The effectiveness of risperidone long-acting injection in oral antipsychotic non-adherent patients with schizophrenia: A retrospective study

Abstract

Objective: To determine effectiveness and adherence to risperidone long-acting injection (RLAI) in schizophrenic patients who were non-adherent to oral antipsychotic treatment.

Method: We retrospectively checked over 30 schizophrenic patients (12 males, mean age=36.1 +/- 9.5 years) who were hospitalized for relapse of their disorder due to non-adherence to oral antipsychotic drugs. Assessment tools were Brief Psychiatric Rating Scale (BPRS), Scale for Assessment of Positive Symptoms (SAPS), Scale for Assessment of Negative Symptoms (SANS) and Simpson-Angus Scale (SAS). Mean follow-up was 236.1 +/- 121.0 (28-336) days. For 11 patients (36.7%), oral add-on antipsychotic treatment (OAT) was discontinued after the 3rd injection of risperidone (No-OAT group); for 19 (63.3%), it was continued (OAT group).

Results: The proportion who discontinued medications was 46.7% overall; it was 45.5% for OAT and 47.4% for No-OAT groups (P=0.781). Mean BPRS, SAPS, SANS, and SAS scores decreased significantly from baseline during follow-up. The No-OAT group had a greater decrease (percent change in BPRS from baseline) than the OAT group at the 3(rd), 6(th), 9(th), 10(th), 11(th), 12(th), 13(th), 15(th) and 17(th) visits; for SANS, it was greater at the 6(th) and 10th visits (P<0.05 for both). The mean dose of RLAI was 46.9 +/- 6.7 mg, and this was similar for OAT and No-OAT groups (49 +/- 9.8 and 44 +/- 9.8, respectively, P = 0.292).

Conclusions: In daily clinical practice, long-acting injectable risperidone is effective in schizophrenic patients, but oral antipsychotic drugs are frequently needed to be used together with RLAI in severe and chronic cases. RLAI had no additional effectiveness or adherence advantage in this study for patients with severe forms of schizophrenia.