Depot neuroleptic therapy: an underutilized treatment option.
BACKGROUND
Depot neuroleptics are effective as long-term maintenance therapy in chronic schizophrenia and are widely used in Europe. In the United States, however, physicians have been reluctant to use them. They assume that depot neuroleptics present an increased risk of major side effects, that patients do not accept or tolerate them as well as oral agents, and that prescribing depot neuroleptics increases the possibility of medicolegal problems.


METHODS
We analyzed the published data on neuroleptic malignant syndrome, tardive dyskinesia, extrapyramidal symptoms, perceptions of depot therapy, and medicolegal concerns. Whenever possible, we used the Mantel-Haenszel test to compare the outcome of oral versus depot neuroleptic medication treatment.


RESULTS
Depot neuroleptics are not associated with an increase in any of the negative outcomes assessed.


CONCLUSIONS
Depot neuroleptics represent a valuable treatment option for many patients and merit wider use.
Department of Psychiatry, Yale University School of Medicine, New Haven, Conn.
W M
WM
Glazer
J M
JM
Kane
D000284:Administration, Oral; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001480:Basal Ganglia Diseases / Q000139:chemically induced / Q000453:epidemiology; D003692:Delayed-Action Preparations; D004409:Dyskinesia, Drug-Induced / Q000453:epidemiology / Q000209:etiology; D005555:Forensic Psychiatry; D006801:Humans; D009459:Neuroleptic Malignant Syndrome / Q000453:epidemiology / Q000209:etiology; D012559:Schizophrenia / Q000188:drug therapy; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations