Effect of long-acting injectable antipsychotics on 1-year hospitalization in bipolar disorder: a mirror-image study

Bartoli, Francesco; Callovini, Tommaso; Cavaleri, Daniele; Crocamo, Cristina; Riboldi, Ilaria; Aguglia, Andrea; Fazio, Pasquale De; Martinotti, Giovanni; D’Agostino, Armando; Ostuzzi, Giovanni; Barbui, Corrado; Carrà, Giuseppe

doi:10.1007/s00406-022-01522-5

Cited by 8 publications

(30 citation statements)

References 44 publications

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“…The remaining six observational studies were included in this review. 23 , 24 , 26 – 29 The flowchart of the study selection process is reported in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Studies were conducted in Italy, 23 , 26 Taiwan, 28 , 29 and Turkey. 24 , 27 The sample size ranged between 17 24 and 287.…”

Section: Resultsmentioning

confidence: 99%

“… 29 Two studies selected individuals with bipolar type I disorder, 27 , 28 while the bipolar type was not specified in the remaining studies. 23 , 24 , 26 , 29 The two studies from Italy were based on two completely independent, not overlapping, cohorts, that is, the Northern Milan Area Cohort (NOMIAC) study 23 ( N = 68) and the multicenter ‘Servizi Territoriali Associati per la Ricerca’ (STAR–Community Services Associated for Research) Network Depot Study 26 ( N = 71). The two studies conducted in Taiwan selected study participants from the E-Da Hospital in Kaohsiung 28 ( N = 77) and the National Health Insurance Research database 29 ( N = 287), respectively.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies investigated mixed first (FGA) and second-generation (SGA) LAIs, 23 , 26 one study included only SGAs, 24 while other studies tested single agents, that is, paliperidone palmitate 1-month 27 (PP1M) and RM, 28 , 29 respectively. In terms of clinical outcomes reported, all studies investigated the number of days spent in hospital, 23 , 24 , 26 – 29 four studies the number of hospital admissions, 23 , 24 , 27 , 29 two studies the hospitalization rates, that is, the proportion of individuals with at least one hospital admission, 26 , 28 four studies acute mood (manic or depressive) relapses, 23 , 27 – 29 and other three the number of emergency department visits. 23 , 28 , 29 The characteristics of the studies included in this review are reported in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

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Long-acting injectable antipsychotics for the treatment of bipolar disorder: evidence from mirror-image studies

Bartoli

Cavaleri

Nasti

et al. 2023

Therapeutic Advances in Psychopharmacology

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Clinical trials and real-world data have shown that long-acting injectable antipsychotics (LAIs) might be an effective therapeutic option also for people with bipolar disorder (BD). However, complementing evidence from mirror-image studies investigating LAIs in BD is scattered and has not been systematically evaluated so far. We thus performed a review of observational mirror-image studies testing the effectiveness of LAI treatment on clinical outcomes in people with BD. Embase, MEDLINE, and PsycInfo electronic databases were systematically searched (via Ovid) up to November 2022. We included six mirror-image studies that compared relevant clinical outcomes between the 12-months after (post-treatment period) and the 12-months before (pre-treatment period) the initiation of a LAI treatment in adults with BD. We found that LAI treatment is associated with a significant reduction in days spent in hospital and number of hospitalizations. Moreover, LAI treatment seems to be associated with a significant decrease in the proportion of individuals with at least one hospital admission, even though data on this outcome were reported by just two studies. In addition, studies consistently estimated a significant reduction of hypo-/manic relapses after LAI treatment initiation, while the effect of LAIs for depressive episodes is less clear. Finally, LAI treatment initiation was associated with a lower number of emergency department visits in the year after LAI initiation. The findings of this review seem to suggest that the use of LAIs is an effective strategy to improve major clinical outcomes in people with BD. Nonetheless, additional research, based on standardized assessments of prevalent polarity and relapses, is needed to identify the clinical characteristics of individuals with BD who are most likely to benefit from a LAI treatment.

