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Efficacy and effectiveness of depot versus oral antipsychotics in schizophrenia: synthesizing results across different research designs.
J Clin Psychiatry
June 2013
Analysis Group, Inc, 111 Huntington Ave, 10th Fl, Boston, MA 02199, USA.
Objective: Nonadherence is a major challenge in schizophrenia treatment. While long-acting (depot) antipsychotic medications are often recommended to address adherence problems, evidence on the comparative effectiveness of depot versus oral antipsychotics is inconsistent. We hypothesize that this inconsistency could be due to systematic differences in study design.
View Article and Find Full Text PDFThe pharmacokinetics of long-acting antipsychotic medications.
Curr Clin Pharmacol
April 2015
NHS, Health Trust No. 3 Umbria, Mental Health Department, Day Hospital, Via Arcamone s.n.c. 06034 Foligno, Perugia, Italia.
The depot antipsychotics are synthesized by esterification of the active drug to a long chain fatty acid and the resultant compound is then dissolved in a vegetable oil, with the exception of some molecules of new generation characterized by microcrystalline technologies. The absorption rate constant is slower than the elimination rate constant and therefore, the depot antipsychotics exhibit 'flip-flop' kinetics where the time to steady-state is a function of the absorption rate, and the concentration at steady-state is a function of the elimination rate. The pharmacokinetics of depot antipsychotic medications are such that an intramuscular injection given at intervals from 1 to 4 weeks will produce adequate plasma concentrations that are sufficient to prevent relapse over the dosage interval.
View Article and Find Full Text PDFChronic deep brain stimulation in patients with tardive dystonia without a history of major psychosis.
Mov Disord
July 2010
Department of Neurosurgery, Medical School Hannover, MHH, Hannover, Germany.
Tardive dystonia usually occurs with a delay after neuroleptic exposure in patients with major psychosis. A subgroup of patients, however, is given such medication for "mild depression" or "neurasthenia." Tardive dystonia, in general, may respond favorably to pallidal deep brain stimulation (DBS).
View Article and Find Full Text PDFDepot fluspirilene for schizophrenia.
Cochrane Database Syst Rev
January 2007
Cochrane Schizophrenia Group, Academic unit of Psychiatry and Behavioural Sciences, 15 Hyde Terrace, Leeds, UK, LS2 9LT.
Background: Antipsychotic drugs are the mainstay treatment for schizophrenia and similar psychotic disorders. Long-acting depot injections of drugs such as fluspirilene are extensively used as a means of long-term maintenance treatment.
Objectives: To review the effects of depot fluspirilene versus placebo, oral anti-psychotics and other depot antipsychotic preparations for people with schizophrenia in terms of clinical, social and economic outcomes.
Intramuscular preparations of antipsychotics: uses and relevance in clinical practice.
Drugs
June 2003
Department of Psychiatry, Department of Clinical Sciences Luigi Sacco, University of Milan, Via G.B. Grassi 74, Milan 20157, Italy.
Intramuscular formulations of antipsychotics can be sub-divided into two groups on the basis of their pharmacokinetic features: short-acting preparations and long-acting or depot preparations. Short-acting intramuscular formulations are used to manage acute psychotic episodes. On the other hand, long-acting compounds, also called "depot", are administered as antipsychotic maintenance treatment to ensure compliance and to eliminate bioavailability problems related to absorption and first pass metabolism.
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