title: Cross-sectional comparison of first-generation antipsychotic long-acting injections vs risperidone long-acting injection: patient-rated attitudes, satisfaction and tolerability.
abstract: OBJECTIVE
  The objective of this study was to compare patients' attitudes and satisfaction with medication and patient-rated tolerability between those prescribed a first-generation antipsychotic long-acting injection (FGA-LAI) and those prescribed risperidone long-acting injection (RLAI).
  
  
  METHODS
  A cross-sectional study of a representative sample of outpatients prescribed an FGA-LAI or RLAI for a minimum of 6 months and attending a depot clinic. Attitudes to medication were assessed by the Drug Attitude Inventory (DAI-30), tolerability was measured by the Liverpool University Neuroleptic Side Effect Rating Scale (LUNSERS) and satisfaction with antipsychotic medication was assessed by the Satisfaction with Antipsychotic Medication (SWAM) scale.
  
  
  RESULTS
  The RLAI (n = 28) and FGA-LAI (n = 39) groups did not differ in terms of mean age, sex, diagnosis and ethnicity. All individual LAIs were prescribed within British National Formulary limits. The most commonly prescribed FGA-LAI was flupentixol decanoate (n = 22). There was no significant difference between the RLAI and FGA-LAI groups in terms of mean total scores on the DAI-30, LUNSERS and SWAM or the tolerability subscales of the LUNSERS or the two subscales (treatment acceptability and medication insight) of the SWAM. In both LAI groups there was a low level of side effects (LUNSERS) and a generally positive attitude (DAI-30) and reasonable satisfaction (SWAM) with medication.
  
  
  CONCLUSIONS
  Patients treated with FGA-LAI and RLAI for at least 6 months did not differ in terms of patient-rated tolerability, attitudes and satisfaction with medication. The current design cannot determine whether differences would have been evident earlier on during treatment. These results should be regarded as preliminary and are subject to prescribing bias. Randomized studies avoid prescribing bias and are a superior way to compare specific LAIs. Ideally randomized studies should include patient-rated outcome measures including medication tolerability; assessment of side effects, efficacy and quality of life made by blinded raters; and additional objective side-effect data including changes in weight and key blood parameters.
authors.affiliation: Lancashire Care NHS Foundation Trust, Preston, UK.
authors.forename: Sourabh Moti
authors.initials: SM
authors.lastname: Singh
authors.affiliation: University of Manchester, Manchester, UK.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Haddad
authors.affiliation: University of Manchester, Manchester, UK.
authors.forename: Nusrat
authors.initials: N
authors.lastname: Husain
authors.affiliation: Lancashire Care NHS Foundation Trust, Preston, UK.
authors.forename: Eamonn
authors.initials: E
authors.lastname: Heaney
authors.affiliation: University of Manchester, Manchester, UK.
authors.forename: Barbara
authors.initials: B
authors.lastname: Tomenson
authors.affiliation: Lead Consultant Psychiatrist, Lancashire Care Early Intervention Service & Honorary Professor of Adult Psychiatry, University of Manchester, The Mount, Whalley Road, Accrington BB5 5DE, UK.
authors.forename: Imran B
authors.initials: IB
authors.lastname: Chaudhry
keywords: depot antipsychotics; patients’ attitudes; safety; satisfaction; side effects; tolerability