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Effects of adding depot antipsychotic medication to oral antipsychotic regimen on treatment compliance in schizophrenic patients.

Salih Saygın Eker, Cengiz Akkaya, Şengül Cangür, Aslı Sarandöl, Gülnihal Deniz, Selçuk Kırlı.

Objective: This study aims to compare the effects of adding depot antipsychotic to oral antipsychotic regimen in schizophrenic patients with respect to sociodemographic, treatment characteristics and prognosis in outpatient practices.

Method: In this study, charts of schizophrenic patients referred to the outpatient psychiatry clinic at the Medical School of Uludag University first time during 1998-2005 period were examined. The evaluation of medical records was concluded in April 2007, this enabled the assessment of the rate of discontinuation over a minimum of 18 months for all patients in the study. Socio-demographics, characteristics of the disorder, and treatment and prognosis of the patients were questioned. The recruited 274 patients were divided into two groups: The depot antipsychotic added and only oral antipsychotic regimen group. Compliance measures were ?the time to all-cause medication discontinuation? and ?rate of discontinuation?.

Results: Forty-eight (17.5%) of 274 patients were prescribed depot antipsychotics in addition to their ongoing oral oral antipsychotic regimen. Of the depot antipsychotic added patients 26 (54.1%) received zuclopenthixol deaconate, 18 (%37.5) received şupentixol, 3 (%6.25) received şufenazin deaconate (%6.25) and 1 (%2.1) received long-acting risperidone. There were no significant statistical differences between treatment groups in terms of sociodemographic variables, age of onset of the disorder, and duration of antipsychotic use prior to follow-up. The depot antipsychotic added patients had significantly higher number of relapses (p=0.031) and hospitalizations (p=0.031) in pre-depot antipsychotic period. However, there were no significant statistical differences during the study period between two groups in terms of rates of relapse and hospitalization. Time to all-cause medication discontinuation and rate of discontinuation did not differ between the groups. Also no significant differences were found between two groups in terms of anticholinergic, antidepressant, mood stabilizer and anxiolytics agent prescription rates.

Conclusions: Adding depot antipsychotics to oral antipsychotic regimen did not improve treatment compliance in our study patients. However, rates of relapse and hospitalization which were significantly higher in depot and oral antipsychotic receiving patients did not differ between two groups during follow-up. Thus, we think the patients with higher rates of relapse and hospitalization may benefit from adding depot antipsychotics to oral antipsychotic regimens.

Key words: Depot antipsychotics, treatment compliance, schizophrenia

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