sant’ Andrea Hospital, Sapienza University of Rome, Rome, Italy
L. Longhini
Affiliation:
4Psychiatry Residency Training Program, Sant’ Andrea Hospital, Sapienza University of Rome, Rome, Italy
L. Rapisarda*
Affiliation:
4Psychiatry Residency Training Program, Sant’ Andrea Hospital, Sapienza University of Rome, Rome, Italy
A. Bruzzese
Affiliation:
4Psychiatry Residency Training Program, Sant’ Andrea Hospital, Sapienza University of Rome, Rome, Italy
S. Sarubbi
Affiliation:
3Human Neuroscience, Sapienza University of Rome
M. Pompili
Affiliation:
1Neurosciences, Mental Health and Sensory Organs, Sant’ Andrea Hospital, Sapienza University of Rome
*
*Corresponding author.

Abstract

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Introduction

In patients affected by Schizophrenia and Bipolar Disorder disorders the use of antipsychotic drugs is essential in preventing the exacerbation of symptoms. The use of long-acting injectable (LAI) antipsychotics is considered an important treatment option. The aim of this study was to evaluate the incidence and predictors of relapse during antipsychotic treatment with LAIs in a sample of psychiatric outpatients up to a year after the start of long-acting therapy.

Objectives

The study included 103 adult patients admitted to the psychiatric unit of Sant’Andrea University Hospital in Rome.

Methods

We evaluated duration of untreated illness, previous treatments, substance abuse, suicidal status, LAI dose, and use of other medicines for association with new episodes of illness or of symptomatic worsening as well as hospitalization, using bivariate and multivariate analyses.

Results

Seventy-three patients were diagnosed with schizophrenia spectrum and 30 with bipolar disorders. Age at study entry averaged 36.7 years (SD= 11.55). 40.8% of patients were women. The mean age at onset were 23.11 (SD= 7.0). All the other information were reported in Table 1. On 103 patients undergoing with LAI treatment for a year only 9 (8.7%) patients had a relapse during the study period. The two groups differed according to the presence of hospitalization during the 12 months before the LAI treatment (p = .022), in particular patients with relapse were more hospitalized than patients with no relapse (62.5% vs. 21.7%). Moreover, group with relapse were more at risk of suicide during the 12 months before the LAI treatment than the other group, for both suicidal ideation (11.1% vs. 4.3%; p= .015) and attempt (25.0% vs. 3.2%; p= .049). Finally, the two groups differed according to the side effects reported during the year of LAI treatment (χ² =38.48; p< .001). Specifically, patients’ group with relapse reported more side effects caused by parkinsonism (25.0% vs. 1.1%) and tremor (25.0% vs. 0%). No differences were found for the other variables (See table 1).

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Conclusions

In conclusion, our observations confirm the importance of LAI therapy in real word. However, our results indicate that these drugs might not prevent subsequent exacerbations for a proportion of individuals whose illness is stabilised on continuous antipsychotic treatment. Extra pyramidal symptoms in particular might have pathophysiological implications for relapse.

Disclosure of Interest

None Declared

Type
Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of European Psychiatric Association
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