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“…The remaining six observational studies were included in this review. 23 , 24 , 26 – 29 The flowchart of the study selection process is reported in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Studies were conducted in Italy, 23 , 26 Taiwan, 28 , 29 and Turkey. 24 , 27 The sample size ranged between 17 24 and 287.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Long-acting injectable antipsychotics for the treatment of bipolar disorder: evidence from mirror-image studies

Bartoli

Cavaleri

Nasti

et al. 2023

Therapeutic Advances in Psychopharmacology

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“…In a systematic review, LAI antipsychotics (risperidone and aripiprazole) were found to be well tolerated and effective for the treatment of manic symptoms and for preventing mood recurrences in adult patients with bipolar disorder [ 84 ]. In a recent mirror-image study including various LAI antipsychotics in adults with bipolar disorder, Bartoli et al [ 85 ] found a significant decrease in terms of 12-month hospitalization rates and the number of days.…”

Section: Comparison Of Second- and Third-generation Antipsychotics In...mentioning

confidence: 99%

Application of Antipsychotic Drugs in Mood Disorders

Rybakowski

2023

Brain Sciences

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Since their first application in psychiatry seventy years ago, antipsychotic drugs, besides schizophrenia, have been widely used in the treatment of mood disorders. Such an application of antipsychotics is the subject of this narrative review. Antipsychotic drugs can be arbitrarily classified into three generations. First-generation antipsychotics (FGAs), such as phenothiazines and haloperidol, were mainly applied for the treatment of acute mania, as well as psychotic depression when combined with antidepressants. The second-generation, so-called atypical antipsychotics (SGAs), such as clozapine, risperidone, olanzapine, and quetiapine, have antimanic activity and are also effective for the maintenance treatment of bipolar disorder. Additionally, quetiapine exerts therapeutic action in bipolar depression. Third-generation antipsychotics (TGAs) started with aripiprazole, a partial dopamine D2 receptor agonist, followed by brexpiprazole, lurasidone, cariprazine, and lumateperone. Out of these drugs, aripiprazole and cariprazine have antimanic activity, lurasidone, cariprazine, and lumateperone exert a significant antidepressant effect on bipolar depression, while there is evidence for the efficacy of aripiprazole and lurasidone in the prevention of recurrence in bipolar disorder. Therefore, successive generations of antipsychotic drugs present a diverse spectrum for application in mood disorders. Such a pharmacological overlap in the treatment of schizophrenia and bipolar illness stands in contrast to the dichotomous Kraepelinian division of schizophrenia and mood disorders.

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Preventive effect of aripiprazole once monthly on rehospitalization for bipolar disorder: A multicenter 1‐year retrospective mirror image study

Goto¹,

Shono²,

Abe³

et al. 2023

Neuropsychopharm Rep

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AimWe conducted a 1‐year retrospective mirror‐image study to investigate the effect of aripiprazole once monthly (AOM) on rehospitalization for bipolar disorder.MethodsParticipants were recruited from psychiatric emergency and acute care hospitals in western Japan. We included 39 participants with bipolar disorder who had been administered AOM for at least 1 year with no missing medical records during the observational period. The primary outcomes were rehospitalization rate, number of rehospitalizations, total hospitalization days, and time to rehospitalization in the context of overall psychiatric readmissions. The significance level was set at p < 0.05.ResultsAOM significantly reduced the rehospitalization rate from 23/39 (59%) to 7/39 (18%) (p = 0.001). The number of rehospitalizations decreased significantly from a mean of 0.85 per person‐year to 0.41 per person‐year (p = 0.048). The total hospitalization days significantly decreased from a mean of 34.9 days to 14.4 days (p = 0.008). AOM significantly prolonged the time to rehospitalization (p < 0.001).ConclusionThis study found that AOM reduces overall psychiatric rehospitalization for bipolar disorder based on data from 1 year before and after AOM administration in the real‐world setting. Future studies should examine the robustness and persistence of the rehospitalization preventive effect of AOM with larger sample sizes and longer observation periods beyond 1 year.

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Effect of long-acting injectable antipsychotics on 1-year hospitalization in bipolar disorder: a mirror-image study

Cited by 8 publications

References 44 publications

Long-acting injectable antipsychotics for the treatment of bipolar disorder: evidence from mirror-image studies

Long-acting injectable antipsychotics for the treatment of bipolar disorder: evidence from mirror-image studies

Application of Antipsychotic Drugs in Mood Disorders

Preventive effect of aripiprazole once monthly on rehospitalization for bipolar disorder: A multicenter 1‐year retrospective mirror image study

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