Risperidone Injectable Long-Acting Treatment vs Other Oral Antipsychotics in First Episode Psychosis: One Year Longitudinal Study

Segarra, Rafael; Ojeda, Natalia; García, Joaquín de Nova; Peña, Javier; Bravo, Elena; Eguíluz, J.I.

doi:10.1016/j.schres.2010.02.939

Cited by 3 publications

(6 citation statements)

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“…After excluding duplicates, 250 articles remained. A total of 15 studies (Abdel‐Baki et al, 2019; Alphs et al, 2018; Barrio et al, 2013; Emsley et al, 2008; Ibach & Schreiner, 2008; Kim et al, 2008; Malla et al, 2016; Privat et al, 2015; Rifkin et al, 1977; Schreiner et al, 2015; Segarra et al, 2010; Subotnik et al, 2015; Taipale et al, 2018; Titus‐Lay et al, 2018; Weiden et al, 2012) (n = 10 584) comparing LAIs with OAPs were selected to be included in the present meta‐analysis. Table 1 summarizes the characteristics of the included studies.…”

Section: Resultsmentioning

confidence: 99%

“…Seven of the studies were RCTs (Alphs et al, 2018; Malla et al, 2016; Privat et al, 2015; Rifkin et al, 1977; Schreiner et al, 2015; Segarra et al, 2010; Weiden et al, 2012), one was a post‐hoc comparison (Emsley et al, 2008), and the remaining were observational studies (Abdel‐Baki et al, 2019; Barrio et al, 2013; Ibach & Schreiner, 2008; Kim et al, 2008; Subotnik et al, 2015; Taipale et al, 2018; Titus‐Lay et al, 2018). Four of the RCTs were open‐label (Alphs et al, 2018; Malla et al, 2016; Subotnik et al, 2015; Weiden et al, 2012), one was double‐blinded (Rifkin et al, 1977), another was single‐blinded (Schreiner et al, 2015), and the remaining study did not provide information about the blinding procedure (Segarra et al, 2010). Two of the included studies (Ibach & Schreiner, 2008; Segarra et al, 2010) were conference publications.…”

Section: Resultsmentioning

confidence: 99%

“…Four of the RCTs were open‐label (Alphs et al, 2018; Malla et al, 2016; Subotnik et al, 2015; Weiden et al, 2012), one was double‐blinded (Rifkin et al, 1977), another was single‐blinded (Schreiner et al, 2015), and the remaining study did not provide information about the blinding procedure (Segarra et al, 2010). Two of the included studies (Ibach & Schreiner, 2008; Segarra et al, 2010) were conference publications. Details of the risk of bias assessment for the RCTs and observational studies is provided in the Appendix S1.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy of long‐acting injectable versus oral antipsychotic drugs in early psychosis: A systematic review and meta‐analysis

Lian

Kim

Procyshyn

et al. 2021

Early Intervention Psych

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Aim Long‐acting injectable antipsychotic drugs (LAIs) are often used as an alternative to oral antipsychotics (OAPs) in individuals with psychosis who demonstrate poor medication adherence. Previous meta‐analyses have found mixed results on the efficacy of LAIs, compared to OAPs, in patients with psychotic disorders. The objective of this meta‐analysis was to compare the effectiveness of using LAIs versus OAPs in the early stages of psychosis. Methods Major electronic databases were used to search for any studies examining the comparative effectiveness (i.e., relapse, adherence, hospitalization, and all‐cause discontinuation) of any LAIs versus OAPs in early stages of psychosis. Studies published up to 6 June, 2019 were included and no language restriction was applied. Inclusion criteria were a diagnosis of schizophrenia or related disorder, where patients were in their first episode or had a duration of illness ≤5 years. Data were analysed using a random‐effects model. Results Fifteen studies (n = 10 584) were included, of which were 7 RCTs, 7 observational studies, and 1 post‐hoc analysis. We found that LAIs provided advantages over OAPs in terms of relapse rates. No significant differences were found between LAI and OAP groups in terms of all‐cause discontinuation, hospitalization, and adherence rates. However, considering only RCTs revealed advantages of LAIs over OAPs in terms of hospitalization rates. Conclusions LAIs may provide benefits over OAPs with respect to reducing relapse and hospitalization rates in early psychosis patients. There is a need for larger and better‐designed studies comparing OAPs and LAIs specifically in early psychosis patients.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Efficacy of long‐acting injectable versus oral antipsychotic drugs in early psychosis: A systematic review and meta‐analysis

Lian

Kim

Procyshyn

et al. 2021

Early Intervention Psych

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“…After excluding duplicates, 197 records were assessed at the abstract level, and 39 were assessed at the full-text level. Finally, 11 independent RCTs were included in the analyses ( Figure 1 ), of which 10 were patient-level randomized RCTs 36 – 38 , 60 – 67 and one was a cluster-randomized RCT. 37 The number of included participants ranged from 37 to 764 (median = 85).…”

