To determine if there are differences in 6 month outcomes in schizophrenia patients with and without a history of SA treated with RLAI.

Spanish patients enrolled in e-STAR, a secure web-based, ongoing, international, long-term observational study of schizophrenia patients, who initiated RLAI have been followed up for 6 months.

Of 1,107 patients enrolled to date 40.1% had a history of SA, including alcohol, prescription medication, and recreational drugs. More males in the SA group (82.2%) than the non-SA group (49.3%); mean age 35.7 and 40.4 years, mean duration of illness 11.7 vs 13.9 years, respectively. At 6 months 92.3% of SA and 94.7% of non-SA patients were continuing RLAI. Baseline mean Clinical Global Impression-Severity (CGI-S) scores were similar (SA 4.77, non-SA 4.63) and 59.0% of SA and 55.0% of non-SA patients had a baseline CGI-S score of 5-7 (marked-very severe illness). At 6 months CGI-S scores had reduced significantly in each group (SA 3.97, non-SA 3.83; both p<0.001 vs baseline) and the proportion with CGI-S scores of 5-7 fell to 27.3% of SA and 22.9% of non-SA patients. Mean Global Assessment of Functioning scale scores significantly improved between baseline and 6 months in each group; SA 46.6 to 56.5, non-SA 46.8 to 56.6 (both p<0.001). Significant reductions in use of concomitant medication in both groups (p<0.001) accompanied these clinical improvements.

Although a history of SA may predict poorer outcomes in schizophrenia, SA patients treated with RLAI are similarly compliant and improve equally well as non-SA patients.