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  • A systematic review and meta-analysis of the effect of depot antipsychotic frequency on compliance and outcome

    Author(s)
    Kisely, Steve
    Sawyer, Emily
    Robinson, Gail
    Siskind, Dan
    Griffith University Author(s)
    Kisely, Steve R.
    Robinson, Pamela G.
    Year published
    2015
    Metadata
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    Abstract
    Background Depot antipsychotics are commonly used to improve adherence and clinical outcomes such as relapse and readmission. Dosing regimens vary but are commonly two- and four-weekly. To date, the effect of administration at two-weekly or four-weekly intervals on outcome has not been examined in a meta-analysis. Aims A systematic review and meta-analysis on whether the frequency of depot antipsychotic administration (e.g., two- vs four-weekly) makes any difference to compliance and outcome. Methods A systematic search of Medline, EMBASE and PsycInfo for RCTs that compared the frequency of depot administration (e.g., two- ...
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    Background Depot antipsychotics are commonly used to improve adherence and clinical outcomes such as relapse and readmission. Dosing regimens vary but are commonly two- and four-weekly. To date, the effect of administration at two-weekly or four-weekly intervals on outcome has not been examined in a meta-analysis. Aims A systematic review and meta-analysis on whether the frequency of depot antipsychotic administration (e.g., two- vs four-weekly) makes any difference to compliance and outcome. Methods A systematic search of Medline, EMBASE and PsycInfo for RCTs that compared the frequency of depot administration (e.g., two- vs four-weekly) for an equivalent dose. Outcomes were compliance, psychiatric symptomatology, quality of life, adverse drug reactions (ADRs), patient preference, admission rates, bed-days and costs. Results Seven studies from eight papers (n = 3994) were found covering olanzapine, paliperidone, risperidone, haloperidol and fluphenazine enanthate/decanoate with follow-up of up to one year. Meta-analyses were possible for psychotic symptoms and ADRs. There were no differences in psychotic symptoms or quality of life between two- and four-weekly doses. Health service use was not reported. For ADRs, the only significant difference detected was that two-weekly injections were less likely to lead to site pain (RR 0.16, 95% CI 0.07–0.38; 2 studies n = 1667). There were no differences in other ADRs. Conclusions There were surprisingly little data on the effect of dosing frequency for an equivalent dose on clinical outcomes. There is a need for long-term studies of a wide range of outcomes including cost-effectiveness. Claims for advantages of new preparations over others require careful evaluation.
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    Journal Title
    Schizophrenia Research
    Volume
    166
    Issue
    1-3
    DOI
    https://doi.org/10.1016/j.schres.2015.04.028
    Subject
    Biomedical and clinical sciences
    Psychology
    Publication URI
    http://hdl.handle.net/10072/101388
    Collection
    • Journal articles

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