Depot Treatment Research Articles

Clinician’s attitude towards clozapine prescription

IntroductionCurrent clinical guidelines recommend the use of clozapine for the treatment of refractory schizophrenia, present in up to a third of patients with this disease. Despite the evidence, the data point to low prescription, underdosing, and delayed initiation.ObjectivesThe objective of the study is to elucidate which factors may interfere in clozpine prescription.MethodsThis is a cross-sectional observational study, carried out using a survey designed specifically for it.It was answered online by seventy psychiatrists affiliated with the Catalan Society of Psychiatry.ResultsMore than half admitted having prescribed two or more antipsychotics without having previously ruled out pseudorefractoriness through depot treatment. 70% recognized the need for monitoring as the main prescription barrier, while the main reason for withdrawal was its adverse effects. The most alarming was considered agranulocytosis, with drooling, drowsiness and weight gain being the most reported.Statistically significant differences (p=0.031) were found in relation to the years of experience and the device where clozapine was preferred to be started: <10 years in hospital, 10-20 years in partial hospitalization and >20 years outpatient office.Statistically significant differences were observed in the preference of the device for its initiation depending on the usual work device: hospitalization (p<0.000) and partial hospitalization (p=0.046) preferred to schedule it from their respective devices, without any preference in consultations.The level of experience and the most reported side effect were statistically significant: for the newest psychiatrists it was weight gain (p=0.031), without presenting differences in the rest of the groups.ConclusionsClozapine is the psychoactive drug of choice in refractory schizophrenia, so efforts should be devoted to reducing prescription barriers, offering training on its management and innovating forms of monitoring to promote its use.Disclosure of InterestNone Declared

The Social, Material, and Temporal Effects of Monthly Extended-Release Buprenorphine Depot Treatment for Opioid Dependence: An Australian Qualitative Study

Aims: This study examined the social, material and temporal effects of extended-release buprenorphine depot treatment (BUP-XR), among a group of participants commencing BUP-XR in Australia, and considered the situated potentials of these new opioid agonist treatment technologies. Methods: Using a longitudinal qualitative design, 36 participants (25 men, 11 women; mean age 44 years) were interviewed, with 32 followed-up, to generate accounts of BUP-XR experiences. Analysis was informed by sociological approaches which attend to the multiple effects of novel health interventions as they are put to use and made to work, with a focus on tracing change over time. Analysis: The shift from daily to monthly dosing altered how opioid agonist treatment was experienced, reconfigured participants’ relationship to treatment, and affected the temporal patterns of participants’ lives. Extending temporal relations released participants from short-term cycles of living and produced different forms of subjectivity, bringing about both transformation and loss. Monthly dosing, and a sense of normalcy characterized by absenting the routines and felt effects of drugs or treatment medications, potentiated a feeling of stability for many participants. For some, disrupting daily routines precipitated disconnection from treatment and social care relations. The transition from daily to monthly dosing required adaptation and new ways of engaging with treatment and care, with medication acting as a bridge to care without necessarily being the focal point. Conclusions: As BUP-XR treatment gains traction internationally, it will be important to attend to the multiple, and sometimes unexpected, effects this intervention makes in the social and material lives of clients. How choice, social connection, and care can be maintained to help secure BUP-XR’s longer-term impact, and how clients can be supported to adjust to what is felt to be a new normal, will be considerations in future treatment delivery.

Impact of the COVID-19 Pandemic on the Global Delivery of Mental Health Services and Telemental Health: Systematic Review.

BackgroundThe COVID-19 pandemic required mental health services around the world to adapt quickly to the new restrictions and regulations put in place to reduce the risk of transmission. As face-to-face contact became difficult, virtual methods were implemented to continue to safely provide mental health care. However, it is unclear to what extent service provision transitioned to telemental health worldwide.ObjectiveWe aimed to systematically review the global research literature on how mental health service provision adapted during the first year of the pandemic.MethodsWe searched systematically for quantitative papers focusing on the impact of the COVID-19 pandemic on mental health services published until April 13, 2021, in the PubMed, Embase, medRxiv, and bioXriv electronic bibliographic databases, using the COVID-19 Open Access Project online platform. The screening process and data extraction were independently completed by at least two authors, and any disagreement was resolved by discussion with a senior member of the team. The findings were summarized narratively in the context of each country’s COVID-19 Stringency Index, which reflects the stringency of a government’s response to COVID-19 restrictions at a specific time.ResultsOf the identified 24,339 records, 101 papers were included after the screening process. Reports on general services (n=72) showed that several countries’ face-to-face services reduced their activities at the start of the pandemic, with reductions in the total number of delivered visits and with some services forced to close. In contrast, telemental health use rapidly increased in many countries across the world at the beginning of the pandemic (n=55), with almost complete virtualization of general and specialistic care services by the end of the first year. Considering the reported COVID-19 Stringency Index values, the increased use of virtual means seems to correspond to periods when the Stringency Index values were at their highest in several countries. However, due to specific care requirements, telemental health could not be used in certain subgroups of patients, such as those on clozapine or depot treatments and those who continued to need face-to-face visits.ConclusionsDuring the pandemic, mental health services had to adapt quickly in the short term, implementing or increasing the use of telemental health services across the globe. Limited access to digital means, poor digital skills, and patients’ preferences and individual needs may have contributed to differences in implementing and accessing telemental health services during the pandemic. In the long term, a blended approach, combining in-person and virtual modalities, that takes into consideration the needs, preferences, and digital skills of patients may better support the future development of mental health services. It will be required to improve confidence with digital device use, training, and experience in all modalities for both clinicians and service users.

Estradiol and Progesterone as key modulators of central systems implicated in schizophrenia

IntroductionIt has been suggested that dysregulation of sex hormones is associated with schizophrenia. However, obesity and metabolic syndrome are very common between schizophrenic patients, and it can also dysregulate sex hormones so they could act as confounders.ObjectivesTo determine if estradiol and progesterone are abnormally elevated regardless of obesity or metabolic syndrome in men with SCZ.MethodsWe measured serum levels of progesterone and estradiol in 56 schizophrenic male patients at treatment with a depot antipsychotic. Subsequently, we studied the association or independence of our results with obesity or metabolic syndrome by a Chi Square Test.Results66.07% of our patients elevated progesterone levels, 19.64% of our patients elevated estradiol levels, and 16.07% of our patients elevated both, progesterone and estradiol, simultaneously. We found no relationship between increased estradiol and / or progesterone with obesity and / or metabolic syndrome.ConclusionsEstradiol and progesterone are abnormally elevated regardless of obesity and / or metabolic syndrome in male schizophrenic patients on depot treatment.DisclosureNo significant relationships.

Effectiveness of oral versus long-acting antipsychotic treatment early-phase schizophrenia patients: an open-label randomized trial

IntroductionSchizophrenia is a chronic psychiatric illness with periods of remission and relapse. Patients vary in the frequency and severity of relapse, time until relapse and time in remission. Discontinuation of antipsychotic medication is by far the most important reason for relapse. A possible method to optimize medication adherence is to treat patients with long-term, depot medication rather than oral medication.ObjectivesPrimary objective is to compare all cause discontinuation rates in patients with schizophrenia randomized to either one of the two depot medications (aripiprazole depot or paliperidone palmitate) with patients randomized to either one of the two oral formulations of the same medication (aripiprazole or paliperidone) over an 19 month follow-up period.MethodsPragmatic, randomized, open label, multicenter, multinational comparative trial consisting of a 19 month treatment period. Patients aged 18 years or older, having experienced the first psychosis 1-7 years ago, currently meeting DSM-IV-R criteria for schizophrenia. Patients are randomized 1:1:1:1 to paliperidone palmitate, aripiprazole depot, oral aripiprazole or oral paliperidone. The primary outcome is all cause discontinuation.ResultsIn the Intent to Treat sample (n=511), no difference was found in time to ACD between the combined oral and combined depot treatment arms, nor between the four individual treatment arms.ConclusionsEven though the scientific evidence comparing oral and depot medication has been inconsistent, most studies were conducted in rigorous clinical settings, which may have biased those results. In contract, given the pragmatic, open label design of the current trial, the results may be more representative of common daily practice.DisclosureNo significant relationships.

Demographic and clinical profile of patients utilising a transitional care intervention in the Western Cape, South Africa.

BackgroundThe World Health Organization’s action plan for 2020 has identified the need for service-based data to motivate for more appropriate community-based services. To date, there is no published data from step-up or step-down facilities in South Africa.AimTo describe the demographic and clinical profile of all patients admitted to New Beginnings between 01 January 2011 and 31 December 2015.SettingNew Beginnings is an intermediary care facility focused on psychosocial rehabilitation and accommodates 40 patients in a step-up or step-down setting.MethodsIn this retrospective audit, we reviewed the medical records of all patients (N = 730) admitted to New Beginnings between 01 January 2011 and 31 December 2015.ResultsMost admissions were male (n = 600; 82.2%), unmarried (92.1%) and unemployed (92.7%) patients with a mean age of 28 years. Only 20.7% had completed their schooling and 37.9% were receiving a disability grant. Most patients lived in the Cape Town Metro area (89%) with their families (94.7%), and 75.6% had no children. Schizophrenia (53.7%) was the most common primary psychiatric diagnosis, and most patients were on a combination of oral and depot treatment (46.8%). Illicit substances were used by 75.9% of patients with 30% using both cannabis and methamphetamine. Most patients (74.9%) had only one admission to New Beginnings.ConclusionsThese baseline data could inform improved service delivery. Further research is needed to evaluate the success of New Beginnings and highlight the need for more of these facilities in the Western Cape and across South Africa.

Phama Sci Preparation, In Vitro and In Vivo Studies of Vitamin B12 Loaded Implants Al-Rasheed University College, Iraq

Vitamin B12 is an important water-soluble vitamin which is found in a variety of food such as fish, shellfish, meat, and dairy products. It helps maintain healthy nerve cells and red blood cells, as well as aid in rapid DNA production during cell division. The daily requirement of vitamin B12 for the human body is approximately 1-25 µg . In 1960 introduced long-acting depot antipsychotic drug as the first long acting medications. Depot formulations providing further reductions in morbidity and mortality. Because they bypass the gastrointestinal tract, Depot treatments decrease the amount of medication needed and reduce certain peripheral side effects. Understanding the clinical and compliance of patients from the use of single dose with multiple and consecutive treatment of B12, we have developed long-term implantable medication delivery loaded with vitamin B12. The proposed method of controlled drug delivery uses sterile implants processed with a Poly (lactic-co-glycolic acid) (PLGA) polymer with a delivery interval of up to one month depending on polymer composition, and drug loading. In this study, 3 goals were addressed: 1: To formulate six different batches of biodegradable polymer implants loaded with vitamin 12 and target profile shown in Tables 1. 2: To characterize the formulated implants and establish an in vitro release for the B12 as a function of time. 3: Perform in vivo study and measure the serum concentration of B12 released from implants subcutaneously inserted into rats. Accomplishment of these three goals could provide the feasibility of controlled release vitamin B12 implants for human treatment for vitamin deficiency.

Multiple antipsychotics use in patients with schizophrenia: Why do we use it, what are the results from patient follow-ups?

In this study, the rates of antipsychotic polypharmacy, factors affecting combined drug use, the relationship between antipsychotic polypharmacy as it relates to duration of hospitalization and re-hospitalization, and treatment compliance were evaluated in schizophrenia patients. The study data was obtained between January 1, 2017 and December 31, 2017 by examining the files of all patients who were hospitalized in Ondokuz Mayıs University Faculty of Medicine Hospital, Ankara Numune Training and Research Hospital, Ankara Gulhane Training and Research Hospital psychiatric services. The inpatients' drug prescriptions at discharge and after one-year outpatient follow-up, as well as treatment compliance and re-hospitalization, were examined. The mean duration of illness was 109.3 ± 109.7 months, and the mean duration of hospitalization was 24.6 ± 19.1 days. For a total of 599 patients, multiple antipsychotic medication was used in 21.2% of hospitalizations. 11.2% of patients using single antipsychotic and 14.2% of patients using multiple antipsychotics were re-hospitalized within one year (X 2 :0.830, p:0.362). Disease duration (Z:-3.654, p < 0.001) and duration of hospitalization (Z:-3.333, p < 0.001) were found to be longer in multiple antipsychotic users. 37.8% of the patients used a depot antipsychotic. There was no significant difference between depot antipsychotic use and oral antipsychotic use as it related re-hospitalization rates. As a conclusion, multiple antipsychotic use has reduced in Turkey. Contrary to popular belief, the use of multiple antipsychotics does not shorten, but rather may prolongs hospitalization, and it has no effect in reducing re-hospitalization. Drug combinations are generally used together with a depot treatment, clozapine treatment is preferred less frequently in combinations, clinicians have proven effectiveness of the drug combination they prefer, and they should give priority to the treatments recommended in treatment guidelines.

Safety and effectiveness of long-acting injectable Aripiprazole in daily practice: A naturalistic retrospective study

Background and objectivesIt was postulated that Aripiprazole may cause impulse-control problems. Therefore, real-world data on the effects and side effects of Aripiprazole 400 mg depot are needed to review the utility, safety and the clinical effectiveness of Aripriprazole 400 mg depot and highlight the occurrence of adverse effects including impulsivity in a naturalistic treatment settings. MethodsA non-interventional, retrospective study was conducted to examine the electronic records of all patients who were receiving or had received Aripiprazole Lauroxil in South West London before May 2017. Disorder symptoms and side effects were compared between pre- and post-Aripiprazole PO and Aripiprazole Depot treatments. ResultsData were considered for 57 patients who switched to Aripiprazole depot due to non-compliance and/or side effects. Most were suffering from chronic schizophrenia (75.4 %) and half (50.9 %) had comorbid alcohol and/or illicit drug use. Oral Aripiprazole was effective in improving hallucinations, delusions and depressive symptoms (P < 0.022); these benefits were maintained or enhanced further with Aripiprazole Depot. Proportions of patients experiencing sexual disinhibition, aggression and deliberate self-ham decreased significantly (P < 0.003) after starting oral Aripiprazole with no further change after Aripiprazole Depot. By study end, a quarter of patients had stopped taking Aripiprazole Depot due to ineffectiveness, side effects or patient request. ConclusionAripriprazole Lauroxil 400 mg depot was safe, effective and well tolerated. Side effects manifestations should prompt full evaluations and dose reduction should be considered.

Triptorelin depot for the treatment of children 2 years and older with central precocious puberty

ABSTRACTIntroduction: Triptorelin depot is largely used to treat central precocious puberty (CPP) in children.Areas covered: This review updates triptorelin depot treatment of CPP, focusing on trials that compared 3.75 mg/28 day treated and untreated children till the adult height (AH). Efficacy of the new 11.25 mg/90 days or 22.5 mg/6 month formulations in suppressing pituitary–gonadal axis in short-term trials is also addressed. Short- and long-term safety was summarized.Expert commentary: Long experience on triptorelin depot use in children with CPP is available. Outcome differences on AH are reported; they may be due to heterogenicity of treated patients; some items remain to be optimized. No long term-adverse events on reproductive function are reported; additional studies would clarify if CPP per sè or triptorelin depot administration may increase hyperandrogenism and/or polycystic ovary syndrome risk in adulthood. The quarterly formulation seems to be able to suppress pituitary–gonadal axis and pubertal development and to determine similar end-results as monthly formulation, but additional trials are needed. Few data are available for the 22.5 mg/6 month formulation. Triptorelin depot treatment of CPP should be restricted to tertiary pediatric endocrinology centers, considering that some uncertainties still exist and that rare but serious adverse events may occur.

Paliperidone palmitate three-month depot formulation: a helpful innovation with practical pitfalls.

Paliperidone palmitate is now available as a three-month depot injection. This paper will review the pharmacokinetics, pharmacodynamics, efficacy and tolerability, as well as practical issues and pitfalls for clinicians with this innovative treatment for schizophrenia. The three-month depot formulation of paliperidone for the treatment of schizophrenia is not a new compound. The nanocrystalline structure of the three-month formulation is larger and takes longer to disperse than the one-month formulation, hence its extended depot action. As expected, it is non-inferior to one-month depot paliperidone, and superior to placebo, for the treatment of schizophrenia. The side effect profile of three-month paliperidone is identical to the one-month formulation. The relapse rate on treatment is low, and the median time to relapse after ceasing the drug is 395 days. An understanding of half-life and kinetics is crucial for clinicians using this compound, and the loading strategy is important to ensure effectiveness. There are significant challenges: ensuring timely administration and switching a three-month depot treatment to another antipsychotic may be problematic. Paliperidone palmitate three-month depot injection represents an advance for both convenience and effectiveness in the long term psychopharmacological treatment of schizophrenia.

Therapeutic Particularities with Depot Medications in Schizophrenia.

Schizophrenia is a neurodegenerative disease with personality degradation, changes in behavior, cognition, affective disorder and reduced socio-professional insertion. Early diagnosis is necessary and maintenance is ensured by antipsychotic treatment and for non-compliant patients there is an alternative to depot medication that greatly improves therapeutic adherence. The study presents the case of a 43-year-old patient diagnosed with paranoid schizophrenia using the Diagnostic and Statistical Manual of Mental Disorders V-TR criteria that showed a favorable evolution under depot treatment.

Switching away from pipotiazine palmitate: a naturalistic study.

In March 2015, pipotiazine palmitate depot antipsychotic was globally withdrawn due to the shortage of its active ingredient. Thus, all patients receiving this medication had to be switched to an alternative antipsychotic drug. In this study we set to evaluate the process of switching away from pipotiazine palmitate within our clinical service, and its impact on hospitalization. Demographic and clinical data on patients who were receiving pipotiazine palmitate in Northamptonshire at the time of its withdrawal were anonymously extracted from their electronic records and analyzed using descriptive statistics. A total of 17 patients were switched away from pipotiazine palmitate at the time of its withdrawal, all of whom had a prior history of nonadherence with oral treatment. A total of 14 patients were switched to another depot antipsychotic drug, while three patients chose an oral alternative which they subsequently discontinued resulting in relapse and hospitalization. There was a five-fold increase in mean hospitalization among patients who completed a year after the switch. Switching away from pipotiazine palmitate was associated with significant clinical deterioration in patients who switched to an oral antipsychotic, whereas most patients who switched to another depot treatment maintained stability. Clinicians should exercise caution when switching patients with schizophrenia away from depot antipsychotic drugs, especially in cases of patients with a history of treatment nonadherence who prefer to switch to oral antipsychotics.

Stress Increases Gonadotropin Inhibitory Hormone Cell Activity and Input to GnRH Cells in Ewes.

Stress reduces GnRH and gonadotropin secretion in sheep, but the central mechanism for this suppressive effect is unknown. Gonadotropin-inhibitory hormone (GnIH) negatively regulates GnRH neurons and gonadotropes. Here, we measured activity of GnIH neurons and contact of GnIH fibers on GnRH neurons during either chronic "pseudostress" or acute stress in sheep. We also measured GnIH secretion into hypophysial portal blood during pseudostress and acute stress. The pseudostress was daily im injections (0.5 mg) of Synacthen Depot (adrenocorticotropin) or vehicle for 4 weeks, which increased the GnIH cell number and gene expression/cell in the hypothalamus, measured by in situ hybridization. Double label immunohistochemistry showed that Synacthen Depot treatment increased the percentage of GnRH cells in close contact with GnIH fibers but did not alter GnIH levels in hypophysial portal blood. Acute stress protocols were either sequential audiovisual predator stress, followed by insulin-induced hypoglycemia, or a single challenge with lipopolysaccharide (iv). Both of these acute stressors activated a c-Fos response in GnIH cells and increased the contacts of GnIH fibers to GnRH cells. Neither acute stress protocol increased GnIH secretion into hypophysial portal blood. These data show that chronic pseudostress and acute stressors increase the function of GnIH cells as well as the degree to which GnIH cells may provide input to GnRH cells. Thus, GnIH cells may provide a central mechanism whereby stress compromises reproduction. Neither chronic pseudostress nor acute stress elevates secretion of GnIH into portal blood, but stress effects mediated by GnIH cells are directed towards GnRH cell bodies.

