PMID- 26913175
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160225
LR  - 20231111
IS  - 2045-1253 (Print)
IS  - 2045-1261 (Electronic)
IS  - 2045-1253 (Linking)
VI  - 6
IP  - 1
DP  - 2016 Feb
TI  - Effectiveness of long-acting antipsychotics in clinical practice : 1. A 
      retrospective, 18-month follow up and comparison between paliperidone palmitate, 
      risperidone long-acting injection and zuclopenthixol decanoate.
PG  - 22-32
LID - 10.1177/2045125315623168 [doi]
AB  - OBJECTIVES: In the UK, nine different compounds are available as long-acting 
      antipsychotic injections (LAIs). There are few clinical guidelines for 
      determining which LAIs are most effective in specific patient groups. To measure 
      the clinical effectiveness of LAIs we aimed to determine the now-established 
      concept of antipsychotic discontinuation rates and measure Clinical Global 
      Impression (CGI) outcomes. METHOD: The population (n was approximately 560,000) 
      was a secondary care NHS adult mental health service in Lanarkshire, Scotland, 
      UK. This was a retrospective, electronic case note search of LAI-naive patients 
      commenced on paliperidone palmitate (n = 31), risperidone long-acting injection 
      (RLAI) (n = 102) or zuclopenthixol decanoate (n = 105), with an 18-month follow 
      up. Kaplan-Meier survival statistics for discontinuation rates and hospital 
      admission were calculated. CGI severity and improvement scores were 
      retrospectively assigned by the investigating team. RESULTS: Paliperidone 
      palmitate performed less favourably than risperidone long-acting injection (RLAI) 
      or zuclopenthixol decanoate. Paliperidone palmitate had higher discontinuation 
      rates due to any cause, inefficacy and increased hospitalization risk. 
      Paliperidone palmitate had the smallest proportion of patients assigned a 
      clinically desirable CGI-I score of 1 (very much improved) or 2 (much improved). 
      CONCLUSIONS: Paliperidone palmitate had less favourable discontinuation and CGI 
      outcomes compared with RLAI and zuclopenthixol decanoate. This could not be 
      adequately explained by patients in the paliperidone group being more chronically 
      or severely unwell, nor by the presence of comorbidities such as alcohol or 
      substance misuse, or by the use of lower mean dosages compared with RLAI or 
      zuclopenthixol decanoate. We considered that prescribers are familiarizing 
      themselves with paliperidone and outcomes may improve over time.
FAU - Cordiner, Matthew
AU  - Cordiner M
AD  - NHS Lanarkshire, Bellshill, UK.
FAU - Shajahan, Polash
AU  - Shajahan P
AD  - NHS Lanarkshire, Bellshill Clinic, Greenmoss Place, Bellshill ML4 1PS, UK.
FAU - McAvoy, Sarah
AU  - McAvoy S
AD  - NHS Lanarkshire, Bellshill, UK.
FAU - Bashir, Muhammad
AU  - Bashir M
AD  - NHS Lanarkshire, Bellshill, UK.
FAU - Taylor, Mark
AU  - Taylor M
AD  - NHS Lothian, Edinburgh, UK.
LA  - eng
PT  - Journal Article
PL  - England
TA  - Ther Adv Psychopharmacol
JT  - Therapeutic advances in psychopharmacology
JID - 101555693
PMC - PMC4749742
OTO - NOTNLM
OT  - antipsychotics
OT  - clinical effectiveness
OT  - discontinuation
OT  - long-acting psychotics
COIS- Conflict of interest statement: All the authors are employed by the NHS. MT has 
      received hospitality and fees from Janssen; Lundbeck; Otsuka; and Roche in the 
      last 3 years.
EDAT- 2016/02/26 06:00
MHDA- 2016/02/26 06:01
PMCR- 2016/02/01
CRDT- 2016/02/26 06:00
PHST- 2016/02/26 06:00 [entrez]
PHST- 2016/02/26 06:00 [pubmed]
PHST- 2016/02/26 06:01 [medline]
PHST- 2016/02/01 00:00 [pmc-release]
AID - 10.1177_2045125315623168 [pii]
AID - 10.1177/2045125315623168 [doi]
PST - ppublish
SO  - Ther Adv Psychopharmacol. 2016 Feb;6(1):22-32. doi: 10.1177/2045125315623168.