Hostname: page-component-58bd8987f9-6brn6 Total loading time: 0 Render date: 2025-05-28T08:33:42.480Z Has data issue: false hasContentIssue false
  • English
  • Français

Psychiatrists’ attitude to antipsychotic depot treatment in patients with first-episode schizophrenia

Published online by Cambridge University Press:  16 April 2020

S. Heres ,
T. Reichhart ,
J. Hamann ,
R. Mendel ,
S. Leucht  and
W. Kissling
S. Heres*
Affiliation:
Klinik und Poliklinik fuer Psychiatrie und Psychotherapie, der Technischen Universitaet Muenchen, am Klinikum rechts der Isar, Moehlstrasse 26, 81675Muenchen, Germany
T. Reichhart
Affiliation:
Klinik und Poliklinik fuer Psychiatrie und Psychotherapie, der Technischen Universitaet Muenchen, am Klinikum rechts der Isar, Moehlstrasse 26, 81675Muenchen, Germany
J. Hamann
Affiliation:
Klinik und Poliklinik fuer Psychiatrie und Psychotherapie, der Technischen Universitaet Muenchen, am Klinikum rechts der Isar, Moehlstrasse 26, 81675Muenchen, Germany
R. Mendel
Affiliation:
Klinik und Poliklinik fuer Psychiatrie und Psychotherapie, der Technischen Universitaet Muenchen, am Klinikum rechts der Isar, Moehlstrasse 26, 81675Muenchen, Germany
S. Leucht
Affiliation:
Klinik und Poliklinik fuer Psychiatrie und Psychotherapie, der Technischen Universitaet Muenchen, am Klinikum rechts der Isar, Moehlstrasse 26, 81675Muenchen, Germany
W. Kissling
Affiliation:
Klinik und Poliklinik fuer Psychiatrie und Psychotherapie, der Technischen Universitaet Muenchen, am Klinikum rechts der Isar, Moehlstrasse 26, 81675Muenchen, Germany
*
*Corresponding author. Tel.: +49 89 4140-4227; fax: +49 89 4140 4898. E-mail address: s.heres@lrz.tum.de (S. Heres).
Get access

Abstract

Objective

Despite good clinical evidence, depot antipsychotics are only seldom prescribed to patients with first episode schizophrenia. The present study aims at investigating psychiatrists’ reasons for this reservation.

Method

We surveyed 198 psychiatrists on their attitude toward offering depot treatment to first episode patients (FEP). Participants scored the extent of influence of individual factors on their decision on a seven-point-scale, additional data on their prescription practice and estimation of the relapse risk of FEP were collected.

Results

Psychiatrists reported that only three out of 12 factors were of influence. These were the limited availability of different second generation antipsychotic depot drugs, the frequent rejection of the depot offer by the patients and the patients’ skepticism based on the lack in experience of a relapse.

Conclusions

There is actually little specific reason for not prescribing depot to FEP according to the current survey. For those factors being reported to be of influence, psychoeducation, including profound information on depot treatment, the development of additional SGA depot drugs and the standard offer of depot treatment to all FEP in a shared-decision-making may be considered.

Type
Original article
Information
European Psychiatry , Volume 26 , Issue 5 , August 2011 , pp. 297 - 301
Copyright
Copyright © Elsevier Masson SAS 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Abbreviations, FEP first episode patients, FGA first generation antipsychotics, SD standard deviation , SGA second generation antipsychotics

References

Ahn, J., McCombs, J.S., Jung, C., Croudace, T.J., McDonnell, D., scher-Svanum, H., et al.Classifying patients by antipsychotic adherence patterns using latent class analysis: characteristics of nonadherent groups in the California Medicaid (Medi-Cal) program. Value Health 2008; 11: 48–56CrossRefGoogle ScholarPubMed
Chue, P., Llorca, P.M., Duchesne, I., Leal, A., Rosillon, D., Mehnert, A.Hospitalization rates in patients during long-term treatment with long-acting risperidone injection. J Appl Res 2005; 5: 266–274Google Scholar
Ciudad, A., Alvarez, E., Bobes, J., San, L., Polavieja, P., Gilaberte, I.Remission in schizophrenia: results from a 1-year follow-up observational study. Schizophr Res 2009; 108: 214–222CrossRefGoogle ScholarPubMed
Correll, C.U., Schenk, E.M.Tardive dyskinesia and new antipsychotics. Curr Opin Psychiatry 2008; 21: 151–156CrossRefGoogle ScholarPubMed
Davis, J.M., Chen, N., Glick, I.D.A meta-analysis of the efficacy of second-generation antipsychotics. Arch Gen Psychiatry 2003; 60: 553–564CrossRefGoogle ScholarPubMed
Davis, J.M., Matalon, L., Watanabe, M.D., Blake, L., Metalon, L.Depot antipsychotic drugs. Place in therapy. Drugs 1994; 47: 741–773CrossRefGoogle ScholarPubMed
de Hert, M., van, W.R., Wampers, M., Kane, J., Van, O.J., Peuskens, J.Remission criteria for schizophrenia: evaluation in a large naturalistic cohort. Schizophr Res 2007; 92: 68–73CrossRefGoogle Scholar
Dunayevich, E., Sethuraman, G., Enerson, M., Taylor, C.C., Lin, D.Characteristics of two alternative schizophrenia remission definitions: relationship to clinical and quality of life outcomes. Schizophr Res 2006; 86: 300–308CrossRefGoogle ScholarPubMed
Eerdekens, M., Van, H.I., Remmerie, B., Mannaert, E.Pharmacokinetics and tolerability of long-acting risperidone in schizophrenia. Schizophr Res 2004; 70: 91–100CrossRefGoogle Scholar
Emsley, R., Medori, R., Koen, L., Oosthuizen, P.P., Niehaus, D.J., Rabinowitz, J.Long-acting injectable risperidone in the treatment of subjects with recent-onset psychosis: a preliminary study. J Clin Psychopharmacol 2008; 28: 210–213CrossRefGoogle ScholarPubMed
Emsley, R, Oosthuizen, P, Koen, L, Niehaus, D, Lex, A, Medori, R. Remission after a first-episode of schizophrenia: Results from a 12-month analysis of patients treated with long-acting risperidone. Poster No. 0295 presented at the IEPA 2006, Birmingham, UK, 2008.Google Scholar
Falkai, P., Wobrock, T., Lieberman, J., Glenthoj, B., Gattaz, W.F., Moller, H.J.World Federation of Societies of Biological Psychiatry (WFSBP) guidelines for biological treatment of schizophrenia, part 2: long-term treatment of schizophrenia. World J Biol Psychiatry 2006; 7: 5–40CrossRefGoogle ScholarPubMed
Gaebel, W, Falkai, P, Weinmann, S, Wobrock, T. Deutsche Gesellschaft für Psychiatrie PuNH (Hrsg) S3-Praxisleitlinien in Psychiatrie und Psychotherapie, Bd 1: Behandlungsleitlinie Schizophrenie. Steinkopff, Darmstadt, 2006.CrossRefGoogle Scholar
Hamann, J., Kolbe, G., Cohen, R., Leucht, S., Kissling, W.How do psychiatrists choose among different antipsychotics? Eur J Clin Pharmacol 2005; 61: 851–854CrossRefGoogle ScholarPubMed
Hamann, J., Leucht, S., Kissling, W.Shared decision making in psychiatry. Acta Psychiatr Scand 2003; 107: 403–409CrossRefGoogle Scholar
Helldin, L., Kane, J.M., Karilampi, U., Norlander, T., Archer, T.Remission in prognosis of functional outcome: a new dimension in the treatment of patients with psychotic disorders. Schizophr Res 2007; 93: 160–168CrossRefGoogle ScholarPubMed
Hendset, M., Molden, E., Refsum, H., Hermann, M.Impact of CYP2D6 genotype on steady-state serum concentrations of risperidone and 9-hydroxyrisperidone in patients using long-acting injectable risperidone. J Clin Psychopharmacol 2009; 29: 537–541CrossRefGoogle ScholarPubMed
Heres, S., Hamann, J., Kissling, W., Leucht, S.Attitudes of psychiatrists toward antipsychotic depot medication. J Clin Psychiatry 2006; 67: 1948–1953CrossRefGoogle ScholarPubMed
Heres, S., Hamann, J., Mendel, R., Wickelmaier, F., Pajonk, F.G., Leucht, S., et al.Identifying the profile of optimal candidates for antipsychotic depot therapy. A cluster analysis. Prog Neuropsychopharmacol Biol Psychiatry 2008; 32: 1987–1993CrossRefGoogle ScholarPubMed
Heres, S., Schmitz, F.S., Leucht, S., Pajonk, F.G.The attitude of patients towards antipsychotic depot treatment. Int Clin Psychopharmacol 2007; 22: 275–282CrossRefGoogle ScholarPubMed
