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Psychiatr Serv 58:482-488, April 2007
doi: 10.1176/appi.ps.58.4.482
© 2007 American Psychiatric Association
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Article

Characteristics and Use Patterns of Patients Taking First-Generation Depot Antipsychotics or Oral Antipsychotics for Schizophrenia

Lizheng Shi, Ph.D., Haya Ascher-Svanum, Ph.D., Baojin Zhu, Ph.D., Douglas Faries, Ph.D., William Montgomery, B.Pharm. and Stephen R. Marder, M.D.

OBJECTIVE: Investigators compared patient characteristics and antipsychotic use patterns between individuals with schizophrenia treated in usual care with first-generation depot antipsychotics and those treated with oral antipsychotics (first- or second-generation or both). METHODS: Analyses used data from the U.S. Schizophrenia Care and Assessment Program, a large, prospective study of treatment for schizophrenia conducted July 1997 through September 2003. Participants were assessed at enrollment and every six months thereafter with patient self-report, validated psychiatric measures, and systematic extraction of medical records. Individuals treated with a first-generation depot antipsychotic at any time during the three-year study (N=569) were compared with those treated with only oral antipsychotics (N=1,617) on characteristics at enrollment and medication use pattern during the year after enrollment. RESULTS: Compared with patients receiving only oral antipsychotics, participants treated with depot medications (haloperidol or fluphenazine decanoate) were more likely to be African American (p<.001); less likely to be a veteran (p=.005); had more psychiatric hospitalizations in the year before enrollment (p<.001); and were more likely to have been arrested (p<.001), to use alcohol and illicit substances (p<.001), and to show higher psychopathology, particularly psychotic symptoms and disorganized thinking (p<.01 for both). In the year after enrollment, participants treated with depot medications had a high mean medication possession ratio (91%), and most of the medication regimens (68%) were augmented with oral antipsychotics for prolonged durations (median of 144 days). CONCLUSIONS: Patients with schizophrenia treated with first-generation depot antipsychotics differed from those treated with only oral antipsychotics. Findings suggest that first-generation depot antipsychotics might address some unmet needs of a unique subgroup of patients with schizophrenia.


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April 2007: This Month's Highlights
Psychiatr Serv 2007 58: 441. [Full Text] [PDF]



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Home page
Schizophr BullHome page
M. Olfson, S. C. Marcus, and H. Ascher-Svanum
Treatment of Schizophrenia With Long-Acting Fluphenazine, Haloperidol, or Risperidone
Schizophr Bull, November 1, 2007; 33(6): 1379 - 1387.
[Abstract] [Full Text] [PDF]




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