The identification of novel genetic variants associated with antipsychotic treatment response outcomes in first-episode schizophrenia patients.

Although antipsychotics are integral to the treatment of schizophrenia, drug efficacy varies between patients. Although it has been shown that antipsychotic treatment response outcomes are heritable, our understanding of the genetic factors that are involved remains incomplete. Therefore, this study aims to use an unbiased scan of the genome to identify the genetic variants contributing toward antipsychotic treatment response outcomes. This study utilized whole-exome sequencing of patients on extreme ends of the treatment response spectrum (n=11) in combination with results from previous antipsychotic studies to design a panel of variants that were genotyped in two well-characterized first-episode schizophrenia cohorts (n=103 and 87). Association analyses were carried out to determine whether these variants were significantly associated with antipsychotic treatment response outcomes. Association analyses in the discovery cohort identified two nonsynonymous variants that were significantly associated with antipsychotic treatment response outcomes (P<2.7 × 10(-5)), which were also significantly associated with the corresponding treatment response outcome in an independent replication cohort. Computational approaches showed that both of these nonsynonymous variants--rs13025959 in MYO7B (E1647D) and rs10380 in MTRR (H622Y)--were predicted to impair the functioning of their corresponding protein products. The use of whole-exome sequencing in a subset of patients from a well-characterized cohort of first-episode schizophrenia patients, for whom longitudinal depot treatment response data were available, allowed for (i) the removal of confounding factors related to treatment progression and compliance and (ii) the identification of two genetic variants that have not been associated previously with antipsychotic treatment response outcomes and whose results were applicable across different classes of antipsychotics. Although the genes that are affected by these variants are involved in pathways that have been related previously to antipsychotic treatment outcomes, the identification of these novel genes will play an important role in improving our understanding of the specific variants involved in antipsychotic treatment response outcomes.

Tolerability and safety of long-acting injectable aripiprazole

IntroductionLong-acting injectable aripiprazole is the most recently introduced depot treatment in schizophrenia.ObjectivesThe objective of this study is to determine the tolerability and safety of this new treatment.AimsThe aim is to provide useful information regarding the use of this new drug.MethodsOur sample consists on 20 patients treated with a monthly dose of long-acting ariprazole. They were previously stabilized on oral aripiprazole before the first injection. The data on tolerability and safety were obtained by face-to-face interviews, using the Hogan Drug Attitude Inventory, the Patient Satisfaction with Medication Questionnaire and the UKU Side Effects Scale.ResultsOur sample consists of 20 patients, with a 50/50 gender distribution and a mean age of 39 years. The average score in the satisfaction scale Hogan was positive (an average of 7.25). In the Patient Satisfaction With Medication Questionnaire, 85% said they were satisfied with the new treatment, compared with 15% who showed some degree of dissatisfaction with the change. Overall, 90% of patients showed a preference for the current treatment compared to the previous. The patients showed good tolerance to medication, with a low score in the UKU scale (total score = 13.5). Side effects did not interfere with daily activity of the patient.ConclusionsLong acting injectable aripiprazole proved to be a safe treatment, with a good degree of acceptance among patients. These advantages makes of this new drug a useful addition to our kit tool.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Long-acting injectable antipsychotics: Diagnostics and patient profile

IntroductionLong-acting injectable antipsychotics (LAIs) were developed in the sixties with the purpose of improving schizophrenia maintenance treatment. The main advantages are: the ability to ensure compliance, maintaining stable plasma concentrations and allowing better clinical management of drug therapy. Long-acting atypical injectable antipsychotics start to develop in the late nineties. Currently, they are the most widely used depot treatment for severe mental illness.ObjectiveChecking patient profile and diagnosis where we use LAIs.MethodsReview of 217 patients treated with LAIs in CSM El Coto–Gijón.ResultsIn our sample, the average age of the patients was 48.94 years old. Most of them were men (135 vs. 82). More than half of treated patients were diagnosed with schizophrenia (112), the paranoid subtype was the most repeated (93). Other severe mental illnesses were also treated with LAIs: emotionally unstable personality disorder (31), delusional disorder (19), bipolar disorder (15), schizoaffective disorder (12) and other less frequently. For all groups, paliperidone palmitate was the most used injectable antipsychotic. The new aripiprazole long-acting injectable starts being used in psychotic patients with a significant affective component.ConclusionsThe schizophrenic patient remains being the prime candidate for this therapy although other severe mental disorders may also benefit of LAIs treatment. Most classical long-acting injectable antipsychotics have been replaced by new atypical injectable antipsychotics with a more tolerable side effects profile.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Buserelin-depot in the treatment of prostate cancer

