Does antipsychotic combination therapy reduce the risk of hospitalization in schizophrenia?

Faden, Justin; Kiryankova-Dalseth, Natasha; Barghini, Ruby; Citrome, Leslie

doi:10.1080/14656566.2020.1847274

Cited by 9 publications

(18 citation statements)

References 92 publications

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“…2018; Faden et al . 2021; Pappa & Mason 2020). Thus, it is important to understand factors that affect medication adherence among people living with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

“…Some factors linked with nonadherence in these patients include not being well informed about medications and negative perceptions of taking medications (Higashi et al 2013;Salzmann-Erikson & Sj€ odin 2018;Velligan et al 2017). Poor adherence is associated with increasing the risk for rehospitalization, symptom recurrence, poor quality of life, and healthcare costs (Barbosa et al 2018;Faden et al 2021;Pappa & Mason 2020). Thus, it is important to understand factors that affect medication adherence among people living with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

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The effect of long‐acting injectable antipsychotic medications compared with oral antipsychotic medications among people with schizophrenia: A systematic review and meta‐analysis

Okoli

Kappi

Wang

et al. 2021

Int J Mental Health Nurs

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Long-acting injectable (LAI) antipsychotic medications may be an important modality of reducing costs, improving symptoms, and fostering quality of life outcomes for those with schizophrenia. Our objective was to systematically review and conduct a meta-analysis of the effectiveness of LAIs compared with oral antipsychotics on medication adherence, symptom remission/relapse, rehospitalization, outpatient visits, emergency department visits, healthcare costs, and social functioning. We performed a systematic search of PsycInfo, CINAHL, PubMed, and Scopus databases to examine studies meeting inclusion criteria prior to August 30th, 2020. Randomized controlled trials, retrospective studies, prospective studies among people with schizophrenia with at least 6-month follow-up data were obtained. Overall effect sizes and associated 95% confidence intervals (CI) were estimated with random-effects modeling. We found 75 articles meeting our inclusion criteria, including 341 730 individuals with schizophrenia. Systematic review results indicated that LAIs compared with orals improved medication adherence (25/29 studies), symptom remission/relapse (10/18 studies), rehospitalizations (26/49 studies), emergency department visits (9/17 studies), medical costs (11/15 studies), and social functioning (5/9 studies); however, LAIs also increased outpatient visits (7/16 studies) and pharmacy costs (10/10 studies). Meta-analytic results of studies with similar outcome measures did not find differences between LAIs and orals in respect to outcomes, except lowering emergency department visits and increasing pharmacy costs. The differences between the results of the

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“…2018; Faden et al . 2021; Pappa & Mason 2020). Thus, it is important to understand factors that affect medication adherence among people living with schizophrenia.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effect of long‐acting injectable antipsychotic medications compared with oral antipsychotic medications among people with schizophrenia: A systematic review and meta‐analysis

Okoli

Kappi

Wang

et al. 2021

Int J Mental Health Nurs

View full text Add to dashboard Cite

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“…Numerous lines of evidence have highlighted the possible involvement of diverse neurotransmitter pathways, including glutamate, serotonin, γ-aminobutyric acid, adenosine, and acetylcholine [5]. Frequently polypharmacy is prescribed to face the most severe psychotic syndromes despite controversial results about the efficacy of the approach [6,7] and related safety concern [8,9], obviously higher in older patients [10].…”

Section: Introductionmentioning

confidence: 99%

Endocannabinoid Degradation Enzyme Inhibitors as Potential Antipsychotics: A Medicinal Chemistry Perspective

et al. 2023

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The endocannabinoid system (ECS) plays a very important role in numerous physiological and pharmacological processes, such as those related to the central nervous system (CNS), including learning, memory, emotional processing, as well pain control, inflammatory and immune response, and as a biomarker in certain psychiatric disorders. Unfortunately, the half-life of the natural ligands responsible for these effects is very short. This perspective describes the potential role of the inhibitors of the enzymes fatty acid amide hydrolase (FAAH) and monoacylglycerol lipase (MGL), which are mainly responsible for the degradation of endogenous ligands in psychic disorders and related pathologies. The examination was carried out considering both the impact that the classical exogenous ligands such as Δ9-tetrahydrocannabinol (THC) and (−)-trans-cannabidiol (CBD) have on the ECS and through an analysis focused on the possibility of predicting the potential toxicity of the inhibitors before they are subjected to clinical studies. In particular, cardiotoxicity (hERG liability), probably the worst early adverse reaction studied during clinical studies focused on acute toxicity, was predicted, and some of the most used and robust metrics available were considered to select which of the analyzed compounds could be repositioned as possible oral antipsychotics.

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“…A lack of association between high dose or combination antipsychotics and side effects has been reported on a mixed-diagnosis sample of 208 inpatients ( Hynes et al, 2020 ). There is also initial evidence that antipsychotic combination therapy might prevent rehospitalization in a subset of patients with schizophrenia ( Faden et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Antipsychotic Polypharmacy and High-Dose Antipsychotic Regimens in the Residential Italian Forensic Psychiatric Population (REMS)

et al. 2022

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Few data exist regarding treatment with antipsychotics in forensic psychiatric patient populations with high social dangerousness. We performed a secondary analysis of 681 patients treated with at least one antipsychotic, extracted from a 1-year observational retrospective study, conducted on 730 patients treated in the Italian Residencies for Execution of Security Measures (REMS) (96.4% of the REMS population). We aimed at investigating antipsychotic polypharmacy (prescription of two or more concomitant antipsychotics) and high dose/very high-dose antipsychotics, as well as the possible factors associated with such therapeutic regimens. High dose/very high-dose antipsychotics were defined as a prescribed daily dose to WHO-defined daily dose ratio greater than 1.5 or 3.0, respectively. Binary logistic regression analysis was used in three models to test possible predictors of antipsychotic polypharmacy, high-dose antipsychotics, and very high-dose antipsychotic prescription. Antipsychotic polypharmacy resulted in n = 308 (45.2%) of the patients, n = 346 (50.8%) received high-dose antipsychotics, and n = 96 (14.1%) very high-dose antipsychotics. The multivariate analysis disclosed an association between antipsychotic polypharmacy and male gender (odds ratio (OR): 2.75 and 95% CI: 1.34–5.65), long-acting injectable (LAI) antipsychotic prescription (OR: 2.62 and 95% CI: 1.84–3.74), and aggressive behavior in REMS (OR: 1.63 and 95% CI: 1.13–2.36). High-dose antipsychotics were also associated with male gender (OR: 2.01 and 95% CI: 1.02–3.95), LAI antipsychotic prescription (OR: 2.78 and 95% CI: 1.95–3.97), and aggressive behavior in REMS (OR: 1.63 and 95% CI: 1.12–2.36). The use of antipsychotic polypharmacy and high-dose antipsychotics is frequent in the REMS population. These results might depend on regulatory and organizational aspects of the REMS system, including variability in structures, lack of a common model of care, and lack of stratified therapeutic security.

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Does antipsychotic combination therapy reduce the risk of hospitalization in schizophrenia?

Cited by 9 publications

References 92 publications

The effect of long‐acting injectable antipsychotic medications compared with oral antipsychotic medications among people with schizophrenia: A systematic review and meta‐analysis

The effect of long‐acting injectable antipsychotic medications compared with oral antipsychotic medications among people with schizophrenia: A systematic review and meta‐analysis

Endocannabinoid Degradation Enzyme Inhibitors as Potential Antipsychotics: A Medicinal Chemistry Perspective

Antipsychotic Polypharmacy and High-Dose Antipsychotic Regimens in the Residential Italian Forensic Psychiatric Population (REMS)

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