Abstract
The value of antipsychotic medication in preventing relapse in schizophrenia has been apparent since soon after its introduction (National Institute of Mental Health, Psychopharmacology Service Centre Study Group, 1964) but non-compliance remains a problem. Failure to take prescribed medication is a challenge in general medicine but presents special difficulties when treating mental illness; residual symptoms of psychosis and impaired insight after discharge increase the likelihood that a patient will stop taking antipsychotic medication, thereby contributing to higher relapse rates. The development of depot antipsychotic medication that could be administered intramuscularly at intervals of several weeks raised treatment and outcome expectations for patients who were felt to be at higher risk of non-compliance when in the community. The need for regular administration and monitoring of patients receiving depot medication led to depot and maintenance medication clinics. Today, with increasing numbers of patients who would previously have been receiving depot medication now taking atypical oral antipsychotics, is there still a need for the depot clinic?
Highlights
Depot antipsychotic medication is produced by esterifying the classical antipsychotic agent with a longchain fatty acid and injecting it in an oily solution
Controlled comparisons of oral and depot forms of antipsychotic medication have not shown a clear compliance benefit for depot forms (Rifkin et al, 1977; Schooler et al, 1980) but this has been linked to the assumption that patients with schizophrenia who enrol in clinical trials may have higher compliance rates than the general population with schizophrenia (Kane & Kissling, 1991)
It is clear that some patients fare poorly on oral antipsychotic medication and the future introduction of depot atypical antipsychotics will be a significant addition to treatment options
Summary
Depot antipsychotic medication is produced by esterifying the classical antipsychotic agent with a longchain fatty acid and injecting it in an oily solution. In the mirror image studies, patients receiving depot antipsychotics were followed up for a set period of time and the number and length of relapses were recorded This result was compared to the number of relapses or days in hospital for an equal period of time before the depot medication was commenced. Controlled comparisons of oral and depot forms of antipsychotic medication have not shown a clear compliance benefit for depot forms (Rifkin et al, 1977; Schooler et al, 1980) but this has been linked to the assumption that patients with schizophrenia who enrol in clinical trials may have higher compliance rates than the general population with schizophrenia (Kane & Kissling, 1991) It must be borne in mind when attempting to critically evaluate these studies or other work looking at depot medication, that the very nature of the patient group who may benefit most from depot medication and depot clinics tends to contain uncooperative, poorly compliant patients. The use of depot medication requires compliance on the part of the patient, attending for administration of medication once every 2 or 3 weeks may be preferable to taking medication every day or several times
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