The high incidence of prostate cancer (PC) and the considerably wide use of hormone therapy for its treatment as an individual modality for its advanced forms (Т3–Т4, N1, M1), recurrences, and progression after local treatments (radical prostatectomy, radiation therapy) and for combined treatment as neoadjuvant and adjuvant therapies determine the importance of a sufficient range of hormonal drugs at an urologic oncologist’s disposal. Among the luteinizing hormone-releasing hormone (LHRH) agonists, there is rather long-known Buserelin made in Russia, the clinical efficacy of which is highly competitive with foreign analogs. The paper presents the results of a 3-month trial of the efficiency and safety of Buserelin depot treatment in 20 patients aged 53 to 87 years with morphologically verified PC. The patients with PC showed a gradual decrease in the mean values of prostate-specific antigen (PCA) from 81.2 to 27.8 and 23.0 ng / ml at 2 and 3 months of Buserelin depot therapy, respectively. The performed therapy could achieve reductions in testosterone levels from 168 ng / dl at baseline to 21 and 19.8 ng / dl postcastration at 1 and 3 months of the therapy. All the patients tolerated Buserelin depot therapy without having clinically significant adverse reactions. The most common complaints were hyperhidrosis and hot flushes, which are typical of all LHRH agonists and which are not marked in the treatment with other drugs of this group. Conclusion. Buserelin depot 3.75 mg is a highly effective Russian drug to treat hormone-dependent PC. Its administration causes a reduction in PSA levels and ensures a steady decline in serum testosterone concentrations to the postcastration level without causing serious side effects. The findings do not differ from those when foreign LHRH analogues are used.

Use of Oral Antipsychotics Versus Depot for Treating Schizophrenia

Introduction Lately is increasingly frequent the use of depot antipsychotic treatment for schizophrenia at any stage of the disease. This issue is still being discussed, since the opinions of experts are occasionally contradictory without reaching a general consensus of the indications for use of depot treatment. Objectives Description of discharge treatment at a short term Hospitalization Unit of 160 psychotic patients, analyzing the use of oral or depot therapy for 9 months in 2014. Methods A pool of 160 patients discharged from January 2014 up to September 2014 with a diagnosis of Schizophrenia and other psychotic disorders according to DSM-IV and DSM-5. A descriptive analysis of the number of patients on antipsychotic treatment is performed oral versus depot, making a brief description of the characteristics of patients in those groups. Results Pending a more thorough analysis of the data, most of the discharged patients discharged were treated with oral antipsychotics and only a minority was discharged with depot treatment. Conclusions The use of depot treatment in the referred unit is still restricted to poorly compliant patients and poor awareness of disease abandoning the oral treatment, despite the fact that in the current scientific literature is becoming more frequent its use in early stages of disease.

Depot Treatment in Schizophrenia

Introduction Monotherapy, treatment adherence and satisfaction of schizophrenic patients are essential for good prognosis and disease evolution. The use of depot treatments such as paliperidone palmitate, could be the beginning to get all these objectives in the treatment of all of our patients. Objectives To measure in a pool of schizophrenic patients starting treatment with paliperidone palmitate, the time they take to re-enter as in-patients, if monotherapy is get and the degree of satisfaction of these patients regarding treatment is achieved. Methods A pool of schizophrenic patients discharged from our Short-Term Hospitalization Unit between October 2014 and February 2015 with introduction into its paliperidone palmitate treatment. Results waiting to be achieved Conclusions and in the results of similar studies, we think that paliperidone palmitate is a drug of choice in many schizophrenic patients who can benefit from their use to be well tolerated, to control the disease by reducing the number of readmissions, improve the therapeutic adherence, patient satisfaction with their treatment and to get a treatment with a single antipsychotic.