Abstract
Background
It has been recently suggested that second-generation antipsychotic long-acting injection (SGA-LAIs) are underutilized in clinical practice, despite that their costs significantly impact on national health system budgets. Hence, an updated analysis of safety data shown by SGA-LAIs may contribute to clarify their role in clinical practice.
Materials and methods
English-language, peer-reviewed articles reporting updated, primary findings on the SGA-LAI safety were identified (updated through an electronic search of five databases – PubMed, EMBASE, PsycInfo, DARE and the Cochrane Library).
Results
The articles reviewed suggest that the most frequent treatment emergent adverse events (TEAEs) associated with aripiprazole long-acting injection (ARI-LAI) are psychotic symptoms, extrapyramidal symptoms (EPS) and weight gain. Data on olanzapine long-acting injection (OLA-LAI)-associated TEAEs highlight the risk of psychosis, metabolic disturbances and hyperprolactinemia. Four-hundred and forty cases of post-injection delirium/sedation syndrome (PDSS) have also been recorded. Although not reported in reviewed studies, the risk of impulse-control problem and drug reaction with eosinophilia and systemic symptoms (DRESS) ARI- and OLA-associated, respectively, must not be underestimated. With regards paliperidone palmitate 1-month formulation (PP1), the high incidence of clinically relevant weight gain and hyperprolactinemia are both findings of concern. Reviewed data also confirm that the leading cause of death in risperidone long-acting injection (RIS-LAI) clinical trials is suicide. The new 3-month paliperidone palmitate formulation, risperidone sustained release 1-month formulation (RIS-SR1), aripiprazole lauroxil (ARI-LXL) are still lacking exhaustive safety data.
Conclusion
The risk of specific TEAEs associated with all SGA-LAIs confirms SGA-LAIs do not offer advantages in safety compared with FGA-LAIs or oral antipsychotics and, especially, in early-phase schizophrenia patients. Implementing non pharmacological intervention and strategies can be effective for people with schizophrenia and bipolar disorder who adhere poorly to medication regimens.
Author Statement
Research funding: Authors state no funding involved.
Conflict of interest: Authors state no conflict of interest.
Informed consent: Informed consent is not applicable.
Ethical approval: The conducted research is not related to either human or animals use.
Appendix 1
Schematic of the study selection process.
[1] Heres S. Long-acting injectable antipsychotics: an underutilized treatment option. J Clin Psychiatry. 2014;75:1263–5.10.4088/JCP.14com09541Search in Google Scholar PubMed
[2] Eli Lilly. ZYPREXA RELPREVV. Highlights of prescribing information Available from: http://pi.lilly.com/us/zyprexa_relprevv.pdf. Accessed: August 7, 2015. Literature revised July 23, 2015.Search in Google Scholar
[3] Kapur S, Langlois X, Vinken P, Megens AA, De Coster R, Andrews JS. The differential effects of atypical antipsychotics on prolactin elevation are explained by their differential blood-brain disposition: a pharmacological analysis in rats. J Pharmacol Exp Ther. 2002;302:129–34.10.1124/jpet.102.035303Search in Google Scholar PubMed
[4] Keks NA, Ingham M, Khan A. Long-acting injectable risperidone v. olanzapine tablets for schizophrenia or schizoaffective disorder. Br J Psychiatry. 2007;191:131–9.10.1192/bjp.bp.105.017020Search in Google Scholar PubMed
[5] Kane JM, Sanchez R, Perry PP, Jin N, Johnson BR, Forbes RA, et al. Aripiprazole intramuscular depot as maintenance treatment in patients with schizophrenia: a 52-week, multicenter, randomized, double-blind, placebo-controlled study. J Clin Psychiatry. 2012;73:617–24.10.4088/JCP.11m07530Search in Google Scholar PubMed
