Attitudes of psychiatrists toward antipsychotic depot medication.
BACKGROUND
Since 2002, a second-generation depot antipsychotic has been available that potentially combines the advantages of depot administration and the favorable aspects of the so-called "atypical" antipsychotics. Nevertheless, long-acting injectable formulations are seldom prescribed in the treatment of schizophrenia.


METHODS
We surveyed 350 psychiatrists at an international conference as to their reasons for not prescribing a first- or second-generation depot antipsychotic for their patients diagnosed with schizophrenia or schizoaffective disorder.


RESULTS
The most important factor opposing depot prescription pertaining to both classes is a presumed sufficient compliance with oral antipsychotic treatment. First-generation depots are avoided due to the threat of extrapyramidal side effects, whereas second-generation long-acting injectable drugs are considered to be associated with high treatment costs. Less than 36% of participants' patients have ever been offered antipsychotic depot treatment.


CONCLUSIONS
Aversions to prescribing depot treatment are frequent among psychiatrists and appear to be unrelated to the antipsychotic class. The stated reasons for not prescribing depots are generally not supported by the current evidence, and further studies are urgently needed to clarify the advantages of depot treatment.
Heres
Stephan
S
Klinik und Poliklinik fuer Psychiatrie und Psychotherapie der Technischen, Universitaet Muenchen am Klinikum rechts der, Muenchen, Germany. s.heres@lrz.tum.de
Hamann
Johannes
J
Kissling
Werner
W
Leucht
Stefan
S
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage*; D001291:Attitude of Health Personnel; D003625:Data Collection; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011570:Psychiatry; D012559:Schizophrenia / Q000188:drug therapy*
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations