Depot neuroleptics in relapse prevention

Gerlach, Jes

doi:10.1097/00004850-199501005-00004

Cited by 227 publications

(73 citation statements)

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“…These findings are in concordance with the consideration that relatives do not trust patients' medication adherence and thus might appreciate the advantage of depots that the patient securely receives the acting agent. The findings of Gerlach (1995) that relatives have a rather negative attitude towards pharmacological treatment of mental diseases can hence not be confirmed.…”

Section: Discussionmentioning

confidence: 87%

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Attitudes towards long-acting depot antipsychotics: A survey of patients, relatives and psychiatrists

Jaeger

Rössler

2010

Psychiatry Research

127

135

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In many countries fewer than 20% of individuals with schizophrenia receive depot antipsychotic medication. Frequently stated reasons are psychiatrist's, patient's and relative's objections to depot treatment. This is the first study that directly compares the attitudes to depot antipsychotics of psychiatrists, patients and relatives. A semi-structured questionnaire about their attitudes to depot antipsychotics was completed by 255 participants (83 patients diagnosed with schizophrenic disorder, 81 psychiatrists in private practice and 91 relatives, not directly related to the patients). Patients were more negative towards depot injections than psychiatrists and relatives. They particularly fear to be constricted in their autonomy when treated with depot antipsychotics and that injections might be painful. About 67% of all patients in our sample did not receive information about depot antipsychotics by their psychiatrist. Less than 10% of psychiatrists offer depot treatment after a first psychotic episode. Psychiatrists use depot antipsychotics in a conservative way although they attribute positive traits to the method. Patients' negative attitudes might relate to the low level of information. To enhance the use of depot antipsychotics, information practices of psychiatrists should be improved. Patients should be informed about different applications forms already during early stages of the illness.

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Section: Discussionmentioning

confidence: 87%

“…In society at large, both public opinion and the media often support the view that depot medication involves an element of coercion and causes more adverse effects. Much more information is needed for patients, relatives and the public to engender more balanced attitudes (Gerlach, 1995).…”

Section: Introductionmentioning

confidence: 99%

Attitudes towards long-acting depot antipsychotics: A survey of patients, relatives and psychiatrists

Jaeger

Rössler

2010

Psychiatry Research

127

135

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“…In this way, a higher proportion of the drug is available centrally [McEvoy, 2006], which arguably can allow the use of the lowest effective dose [Gerlach, 1995]. As a rule, calculation of total doses for oral versus LAI APs over time will usually show lower doses for the LAIs.…”

Section: Bioavailability and Dosing Of Lai Apsmentioning

confidence: 99%

The role of long-acting injectable antipsychotics in schizophrenia: a critical appraisal

Brissos¹,

Ruiz‐Veguilla

Taylor

et al. 2014

Therapeutic Advances in Psychopharmacology

232

200

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Historical background of long-acting injectable antipsychotics Soon after the introduction of antipsychotics (APs) in the 1950s, poor adherence to oral formulations was found to be a critical issue. This led to the development in 1966 of the first long-acting injectable (LAI) AP fluphenazine enanthate, and fluphenazine decanoate some 18 months later, to reduce the incidence of side effects of the former [Johnson, 2009]. Haloperidol decanoate became available in Europe in 1981 and in the USA in 1986 [Knudsen, 1985]. Clinical trial results showed a dramatic reduction in the morbidity of schizophrenia [Gottfries and Green, 1974; Johnson, 2009]. However, the concept of LAIs for schizophrenia was not initially received warmly by the medical profession for fears of increased side effects, lack of efficacy, and the fact this was seen as an attempt by psychiatrists to impose a treatment upon patients without due regard to their feelings or rights [Johnson, 2009] as well as the potential for medicolegal problems [Glazer and Kane, 1992]. However, with subsequent surveys and trials suggesting their benefits [Rifkin et al. 1977; Schooler et al. 1980; Hogarty et al. 1979], LAIs became more widely adopted. The introduction of the oral second-generation APs (SGAs) brought claims of better tolerance and less severe side effects, even though their use may be hindered by metabolic syndrome [Meyer and Stahl, 2009]. They also have potential to prevent or reverse accelerated frontotemporal cortical grey matter decline, and to provide a greater degree of neuroprotection than first generation APs (FGAs) [Keefe et al. 2004; Robinson et al. 2006]. The introduction of SGAs led to a decline in the use of LAI FGAs [Patel et al. 2003; Patel and David, 2005]. However, it soon became clear that atypical characteristics did not bring better adherence rates with oral SGAs. The recent introduction of LAI SGAs allows psychiatrists once

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“…Disadvantages include the discomfort of the injection itself, potential localised inflammation at injection site, perceived stigma and the fact that sideeffects and adverse reactions may be harder to address once a dose has been administered. 4 The relative merits and drawbacks of FGAs and SGAs has been an area of much interest since SGAs were introduced amidst high expectations of superior efficacy and improved side-effect profiles. Evidence has been variable and at times contradictory as to the The relative benefits and disadvantages of first-generation antipsychotics (FGAs) and second-generation antipsychotics (SGAs) has been an area of much interest since SGAs were introduced amidst high expectations of superior efficacy and improved side-effect profiles.…”

mentioning

confidence: 99%

Factors important to psychiatrists when prescribing depot antipsychotics

Kenicer¹,

Ellahi²,

Davies³

et al. 2016

Prog. Neurol. Psychiatry

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The relative benefits and disadvantages of first‐generation antipsychotics (FGAs) and second‐generation antipsychotics (SGAs) has been an area of much interest since SGAs were introduced amidst high expectations of superior efficacy and improved side‐effect profiles. In this article, Dr Kenicer et al. analyse a survey of psychiatrists to establish trends in prescribing preferences and the factors influencing them when prescribing antipsychotics. A key finding highlighted the need for an evidence based algorithm when prescribing these antipsychotics.

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Depot neuroleptics in relapse prevention

Cited by 227 publications

References 1 publication

Attitudes towards long-acting depot antipsychotics: A survey of patients, relatives and psychiatrists

Attitudes towards long-acting depot antipsychotics: A survey of patients, relatives and psychiatrists

The role of long-acting injectable antipsychotics in schizophrenia: a critical appraisal

Factors important to psychiatrists when prescribing depot antipsychotics

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