Long-acting Injection No Better than Oral Antipsychotic

Rob Wipond
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A study of 5-year outcomes for people taking either an ordinary oral antipsychotic or a long-acting injection of an antipsychotic found no differences between the two. In both groups, over 80% of the participants discontinued use of the drugs, mainly citing bad side effects and lack of efficacy.

Researchers from the School of Pharmacy and Pharmaceutical Sciences at Cardiff University in the UK followed nearly 200 patients at the beginning of the study who were taking either risperidone long-acting injection (RLAI) or aripiprazole. In the fifth year, there were only 50 who had not yet discontinued and were available for follow-up.

“Fifteen patients from each group were continuers at 5 years,” they wrote. “Of these, four receiving RLAI and three receiving aripiprazole were coprescribed other antipsychotics at study endpoint. Reasons for discontinuation of RLAI and aripiprazole respectively were lack of effect (n = 4; n = 4), adverse effects (n = 3; n = 1), noncompliance or patient choice (n = 2; n = 4) and patient death (n = 2; n = 0).”

“There was no significant difference between the proportions of patients continuing RLAI or aripiprazole for 5 years,” the researchers concluded. “Continuation rates were relatively low (18% and 16% of the original RLAI and aripiprazole cohorts respectively), whilst coprescription of other antipsychotics at endpoint was relatively common. Lack of effectiveness was the most common reason for discontinuation of both compounds. These findings suggested that clinical effectiveness was somewhat disappointing…”

Deslandes, Paul Nicholas, Matthew Dwivedi, and Robert D. E. Sewell. “Five-Year Patient Outcomes with Risperidone Long-Acting Injection or Oral Aripiprazole.” Therapeutic Advances in Psychopharmacology, April 30, 2015, 2045125315581997. doi:10.1177/2045125315581997. (Abstract)

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Rob Wipond
Rob Wipond is a freelance journalist who writes frequently on the interfaces between psychiatry, civil rights, the justice system, and social change. His articles have been nominated for three Canadian National Magazine Awards, nine Western Magazine Awards, and five Webster Awards for journalism. He is currently working on a book about people's experiences of forced psychiatric treatment, and can be contacted through his website.

7 COMMENTS

  1. Wow! So despite all the claims that people are just going off their meds because they “feel better and don’t think they need them any more,” apparently as many stopped by DYING as stopped by “patient choice.” The main reasons, as I’ve always said, are lack of effectiveness and intolerable side effects. Good to have this in black and white to help counter the claims that “if these poor people would just stay on their meds, everything will be better.”

    —- Steve

    • The drug withdrawal induced super sensitivity manic psychosis is definitely a problem, especially since the psychiatrists almost always misdiagnose it as one of their scientifically invalid DSM “mental illnesses.”

      “These findings suggested that clinical effectiveness was somewhat disappointing…” Perhaps 80% of people go off the antipsychotics because forcing people to take drugs that are known to cause the positive and negative “schizophrenia” symptoms isn’t the best way to help people?

      “neuroleptics … may result in … the anticholinergic intoxication syndrome … Central symptoms may include memory loss, disorientation, incoherence, hallucinations, psychosis, delirium, hyperactivity, twitching or jerking movements, stereotypy, and seizures.”

      “Neuroleptic induced deficit syndrome is principally characterized by the same symptoms that constitute the negative symptoms of schizophrenia—emotional blunting, apathy, hypobulia, difficulty in thinking, difficulty or total inability in concentrating, attention deficits, and desocialization. This can easily lead to misdiagnosis and mistreatment. Instead of decreasing the antipsychotic, the doctor may increase their dose to try to “improve” what he perceives to be negative symptoms of schizophrenia, rather than antipsychotic side effects.”

  2. Rob thanks, get radical. I know “radical” seems not to be respected, but really, who does one want to be respected by, or tolerated.
    I honestly can’t figure out why they don’t do these studies within the psychiatric community?
    After all, the drugs are supposed to help with delusions, delusions of grandiosity etc etc.
    Perhaps the forced injections would have to be used for the non compliance issues.

    Ugh, these studies are so pathetically inhumane. Just give the drugs already and quit looking at other people like little experimental animals.
    It must be getting old and VERY embarrassing.

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