RESEARCH EXPERIENCE WITH A LONG-ACTING ATYPICAL ANTIPSYCHOTIC MEDICATIONS

Samuel J. Keith, M.D., 2400 Tucker N.E., Suite 404, Albuquerque, NM 87131

Long-acting antipsychotics have the potential to improve treatment adherence, which helps to sustain symptom remission, prevent relapse, and improve level of functioning in patients with schizophrenia and related disorders. Specific treatment protocols that maximize this potential are still under investigation. The effect of different dosing strategies of fluphenazine decanoate in conjunction with family intervention was assessed in a large, multicenter, randomized, double-blind study. Acutely ill patients (N = 528) were enrolled; 313 stable patients were then randomized to receive one of two family interventions and either a continuous low dose (2.5_10 mg), standard dose (12.5_50 mg), or targeted dose (vehicle), delivered by injection every two weeks for two years. Rescue medication and relapse were more frequent with low-dose and targeted therapy, while rehospitalization was increased only with targeted therapy. There were no differences between family interventions.
The first long-acting newer antipsychotic, a microspheres formulation of risperidone, has now been evaluated in Phase III trials. Data from a 12-week study in patients with schizophrenia and schizoaffective disorder show that this formulation was effective and well tolerated. As it appears to offer the same advantages as the newer oral antipsychotics, this medication may have increased potential to improve treatment adherence and overall outcome.