[6] Gentile S. Adverse effects associated with second-generation antipsychotic long-acting injection treatment: a comprehensive, systematic review. Pharmacotherapy. 2013;33:1087–106.10.1002/phar.1313Search in Google Scholar PubMed
[7] Nasrallah HA, Gopal S, Gassmann-Mayer C, Quiroz JA, Lim P, Eerdekens M, et al. A controlled, evidence-based trial of paliperidone palmitate, a long-acting injectable antipsychotic, in schizophrenia. Neuropsychopharmacology. 2010;35:2072–82.10.1038/npp.2010.79Search in Google Scholar PubMed PubMed Central
[8] INVEGA SUSTENNA® Product Monograph – http://www.janssen.ca/product/169. Accessed: August 8, 2015.Search in Google Scholar
[9] 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;69:790–9.10.4088/JCP.v69n0512Search in Google Scholar PubMed
[10] RISPERDAL® CONSTA® PRESCRIBING INFORMATION https://www.risperdalconsta.com/sites/default/files/RisperdalConstaPI.pdf. Accessed: August 7, 2015.Search in Google Scholar
[11] Lucca JM, Ramesh M, Parthasarathi G, Ram D. Incidence and factors associated with medication nonadherence in patients with mental illness: a cross-sectional study. J Postgrad Med. 2015;61:251–6.10.4103/0022-3859.166514Search in Google Scholar PubMed PubMed Central
[12] Taylor DM, Sparshatta A, O’Hagana M, Dzahinia O. Paliperidone palmitate: factors predicting continuation with treatment at 2years. Eur J Neuropsychopharmacol. 2016;26:2011–7.10.1016/j.euroneuro.2016.09.638Search in Google Scholar PubMed
[13] Reckitt Benckiser Pharmaceuticals Inc. Multiple ascending dose study of the safety, tolerability, pharmacokinetic/efficacy. Bethesda, MD: National Library of Medicine (US). Available at: http://clinicaltrials.gov/show/ NCT01677377 2000. Accessed November 12, 2015.Search in Google Scholar
[14] Johnson & Johnson. Janssen submits new drug application to U.S. FDA for three-month paliperidone palmitate first long-acting treatment to be used four times a year for schizophrenia in adults November 19, 2014. http://www.investor.jnj.com/releasedetail.cfm?releaseid = 883843. Accessed: August 10, 2015.Search in Google Scholar
[15] Bernardo M, Bioque M. Drug profile three-month paliperidone palmitate. A new treatment option for schizophrenia. Exp Rev Clin Pharmaco. 2016;9:899–904.10.1080/17512433.2016.1191945Search in Google Scholar PubMed
[16] Berwaerts J, Liu Y, Gopal S, Nuamah I, Xu H, Savitz A, et al. Efficacy and safety of the 3-month formulation of paliperidone palmitate vs placebo for relapse prevention of schizophrenia. A randomized clinical trial. J Am Med Assoc Psychiatry. 2015;72:830–9.Search in Google Scholar
[17] Alkermes Inc. BiotechnologyEvents.Com. 2015 Alkermes’ New Drug Application for Aripiprazole Lauroxil for Treatment of Schizophrenia Accepted for Filing by U.S. FDA. http://www.biotechnologyevents.com/node/9099. Accessed: October 8, 2015.Search in Google Scholar
[18] Meltzer HY, Risinger R, Nasrallah HA, Zummo J, Corey L, Bose A, et al. A randomized, double-blind, placebo-controlled trial of aripiprazole lauroxil in acute exacerbation of schizophrenia. J Clin Psychiatry. 2015;76:1085–90.10.4088/JCP.14m09741Search in Google Scholar PubMed
[19] Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M PRISMA-P Group. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. Syst Rev. 2015;4:1 .10.1186/2046-4053-4-1Search in Google Scholar PubMed PubMed Central
[20] Guyatt GH, Oxman AD, Kunz R. GRADE guidelines: 1, Introduction-GRADE evidence profiles and summary of findings tables. J Clin Epidemiol. 2011;66:383–94.10.1016/j.jclinepi.2010.04.026Search in Google Scholar PubMed
[21] Wolters Kluver Health. UpToDate Grading Guide. Available from: http://www.uptodate.com/home/grading-guide. Accessed: October 7, 2015.Search in Google Scholar
[22] Kane JM, Sanchez R, Zhao J, Baker RA, Eramo A, McQuade RD, et al. Hospitalisation rates in patients switched from oral anti-psychotics to aripiprazole once-monthly for the management of schizophrenia. J Med Econom. 2013;6:917–25.10.3111/13696998.2013.804411Search in Google Scholar PubMed PubMed Central