Kane, J.M., Aguglia, E., Altamura, A.C., Ayuso Gutierrez, J.L., Brunello, N., Fleischhacker, W.W., et al.Guidelines for depot antipsychotic treatment in schizophrenia. European Neuropsychopharmacology Consensus Conference in Siena, Italy. Eur Neuropsychopharmacol 1998; 8: 55–66CrossRefGoogle ScholarPubMed
Lambert, M., Schimmelmann, B.G., Naber, D., Schacht, A., Karow, A., Wagner, T., et al.Prediction of remission as a combination of symptomatic and functional remission and adequate subjective well-being in 2960 patients with schizophrenia. J Clin Psychiatry 2006; 67: 1690–1697CrossRefGoogle ScholarPubMed
Lauriello, J, Lambert, T, Andersen, S, Lin, D, Taylor, CC, McDonnell, D. An 8-week, double-blind, randomized, placebo-controlled study of olanzapine long-acting injection in acutely ill patients with schizophrenia. J Clin Psychiatry 2008:69(5):790–9.CrossRefGoogle Scholar
Lehman, A.F., Lieberman, J.A., Dixon, L.B., McGlashan, T.H., Miller, A.L., Perkins, D.O., et al.Practice guideline for the treatment of patients with schizophrenia, second edition. Am J Psychiatry 2004; 161: 1–56Google ScholarPubMed
Leucht, S., Corves, C., Arbter, D., Engel, R.R., Li, C., Davis, J.M.Second-generation versus first-generation antipsychotic drugs for schizophrenia: a meta-analysis. Lancet 2009; 373: 31–41CrossRefGoogle ScholarPubMed
Medori, R, Wapenaar, R, de Rosario, A, Rouillon, F, Gaebel, W, Cordes, J et al. Relapse prevention and effectiveness in schizophrenia with risperidone long-acting injectable (RLAI) versus quetiapine. Poster presented at the 116th Annual Convention of the APA, Boston 2008.Google Scholar
Mentschel, C LSKJ. Depot-drugs may reduce relapse rates in schizophrenic outpatients: a meta-analysis. Presented at the 156th meeting of the American Psychiatric Association, San Francisco 2003; Abstract book, p. 71.Google Scholar
Nasrallah, H.A.The case for long-acting antipsychotic agents in the post-CATIE era. Acta Psychiatr Scand 2007; 115: 260–267CrossRefGoogle ScholarPubMed
Patel, M.X., David, A.S.Why aren’t depot antipsychotics prescribed more often and what can be done about it? Adv Psychiatric Treat 2005; 11: 203–213CrossRefGoogle Scholar
Patel, MX, Haddad, PM, Chaudry, HR, McLoughlin, S, Husain, N, David, AS. Psychiatrists’ use, knowledge and attitudes to first- and second-generation antipsychotic long-acting injections: comparisons over 5 years. J Psychopharmacol 2009 [Epub ahead of print].CrossRefGoogle Scholar
Patel, M.X., Nikolaou, V., David, A.S.Psychiatrists’ attitudes to maintenance medication for patients with schizophrenia. Psychol Med 2003; 33: 83–89CrossRefGoogle ScholarPubMed
Rummel-Kluge, C., Kissling, W.Psychoeducation in schizophrenia: new developments and approaches in the field. Curr Opin Psychiatry 2008; 21: 168–172CrossRefGoogle ScholarPubMed
San, L., Ciudad, A., Alvarez, E., Bobes, J., Gilaberte, I.Symptomatic remission and social/vocational functioning in outpatients with schizophrenia: prevalence and associations in a cross-sectional study. Eur Psychiatry 2007; 22: 490–498CrossRefGoogle ScholarPubMed
Sim, K., Su, A., Ungvari, G.S., Fujii, S., Yang, S.Y., Chong, M.Y., et al.Depot antipsychotic use in schizophrenia: an East Asian perspective. Hum Psychopharmacol 2004; 19: 103–109CrossRefGoogle ScholarPubMed
Simpson, G.M., Mahmoud, R.A., Lasser, R.A., Kujawa, M., Bossie, C.A., Turkoz, I., et al.A 1-year double-blind study of 2 doses of long-acting risperidone in stable patients with schizophrenia or schizoaffective disorder. J Clin Psychiatry 2006; 67: 1194–1203CrossRefGoogle ScholarPubMed
Taylor, D.Psychopharmacology and adverse effects of antipsychotic long-acting injections: a review. Br J Psychiatry 2009; 195: s13–s19CrossRefGoogle Scholar
Tiihonen, J., Walhbeck, K., Lonnqvist, J., Klaukka, T., Ioannidis, J.P., Volavka, J., et al.Effectiveness of antipsychotic treatments in a nationwide cohort of patients in community care after first hospitalisation due to schizophrenia and schizoaffective disorder: observational follow-up study. BMJ 333 2006 224CrossRefGoogle Scholar
Zygmunt, A., Olfson, M., Boyer, C.A., Mechanic, D.Interventions to improve medication adherence in schizophrenia. Am J Psychiatry 2002; 159: 1653–1664CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.