Abstract
Background Long-acting injectable (LAI) antipsychotics are used as a monotherapy in patients with schizophrenia. However, the combination of LAI and oral antipsychotics is commonly used in clinical practice, despite there being very limited studies investigating the efficacy and safety of this combination compared with LAI antipsychotic monotherapy. Objective To study the efficacy and safety of LAI antipsychotic monotherapy compared with the combination of LAI and oral antipsychotics in patients with schizophrenia. Methods This study was a retrospective cohort study, which classified eligible patients into two groups: the LAI antipsychotic monotherapy group and the combination of LAI and oral antipsychotic group. The primary outcome was hospitalization between groups. The duration of the study was 2 years. Results In total, 86 patients completed the study and were analysed (LAI antipsychotic monotherapy group: n = 25; combination of LAI and oral antipsychotic group: n = 61). There was no significant difference in hospitalization between the two groups (P = 1.000). For other outcomes, there were also no significant differences in both all-cause discontinuation (P = 0.667) and adverse drug reactions (P = 0.732) between the two groups. Conclusion The efficacy and safety of LAI antipsychotic monotherapy appeared similar to the combination of LAI and oral antipsychotics in patients with schizophrenia. Therefore, the combination of LAI and oral antipsychotics, which is commonly used in clinical practice, may not be necessary.
Highlights
Schizophrenia is a chronic psychiatric disorder that impairs many aspects of functional outcomes, including social and vocational functioning
There were no significant differences between treatment groups, including age, sex, marital status, body weight, body mass index, duration of illness, age at onset of illness, psychiatric comorbidities, comedications, type and dose of Long-acting injectable (LAI) antipsychotic, and substance use, except for tobacco dependence in patients in the combination of LAI and oral antipsychotic group compared to the LAI antipsychotic monotherapy group (P = 0:047)
This study showed no significant differences in hospitalization and safety between LAI antipsychotic monotherapy and the combination of LAI and oral antipsychotics in patients with schizophrenia
Summary
Schizophrenia is a chronic psychiatric disorder that impairs many aspects of functional outcomes, including social and vocational functioning. Nonadherence to oral antipsychotics causes deleterious consequences, including relapse, rehospitalization, longer time to remission, and risk of suicide and substance use. Long-acting injectable (LAI) antipsychotics are used as a monotherapy in patients with schizophrenia. The combination of LAI and oral antipsychotics is commonly used in clinical practice, despite there being very limited studies investigating the efficacy and safety of this combination compared with LAI antipsychotic monotherapy. To study the efficacy and safety of LAI antipsychotic monotherapy compared with the combination of LAI and oral antipsychotics in patients with schizophrenia. 86 patients completed the study and were analysed (LAI antipsychotic monotherapy group: n = 25; combination of LAI and oral antipsychotic group: n = 61). The efficacy and safety of LAI antipsychotic monotherapy appeared similar to the combination of LAI and oral antipsychotics in patients with schizophrenia. The combination of LAI and oral antipsychotics, which is commonly used in clinical practice, may not be necessary
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