Depot Antipsychotics Discontinued Less Than Oral

A depot antipsychotic regimen is less likely to be discontinued than an oral dosage form according to a 12-month, matched cohort, observational study of medication discontinuation for any reason, including switching agents, augmentation, preference or adverse effects.

The investigators, reporting in the September International Journal of Clinical Practice,1 compared 40 patients starting a depot regimen, to a demographically matched group of 40 patients beginning oral antipsychotic treatment, from an enrolled study population of 406 patients. The investigators report that 20% of those receiving depot treatment discontinued medication within the first year, compared to 40% of those started on an oral antipsychotic.

Reasons for discontinuing the depot antipsychotic were described as: investigator decision (N = 4), patient request (N = 2) and inadequate response (N = 2). Discontinuation of the oral antipsychotic followed from: inadequate response (N = 9), clinical relapse (N = 3), lack of compliance (N = 2), drug intolerance (N = 1) and one for unknown reason.

The lower rate of discontinuation in patients receiving the depot form is particularly notable, the investigators point out, as these patients were started on the depot form after being found at greater risk of not adhering to their oral medication regimen.

“These findings highlight the potential value of depot antipsychotic therapy in the treatment of patients with schizophrenia who are considered non-adherent with the previous oral antipsychotics,” the investigators concluded.

Reference

1. Brnabic AJ, Kelin K, Ascher-Svanum H, et al. Medication discontinuation with depot and oral antipsychotics in outpatients with schizophrenia: Comparison of matched cohorts from a 12-month observational study. Int J Clin Pract. 2011;65:945-953.