Switching patients to atypical oral antipsychotics: A retrospective audit of depot clinic attenders
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Objectives: To compare the 12-month clinical outcome of patients attending a depot clinic who were changed to oral atypical antipsychotic medication, with those who remained on depot preparations. Method: A systematic review of the case records of all patients aged between 18 and 65 attending the depot clinic at Fremantle Hospital, Western Australia. Results: The records of 72 patients were identified (mean age 43.3 years; duration of illness 8.5 years; 37% female); 71% had schizophrenia. Twenty-five patients were successfully switched to an oral atypical antipsychotic (34%), 34 controls remained on a depot (47%), five were managed on a combination of a depot and an atypical, and eight returned to depot medication after a trial of an oral atypical. At 12 month follow-up, patients on oral atypicals showed significant improvement on the CGI (z=-2.57, p=0.01), less akathisia (z=-2.12, p=0.03), and reduced use of antiparkinsonian medication (z=-1.97, p=0.04); these changes were not mirrored in the controls. On multivariate analysis, being on an atypical agent was an independent predictor of improved outcome as measured by the CGI scale (t=-2.1, p=0.04), but also weight gain (t=-2.9, p=0.006). Conclusions: This retrospective survey reveals that a proportion of patients on depot antipsychotic medication can successfully be changed to oral atypical agents, with enhanced clinical outcomes. Declaration of interest: This study was supported by an investigator-initiated grant to SK and DC from Janssen Cilag. DC has received honoraria, travel support, and other grant funding from both Janssen Cilag and Eli Lilly.
Journal of Mental Health
Clinical Sciences not elsewhere classified