[23] Fleischhacker WW, Sanchez R, Perry PP, Jin N, Peters-Strickland T, Johnson BR, et al. Aripiprazole once-monthly for treatment of schizophrenia: double-blind, randomised, non-inferiority study. Br J Psychiatry. 2014;205:135–44.10.1192/bjp.bp.113.134213Search in Google Scholar PubMed
[24] Naber D, Hansen K, Forray C, Baker RA, Sapin C, Beillat M, et al. Qualify: a randomized head-to-head study of aripiprazole once-monthly and paliperidone palmitate in the treatment of schizophrenia. Schizophr Res. 2015;168:498–504.10.1016/j.schres.2015.07.007Search in Google Scholar PubMed
[25] Ishigooka J, Nakamura J, Fujii Y, Iwata N, Kishimoto T, Iyo M, et al. ALPHA Study Group. Efficacy and safety of aripiprazole once-monthly in Asian patients with schizophrenia: a multicenter, randomized, double-blind, non-inferiority study versus oral aripiprazole. Schizophr Res. 2015;161:421–8.10.1016/j.schres.2014.12.013Search in Google Scholar PubMed
[26] Nasrallah HA, Newcomer JW, Risinger R, Du Y, Zummo J, Bose A, et al. Effect of aripiprazole lauroxil on metabolic and endocrine profiles and related safety considerations among patients with acute schizophrenia. J Clin Psychiatry. 2016;77:1519–25.10.4088/JCP.15m10467Search in Google Scholar PubMed
[27] Lewis SW, Barnes TR, Davies L, Murray RM, Dunn G, Hayhurst KP, et al. Randomized controlled trial of effect of prescription of clozapine versus other second-generation antipsychotic drugs in resistant schizophrenia. Schizophr Bull. 2006;32:715–23.10.1093/schbul/sbj067Search in Google Scholar PubMed PubMed Central
[28] Detke HC, Weiden PJ, Llorca PM, Choukour M, Watson SB, Brunner E, Ascher-Svanum H. Comparison of olanzapine long-acting injection and oral olanzapine. A 2-year, randomized, open-label study in outpatients with schizophrenia. J Clin Psychopharmacol. 2014;34:426–34.10.1097/JCP.0000000000000140Search in Google Scholar PubMed
[29] McDonnell D, Landry J, Detke HC. Long-term safety and efficacy of olanzapine long-acting injection in patients with schizophrenia or schizoaffective disorder: a 6-year, multinational, single-arm, open-label study. Int Clin Psychopharmacol. 2014;29:322–31.10.1097/YIC.0000000000000038Search in Google Scholar PubMed PubMed Central
[30] Bushe CJ, Falk D, Anand E, Asillas M, Perrin E, Chhabra-Khanna R, et al. Olanzapine long-acting injection: a review of first experiences of post-injection delirium/sedation syndrome in routine clinical practice. BMC Psychiatry. 2015;15:65.10.1186/s12888-015-0450-9Search in Google Scholar PubMed PubMed Central
[31] Sarangula SM, Mythri SV, Reddy MS. Postinjection Delirium/Sedation Syndrome with olanzapine depot injection. Ind J Psychol Med. 2016;38:366–9.10.4103/0253-7176.185946Search in Google Scholar PubMed PubMed Central
[32] Kane JM, Detke HC, Naber D, Ethuraman G, Lin DY, Bergstrom RF, et al. Olanzapine long-acting injection: a 24-week, randomized, double-blind trial of maintenance treatment in patients with schizophrenia. Am J Psychiatry. 2010;167:181–9.10.1176/appi.ajp.2009.07081221Search in Google Scholar PubMed
[33] EMEA/608654/2008. EMEA. Assessment report for Zyphadera. Accessed August 9, 2015 http://www.ema.europa.eu/docs/en_GB/document_library/EPAR__Public_assessment_report/human/000890/WC500054428.pdf.Search in Google Scholar
[34] McDonnell DP, Detke HC, Bergstrom RF, Kothare P, Johnson J, Stickelmeyer M. Post-injection delirium/sedation syndrome in patients with schizophrenia treated with olanzapine long-acting injection, II: investigations of mechanism. BMC Psychiatry. 2010;10:45.10.1186/1471-244X-10-45Search in Google Scholar PubMed PubMed Central
[35] McEvoy JP, Byerly M, Hamer RM, Dominik R, Swartz MS, Rosenheck RA, et al. Effectiveness of paliperidone palmitate vs. haloperidol decanoate for maintenance treatment of schizophrenia. A randomized clinical trial. J Am Med Assoc. 2014;311:1978–86.10.1001/jama.2014.4310Search in Google Scholar PubMed PubMed Central
[36] Si T, Zhang K, Tang J, Fang M, Li K, Zhuo J, et al. Efficacy and safety of flexibly dosed paliperidone palmitate in Chinese patients with acute schizophrenia: an open-label, single-arm, prospective, interventional study. Neuropsy Dis Treat. 2015;11:1483–92.10.2147/NDT.S81760Search in Google Scholar PubMed PubMed Central
[37] Zhang F, Si T, Chiou CF, Harris AW, Kim CY, Jahagirdar P, et al. Efficacy, safety, and impact on hospitalizations of paliperidone palmitate in recent-onset schizophrenia. Neuropsy Dis Treat. 2015;11:657–68.10.2147/NDT.S77778Search in Google Scholar PubMed PubMed Central
[38] Schreiner A, Bergmans P, Cherubin P, Keim S, Llorca PM, Cosar B, et al. Paliperidone palmitate in non-acute patients with schizophrenia previously unsuccessfully treated with risperidone long-acting therapy or frequently used conventional depot antipsychotics. J Psychopharmacol. 2015;29:910–22.10.1177/0269881115586284Search in Google Scholar PubMed PubMed Central
[39] Hargarter L, Cherubin P, Bergmans P, Keim S, Rancans E, Bez Y, et al. Intramuscular long-acting paliperidone palmitate in acute patients with schizophrenia unsuccessfully treated with oral antipsychotics. Progr NeuroPsychopharm Biol Psychiatry. 2015;58:1–7.10.1016/j.pnpbp.2014.11.006Search in Google Scholar PubMed
[40] Fu DJ, Turkoz I, Simonson B, Walling D, Schooler N, Lindenmayer JP, et al. Paliperidone palmitate once-monthly injectable reduce risk of relapse of psychotic, depressive, and manic symptoms and maintains functioning in a double-blind, randomized study of schizoaffective disorder. J Clin Psychiatry. 2015;6:263–72.Search in Google Scholar
[41] Fu DJ, Turkoz I, Simonson B, Walling D, Schooler N, Lindenmayer JP, et al. Paliperidone palmitate once-monthly injectable treatment for acute exacerbations of schizoaffective disorder. J Clin Psychopharmacol. 2016;36:372–6.10.1097/JCP.0000000000000535Search in Google Scholar PubMed PubMed Central
[42] Alphs L, Benson C, Cheshire-Kinney K, Lindenmayer JP, Mao L, Rodriguez SC, et al. Real-world outcomes of paliperidone palmitate compared to daily oral antipsychotic therapy in schizophrenia: an randomized, open-label, review-board blinded 15-month study. J Clin Psychiatry. 2015;76:554–61.10.4088/JCP.14m09584Search in Google Scholar PubMed
[43] Alphs L, Mao L, Lynn Starr H, Benson C. Pragmatic analysis comparing once-monthly paliperidone palmitate versus daily oral antipsychotic treatment in patients with schizophrenia. Schizophr Res. 2016;170:259–64.10.1016/j.schres.2015.12.012Search in Google Scholar PubMed
[44] Kim E, Correll CU, Mao L, Starr HL, Larry Alphs L. Once-monthly paliperidone palmitate compared with conventional and atypical daily oral antipsychotic treatment in patients with schizophrenia. CNS Spectrums. 2016;21:466–77.10.1017/S1092852916000444Search in Google Scholar PubMed
[45] Schreiner A, Aadamsoo K, Altamura C, Franco M, Gorwood P, Neznanov NG, et al. Paliperidone palmitate versus oral antipsychotics in recently diagnosed schizophrenia. Schizophr Res. 2015;169:393–9.10.1016/j.schres.2015.08.015Search in Google Scholar PubMed
[46] Li H, Turkoz I, Zhang F. Efficacy and safety of once-monthly injection of paliperidone palmitate in hospitalized Asian patients with acute exacerbated schizophrenia: an open-label, prospective, noncomparative study. Neuropsychiatr Dis Treat. 2016;12:15–24.Search in Google Scholar
[47] Rosso G, Pessina E, Martini A, Di Salvo G, Maina G. Paliperidone palmitate and metabolic syndrome in patients with schizophrenia. A 12-month observational prospective cohort study. J Clin Psychopharmacol. 2016;36:206–12.10.1097/JCP.0000000000000494Search in Google Scholar PubMed
[48] Ravenstijn P, Remmerie RB, Savitz A, Samtani MN, Nuamah I, Chang CT, et al. Pharmacokinetics, safety, and tolerability of paliperidone palmitate 3-month formulation in patients with schizophrenia: a Phase-1, single-dose, randomized, open-label study. J Clin Pharmacol. 2016;56:330–9.10.1002/jcph.597Search in Google Scholar PubMed
[49] Savitz AJ, Xu H, Gopal S, Nuamah I, Ravenstijn P, Janik A, et al. Efficacy and safety of paliperidone palmitate 3-month formulation for patients with schizophrenia: a randomized, multicenter, double-blind, noninferiority study. Int J Neuropsychopharmacol. 2016;19: pii: pyw01819.10.1093/ijnp/pyw018Search in Google Scholar PubMed PubMed Central
[50] Lee NY, Kim SH, Cho SJ, Chung YC, Jung IK, Kimj CY, et al. A prospective, open-label study to evaluate symptomatic remission in schizophrenia with risperidone long-acting injectable in Korea. Int Clin Psychopharmacol. 2014;29:279–87.10.1097/YIC.0000000000000030Search in Google Scholar PubMed
[51] Fernández-Miranda JJ, Caramés-García V, Sánchez-García A. Effectiveness, good tolerability, and high compliance of doses of risperidone long-acting injectable higher than 75 mg in people with severe schizophrenia. A 3-year follow-up. J Clin Psychopharmacol. 2015;35:1–5.10.1097/JCP.0000000000000400Search in Google Scholar PubMed
[52] Giraud-Baro E, Dassa D, De Vathaire F, Garay RP, Obeid J. Schizophrenia-spectrum patients treated with long-acting injectable risperidone in real-life clinical settings: functional recovery in remitted versus stable, non-remitted patients (the EVeREST prospective observational cohort study). BMC Psychiatry. 2016;16:8.10.1186/s12888-016-0712-1Search in Google Scholar PubMed PubMed Central
[53] Nasser AF, Henderson DC, Fava M, Fudala PJ, Twumasi-Ankrah P, Kouassi A, et al. Efficacy, safety, and tolerability of RBP-7000 once-monthly risperidone for the treatment of acute schizophrenia. An 8-week, randomized, double-blind, placebo-controlled, multicenter phase 3 study. J Clin Psychopharmacol 2016. 36;130–40.10.1097/JCP.0000000000000479Search in Google Scholar PubMed
[54] Hudson KL, Lauer MS, Collins FS. Toward a new era of trust and transparency in clinical trials. J Am Med Assoc. 2016;316:1353–4.10.1001/jama.2016.14668Search in Google Scholar PubMed PubMed Central
[55] FDA Safety. What is a serious adverse event? Last update: 01/10/2014. http://www.fda.gov/Safety/MedWatch/HowToReport/ucm053087.htm. Accessed January 2016.Search in Google Scholar
[56] Shirley M, Perry CM. Aripiprazole (ABILIFY MAINTENA®): a review of its use maintenance treatment for adult patients with schizophrenia. Drugs. 2014;74:1097–110.10.1007/s40265-014-0231-7Search in Google Scholar PubMed
[57] FDA Drug Safety Communication: FDA warns about new impulse-control problems associated with mental health drug aripiprazole (Abilify, Abilify Maintena, Aristada). Accessed may 12, 2016 http://www.fda.gov/Drugs/DrugSafety/ucm498662.htm.Search in Google Scholar
[58] FDA Drug Safety Communication. FDA is investigating two deaths following injection of long-acting antipsychotic Zyprexa Relprevv (olanzapine pamoate). 2013. Accessed August 14, 2015 http://www.fda.gov/Drugs/DrugSafety/ucm356971.htm.Search in Google Scholar
[59] FDA Drug Safety Communication. FDA review of study sheds light on two deaths associated with the injectable schizophrenia drug Zyprexa Relprevv (olanzapine pamoate). 2015. Accessed August 14, 2015 http://www.fda.gov/Drugs/DrugSafety/ucm439147.htm.Search in Google Scholar
[60] PHARMAFILE. FDA issues warning about rare, but serious, side effect in Lilly antipsychotic drug. http://www.pharmafile.com/news/504420/fda-issues-warning-about-rare-serious-side-effect-lilly-antipsychotic-drug. Accessed May 12, 2016.Search in Google Scholar