Section: Resultsmentioning

confidence: 99%

“…Only one study 63 used a first-generation LAI (fluphenazine decanoate); all others used a second-generation LAI, such as LAI paliperidone, 38 , 62 , 65 , 66 LAI risperidone, 60 , 61 , 64 , 67 LAI aripiprazole 37 and both LAI aripiprazole and LAI paliperidone. 36 In seven RCTs, LAIs were compared against a mix of different OAPs 37 , 38 , 60 – 62 , 64 , 66 ; in the other four trials, the comparators were oral risperidone 67 oral olanzapine 65 oral fluphenazine 63 and both oral aripiprazole and oral paliperidone. 36 Only three RCTs matched the antipsychotics in the LAI and OAP treatment arm.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of long-acting injectable versus oral antipsychotics in the treatment of patients with early-phase schizophrenia-spectrum disorders: a systematic review and meta-analysis

Vita,

Tavella,

Ostuzzi

et al. 2024

Therapeutic Advances in Psychopharmacology

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Background: Long-acting injectable antipsychotics (LAIs) have advantages over oral antipsychotics (OAPs) in preventing relapse and hospitalization in chronically ill patients with schizophrenia-spectrum disorders (SSDs), but evidence in patients with first-episode/recent-onset, that is, early-phase-SSDs is less clear. Objectives: To assess the relative medium- and long-term efficacy and safety of LAIs versus OAPs in the maintenance treatment of patients with early-phase SSDs. Method: We searched major electronic databases for head-to-head randomized controlled trials (RCTs) comparing LAIs and OAPs for the maintenance treatment of patients with early-phase-SSDs. Design: Pairwise, random-effects meta-analysis. Relapse/hospitalization and acceptability (all-cause discontinuation) measured at study-endpoint were co-primary outcomes, calculating risk ratios (RRs) with their 95% confidence intervals (CIs). Subgroup analyses sought to identify factors moderating differences in efficacy or acceptability between LAIs and OAPs. Results: Across 11 head-to-head RCTs ( n = 2374, median age = 25.2 years, males = 68.4%, median illness duration = 45.8 weeks) lasting 13–104 (median = 78) weeks, no significant differences emerged between LAIs and OAPs for relapse/hospitalization prevention (RR = 0.79, 95%CI = 0.58–1.06, p = 0.13) and acceptability (RR = 0.92, 95%CI = 0.80–1.05, p = 0.20). The included trials were highly heterogeneous regarding methodology and patient populations. LAIs outperformed OAPs in preventing relapse/hospitalization in studies with stable patients (RR = 0.65, 95%CI = 0.45–0.92), pragmatic design (RR = 0.67, 95%CI = 0.54–0.82), and strict intent-to-treat approach (RR = 0.64, 95%CI = 0.52–0.80). Furthermore, LAIs were associated with better acceptability in studies with schizophrenia patients only (RR = 0.87, 95%CI = 0.79–0.95), longer illness duration (RR = 0.88, 95%CI = 0.80–0.97), unstable patients (RR = 0.89, 95%CI = 0.81–0.99) and allowed OAP supplementation of LAIs (RR = 0.90, 95%CI = 0.81–0.99). Conclusion: LAIs and OAPs did not differ significantly regarding relapse prevention/hospitalization and acceptability. However, in nine subgroup analyses, LAIs were superior to OAPs in patients with EP-SSDs with indicators of higher quality and/or pragmatic design regarding relapse/hospitalization prevention (four subgroup analyses) and/or reduced all-cause discontinuation (five subgroup analyses), without any instance of OAP superiority versus LAIs. More high-quality pragmatic trials comparing LAIs with OAPs in EP-SSDs are needed. Trial registration: CRD42023407120 (PROSPERO).

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Risperidone (depot) for schizophrenia

Sampson

Hosalli

Furtado

et al. 2016

Cochrane Database of Systematic Reviews

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Depot risperidone may be more acceptable than placebo injection but it is hard to know if it is any more effective in controlling the symptoms of schizophrenia. The active drug, especially higher doses, may be associated with more movement disorders than placebo. People already stabilised on oral risperidone may continue to maintain benefit if treated with depot risperidone and avoid the need to take tablets, at least in the short term. In people who are happy to take oral medication the depot risperidone is approximately equal to oral risperidone. It is possible that the depot formulation, however, can bring a second-generation antipsychotic to people who do not reliably adhere to treatment. People with schizophrenia who have difficulty adhering to treatment, however, are unlikely to volunteer for a clinical trial. Such people may gain benefit from the depot risperidone with no increased risk of extrapyramidal side effects.

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Risperidone Injectable Long-Acting Treatment vs Other Oral Antipsychotics in First Episode Psychosis: One Year Longitudinal Study

Cited by 3 publications

References 1 publication

Efficacy of long‐acting injectable versus oral antipsychotic drugs in early psychosis: A systematic review and meta‐analysis

Efficacy of long‐acting injectable versus oral antipsychotic drugs in early psychosis: A systematic review and meta‐analysis

Efficacy and safety of long-acting injectable versus oral antipsychotics in the treatment of patients with early-phase schizophrenia-spectrum disorders: a systematic review and meta-analysis

Risperidone (depot) for schizophrenia

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