title: Risperidone long-acting injection in the treatment of schizophrenia spectrum illnesses: A retrospective chart review of 19 patients in the Vancouver Community Mental Health Organization (Vancouver, Canada).
abstract: BACKGROUND
  Schizophrenia is a chronic debilitating disease that affects ~110,000 Canadians (0.55% lifetime prevalence). Risperidone long-acting injection (RLAI) is the first injectable, long-acting, atypical antipsychotic drug marketed in Canada.
  
  
  OBJECTIVE
  The aim of this study was to assess the clinical effectiveness and hospitalization rates of patients with schizophrenia, schizoaffective disorder, or schizophreniform disorder treated with RLAI in a community mental health care setting.
  
  
  METHODS
  Data were collected between August 1, 2006 and September 30, 2006 via a retrospective chart review of outpatients diagnosed with schizophrenia, schizoaffective disorder, or schizophreniform disorder who received treatment from 1 of the 8 mental health teams within the Vancouver Community Mental Health Organization (VCMHO) in Vancouver, British Columbia, Canada. Collected data included: frequency and duration of institutional care, discharge and relapse rates, demographic variables, diagnosis history, RLAI medication history, and history of other medications. The overall severity of symptoms before and after RLAI treatment and the improvement in symptoms during treatment were evaluated using the Clinical Global Impression Scales for severity (CGI-S)(1 = not ill to 7 = extremely ill) and improvement (CGI-I)(1 = very much improved to 7 = very much worse).
  
  
  RESULTS
  Forty-four patients were identified as having received RLAI. The charts of 19 patients (10 men, 9 women; mean [SD] age at time of chart audit, 36.7 [11.7] years; mean [SD] age at primary diagnosis, 23.6 [7.4] years; race: white, 10 [52.6%]; Asian, 6 [31.6%]; American Indian, 1 [5.3%]; black, 1 [5.3%]; other, 1 [5.3%]) were included in the analysis. The majority of patients (78%) had been treated with another antipsychotic drug prior to treatment with RLAI: risperidone (77%), quetiapine (47%), zuclopenthixol (43%), olanzapine (43%), and loxapine (17%). Mean (SD) CGI-S Scale score declined significantly from 5.29 (1.3) before treatment initiation to 3.05 (1.0) posttreatment (P < 0.001). Mean (SD) CGI-I Scale score was 2.58 (0.71) (P < 0.001); 94% of patients had a CGI-I score ≤3. Mean (SD) duration of hospitalization decreased significantly from 15.7 (19.7) days before treatment to 2.4 (6.0) days after treatment (P < 0.05). Mean (SD) number of hospializations also decreased significantly from 2.0 (1.8) before treatment to 0.5 (1.3) after treatment (P < 0.01).
  
  
  CONCLUSIONS
  The results of this pilot study suggest that use of the atypical-antipsychotic medication RLAI significantly decreased duration and rates of hospitalization, compared with baseline, in these VCMHO patients with schizophrenia spectrum illnesses.
authors.affiliation: University of British Columbia,Vancouver, British Columbia, Canada; Department of Psychiatry, Vancouver General Hospital, Vancouver, British Columbia, Canada; University of British Columbia Hospital, Vancouver, British Columbia, Canada; Adult Mental Health Services, Vancouver Community Mental Health Services, Vancouver, British Columbia, Canada; Riverview Hospital, Cross Cultural Psychiatry Program, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Soma
authors.initials: S
authors.lastname: Ganesan
authors.affiliation: Department of Psychiatry, Vancouver General Hospital, Vancouver, British Columbia, Canada.
authors.forename: Mario
authors.initials: M
authors.lastname: McKenna
authors.affiliation: Division of Research, Riverview Hospital, Port Coquitlam, British Columbia, Canada ; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Ric M
authors.initials: RM
authors.lastname: Procyshyn
authors.affiliation: University of Bristish Columbia, Vancouver, british Columbia, Canada; Adult Mental Health Services, Vancouver Community Mental Health Services, Vancouver, British Columbia, Canada; Department of Psychiatry, Richmond Hospital, Richmond, British Columbia, Canada; Community Mental Health and Addictions, Richmond Health Services, Richmond, British Columbia, Canada.
authors.forename: Sheldon
authors.initials: S
authors.lastname: Zipursky
keywords: atypical antipsychotics; hospitalization; relapse; risperidone long-acting injection; schizophrenia