Evaluation of initial treatment course in schizophrenic patients after transition to RIS-CONSTA under clinical routine conditions seems important for understanding of long-term disease stability.

Pretreated moderate-to-severely ill schizophrenic in-patients were switched to RIS-CONSTA (i.m. two-weekly). Assessments included reasons for transition, co-medication, PANSS, NOSIE, AE, EPMS. Study completion criteria were clinical stability with RIS-CONSTA and/or discharge within/maximum 12 weeks. Criteria for stable adjustment were (1)RIS-CONSTA was the only high-potency/atypical antipsychotic, (2)stable/improved CGI, (3)stable RIS-CONSTA dosage since previous visit.

Prospective naturalistic study with 290 patients (Mean age 40.3y; 56.2% male). Causes for transition were insufficient efficacy (46.9%), tolerability (13.8%), compliance (70.4%), initiation of long-term treatment (70.3%). At discharge n=123 (43.8%) patients were judged as clinically stable (S), n=167 (56.2%) as not stable (NS). Median hospitalization duration (S-group) was 42, for NS-group 28 days. PANSS and NOSIE revealed clinical and psychosocial amelioration in favor of S-group. Most common AEs were EPMS (both groups), although total EMPS-score improved in 63% during the study. Variables that correlated with given definition for stability were not identified.

A shorter stay in hospital for clinically NS-patients with schizophrenia may be due to several factors [e.g. higher need of patients for discharge (prior to remission) leading to "revolving door effect", low potential for long-term remission, lack of therapeutic adherence, pressure of external health care providers]. These results raise the question, whether extended hospitalization of NS-patients may foster clinical stability. This study suggests effectiveness and improved tolerability (EPMS) of RIS-CONSTA in moderate-to-severely ill patients with schizophrenia.