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Depot bromperidol decanoate for schizophrenia
1Academic Department of Psychiatry and Behavioural Sciences, University of Leeds, 15 Hyde Terrace, Leeds, West Yorkshire, UK, LS2 9LT. ugm0dwcw@leeds.ac.uk
The Cochrane Database of Systematic Reviews
|July 22, 2004
Summary
Bromperidol decanoate may be better than placebo for schizophrenia but less effective than other antipsychotic depots. Limited data suggests it could be a viable option when other treatments are unsuitable.
Area of Science:
- Psychiatry and Pharmacology
- Clinical Trials and Evidence-Based Medicine
Background:
- Antipsychotic medications, particularly long-acting depot injections like bromperidol decanoate, are standard treatments for schizophrenia.
- These long-acting formulations are crucial for sustained maintenance therapy in schizophrenia management.
Purpose of the Study:
- To evaluate the efficacy and safety of depot bromperidol compared to placebo, oral antipsychotics, and other depot antipsychotic preparations.
- To assess clinical, social, and economic outcomes in schizophrenia patients treated with depot bromperidol.
Main Methods:
- Systematic review of randomized controlled trials identified through extensive database searches (Biological Abstracts, Cochrane Library, EMBASE, MEDLINE, PsycLIT) and contact with manufacturers.
- Inclusion criteria focused on schizophrenia patients, comparing depot bromperidol against placebo, oral antipsychotics, or other depot preparations.
- Primary outcomes included mortality, global functioning, mental state, relapse rates, hospital admissions, adverse effects, and treatment acceptability.
Main Results:
- Limited data from four trials (n=117) suggests bromperidol decanoate may be superior to placebo but less effective than fluphenazine or haloperidol decanoate regarding relapse rates.
- No significant differences were observed in global outcomes or most adverse effects (akathisia, weight gain, tremor, anticholinergic effects, movement disorders) when compared to other depots.
- Patients on bromperidol decanoate required additional antipsychotic medication more frequently than those on fluphenazine or haloperidol decanoate, though not statistically significant.
Conclusions:
- Current evidence indicates bromperidol decanoate may be a viable treatment option for schizophrenia, especially when fluphenazine or haloperidol decanoate are not suitable.
- The available trial data is limited and poorly reported, necessitating well-conducted randomized trials to confirm these findings.
- Further research is crucial to guide clinical practice regarding the use of bromperidol decanoate in specific regions like Belgium, Germany, Italy, and the Netherlands.