Naturalistic, retrospective comparison between second-generation antipsychotics and depot neuroleptics in patients affected by schizophrenia.
OBJECTIVE
Data in the literature comparing second-generation antipsychotics (SGAs) and depot neuroleptics are scarce. The aim of this retrospective, naturalistic study is to examine the relative effectiveness of SGAs and depot neuroleptics in 2 matched groups of patients affected by schizophrenia.


METHODS
Between July 2004 and September 2004, we collected data from 2 groups of 30 DSM-IV-TR schizophrenia outpatients, matched for a number of demographic and clinical characteristics, who received a 2-year treatment with depot neuroleptics or SGAs. Treatments were compared through the Clinical Global Impressions-Severity of Illness scale (CGI-S), performed on several symptom domains of schizophrenia. Other outcomes included 1-and 2-year readmission rates, the number of self-injuries during the treatment period, and anticholinergic drug prescription, considered as an index of extrapyramidal symptoms.


RESULTS
Treatment with both drug classes produced broadly comparable clinical effects. Clinician-assessed effectiveness was similar for SGA and depot recipients, with significant decreases over baseline in all CGI-S symptom domain scores. The percentages of patients readmitted during the follow-up period were similar among drug groups. After 1 year, 6 SGA patients (20%) were readmitted compared with 7 depot patients (23%); after 2 years, 9 SGA patients (30%) were rehospitalized compared with 11 depot patients (37%). Also, no between-group differences were detected with respect to the number of self-injuries. Anticholinergic drug prescription was significantly less common in SGA patients compared with depot recipients (p = .0112).


CONCLUSIONS
These findings confirm at least equal long-term effectiveness of depot neuroleptics and SGAs, but a possible advantage for SGAs in decreased use of anticholinergic drugs.
Marchiaro
Livio
L
Department of Mental Health Turin 1 South, University of Turin, Via Cherasco 11, 10126 Turin, Italy.
Rocca
Paola
P
LeNoci
Ferdinando
F
Longo
Pierpaolo
P
Montemagni
Cristiana
C
Rigazzi
Cristiana
C
Bogetto
Filippo
F
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D001480:Basal Ganglia Diseases / Q000139:chemically induced / Q000517:prevention & control; D018680:Cholinergic Antagonists / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D010359:Patient Readmission; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D016728:Self-Injurious Behavior / Q000175:diagnosis; D012720:Severity of Illness Index; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D018680:Cholinergic Antagonists; D003692:Delayed-Action Preparations