Antipsychotic Efficacy Compared in Real-World Schizophrenia Study

Risk of rehospitalization substantially lower with long-acting injectables versus oral equivalents
Risk of rehospitalization substantially lower with long-acting injectables versus oral equivalents

(HealthDay News) — For patients with schizophrenia, clozapine and long-acting injectable antipsychotic medications are associated with the lowest risk of psychiatric rehospitalization, according to a study published online June 7 in JAMA Psychiatry.

Jari Tiihonen, M.D., Ph.D., from the Karolinska Institutet in Stockholm, and colleagues used data from prospectively gathered nationwide databases to examine the risk of rehospitalization and treatment failure among patients in Sweden with a schizophrenia diagnosis (29,823 patients in the total prevalent cohort; 4,603 in the incident cohort of newly diagnosed patients).

The researchers found that 43.7 percent of patients in the total prevalent cohort were rehospitalized during follow-up, and 71.7 percent experienced treatment failure. Compared with no use of antipsychotic medication, the risk of psychiatric rehospitalization was lowest during monotherapy with once-monthly long-acting injectable paliperidone, long-acting injectable zuclopenthixol, clozapine, long-acting injectable perphenazine, and long-acting injectable olanzapine. The highest risk of rehospitalization was seen with oral flupentixol, quetiapine, and oral perphenazine. Compared with the equivalent oral formulations, the risk of rehospitalization was substantially lower for long-acting injectable antipsychotic medications. The lowest rates of treatment failure were seen for clozapine and all long-acting injectable antipsychotic medications, compared with oral olanzapine, which was the most widely used medication.

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"Clozapine and long-acting injectable antipsychotic medications were the pharmacologic treatments with the highest rates of prevention of relapse in schizophrenia," the authors write.

Several authors disclosed financial ties to pharmaceutical companies, including Janssen-Cilag, which manufactures paliperidone and funded the study.

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