The authors concluded that “given that low compliance is a frequent cause of relapse in the early course of schizophrenia, more active consideration of LAI drugs should be encouraged, and patients should be informed about the different types of medications that are available during the early stages of the illness.”

A recent study of the use of a LAI antipsychotics in first-episode schizophrenia supports this contention. Viala et al. studied 25 patients over an 18-month period, using the Clinical Global Impression (CGI) scale and the Global Assessment of Function (GAF) scale to assess outcomes.1 The patients were treated with long-acting risperidone, with the first injection administered prior to discharge from the hospital, and subsequent injections administered bimonthly. In addition, patients received psychosocial interventions, consisting of day hospital, part-time therapy center, sheltered housing, protected employment, dietetic education, physical exercise, and an ongoing relationship with two nurses and a social worker.

The researchers found that “clinical improvement was coupled with a good reintegration rate and very few relapses or rehospitalizations.” They concluded that “treating with LAI antipsychotic drugs as early as possible, from the first episode if possible, can reduce relapse, number and duration of rehospitalization and cognitive symptoms and can improve the quality of life and prognosis.” 1 They noted that interactive, interdisciplinary follow-up enables patients to “progress from compliance to adherence,” and that working with family and caregivers, providing psychoeducation and other ongoing psychosocial interventions “may improve adherence and outcomes” and provide “motivational enhancement.” 1


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REFERENCES

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2.    Kane J. Improving treatment adherence in patients with schizophrenia. J Clin Psychiatry. 2011;72(9):e28.

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14. Texas Department of State Health Services. Algorithm for the treatment of schizophrenia. (2007). Available at: http://bellsouthpwp2.net/d/r/drcook/Lane/TMAP/TMAP%20Schizophrenia%20Web.pdf. Accessed: December 4, 2012.