[61] FDA Warns of Rare but Serious Skin Reaction Reportedly Linked to Olanzapine. http://alert.psychnews.org/2016/05/fda-warns-of-rare-but-serious-skin.html. Accessed: January 30, 2016.Search in Google Scholar
[62] Nielsen J, Jensen SO, Friis RB, Valentin JB, Correll CU. Comparative effectiveness of risperidone long-acting injectable vs first-generation antipsychotic long-acting injectables in schizophrenia: Results from a nationwide, retrospective inception cohort study. Schizophr Bull. 2015;41:627–36.10.1093/schbul/sbu128Search in Google Scholar PubMed PubMed Central
[63] Suzuki H, Hibino H, Inoue Y, Takaya A. Comparison of hospitalization risk before and after changing from risperidone long-acting injection to another long-acting injection or oral antipsychotic in patients with schizophrenia: Mirror-image study. Psy Clin Neurosci. 2016;70:365–6.10.1111/pcn.12409Search in Google Scholar PubMed
[64] Sampson S, Hosalli P, Furtado VA, Davis JM. Risperidone (depot) for schizophrenia. Cochr Database Sys Rev. 2016;4:CD00416.10.1002/14651858.CD004161.pub2Search in Google Scholar PubMed
[65] Rosenheck RA, Leslie DL, Sint KJ, Lin H, Li Y, McEvoy JP, et al. Cost-effectiveness of long-acting injectable paliperidone palmitate versus haloperidol decanoate in maintenance treatment of schizophrenia. Psychiatr Serv. 2016;67:1124–30.10.1176/appi.ps.201500447Search in Google Scholar PubMed PubMed Central
[66] Marcus SC, Zummo J, Pettit AR, Stoddard J, Jalpa A, Doshi JA. Antipsychotic adherence and rehospitalization in schizophrenia patients receiving oral versus long-acting injectable antipsychotics following hospital discharge. J Manag Care Spec Pharm. 2015;21:754–68.10.18553/jmcp.2015.21.9.754Search in Google Scholar PubMed
[67] Cordiner M, Shajahan P, McAvoy S, Bashir M, Taylor M. Effectiveness of long-acting antipsychotics in clinical practice: 1. A retrospective, 18-month follow up and comparison between paliperidone palmitate, risperidone long-acting injection and zuclopenthixol decanoate. Ther Adv Psychopharmacol. 2016;6:22–32.10.1177/2045125315623168Search in Google Scholar PubMed PubMed Central
[68] Alphs L, Nasrallah HA, Bossie CA, Fu DJ, Gopal S, Hough D, et al. Factors associated with relapse in schizophrenia despite adherence to long-acting injectable antipsychotic therapy. Int Clin Psychopharmacol. 2016;31:202–9.10.1097/YIC.0000000000000125Search in Google Scholar PubMed
[69] Buckley PF, Schooler NR, Goff DC, Hsiao J, Kopelowicz A, Lauriello J, et al. the PROACTIVE Study. Comparison of SGA oral medications and a long-acting injectable SGA. The PROACTIVE Study. Schizophr Bull. 2015;41:449–59.10.1093/schbul/sbu067Search in Google Scholar PubMed PubMed Central
[70] Yu HY, Hsiao CY, Chen KC, Lee LT, Chang WH, Chi MH, et al. A comparison of the effectiveness of risperidone, haloperidol and flupentixol long-acting injections in patients with schizophrenia. A nationwide study. Schizophr Res. 2015;169:400–5.10.1016/j.schres.2015.09.006Search in Google Scholar PubMed
[71] Doshi JA, Pettit AR, Stoddard JJ, Zummo J, Marcus SC. Concurrent oral antipsychotic drug use among schizophrenia patients initiated on long-acting injectable antipsychotics post-hospital discharge. J Clin Psychopharmacol. 2015;35:442–6.10.1097/JCP.0000000000000353Search in Google Scholar PubMed
[72] Cordiner M, Shajahan P, McAvoy S, Bashir M, Taylor M. Effectiveness of long-acting antipsychotics in clinical practice: 2. Effects of antipsychotic polypharmacy on risperidone long-acting injection and zuclopenthixol decanoate. Ther Adv Psychopharmacol. 2016;6:66–76.10.1177/2045125315623584Search in Google Scholar PubMed PubMed Central
[73] Correll CU, Citrome L, Haddad PM, Lauriello J, Olfson M, Calloway SM, et al. The use of long-acting injectable antipsychotics in schizophrenia: evaluating the evidence. J Clin Psychiatry. 2016;77(Suppl. 3):1–24.10.4088/JCP.15032su1Search in Google Scholar PubMed
©2018 Walter de Gruyter GmbH, Berlin/Boston
