Impact of long-acting injectable antipsychotics vs. oral medication on relapses of patients with psychosis and bipolar disorder

• Published in: Psychiatry research 2024-02, Vol.332, p.115676-115676, Article 115676
• Main Authors: Vgontzas, Alexandros N, Paschalidou, Anna, Simos, Panagiotis G, Anastasaki, Maria, Zografaki, Avgi, Volikos, Emmanouil, Koutra, Katerina, Basta, Maria
• Format: Article
• Language: English
• Subjects: Administration, Oral; Antipsychotic Agents - adverse effects; Bipolar Disorder - chemically induced; Bipolar Disorder - drug therapy; Delayed-Action Preparations - therapeutic use; Humans; Medication Adherence; Psychotic Disorders - drug therapy; Recurrence; Schizophrenia - drug therapy
• ISSN: 0165-1781; 1872-7123
• DOI: 10.1016/j.psychres.2023.115676

Relapse associated with multiple hospital readmissions of patients with chronic and severe mental disorders, such as psychosis and bipolar disorder, is frequently associated with non-adherence to treatment. The primary aim of the study was to compare the effectiveness of long-acting injectable (LAI) treatment, vs. oral medication in reducing readmissions of patients with psychotic or bipolar disorder in a community sample of 164 patients with psychosis and 29 patients with bipolar disorder (n = 193), with poor adherence to oral medication. The mean follow up period was 5.6 years and the number of readmissions were compared for an equal-length period of oral treatment preceding the onset of LAI administration. We observed a significant decrease of 45.2 % in total hospital readmissions after receiving LAIs treatment. The effect was significant both for patients with a pre-LAI treatment history of predominantly voluntary hospitalizations and with predominantly involuntary admissions. In addition, we observed equal effectiveness of first- vs. second-generation LAIs in reducing total hospital readmissions regardless of type of pre-treatment admission history (voluntary vs. involuntary). LAIs appear to be effective in reducing both voluntary and involuntary hospital readmissions in patients with psychosis and bipolar disorder with a history of poor adherence to treatment.