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Comparison of Injectable and Oral Antipsychotics in Relapse Rates in a Pragmatic 30-Month Schizophrenia Relapse
Peter F Buckley1, Nina R Schooler1, Donald C Goff1
1Dr. Buckley is with the Department of Psychiatry and is dean of the Medical College of Georgia Regents University, Augusta, where Dr. Looney is affiliated with the Department of Biostatistics and Epidemiology (e-mail: pbuckley@gru.edu ). Dr. Schooler is with the Department of Psychiatry and Behavioral Sciences, State University of New York Downstate Medical Center, Brooklyn. Dr. Goff is with the Department of Psychiatry, New York University Medical Center, New York City. Dr. Kopelowicz and Dr. Ames are with the Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles. Dr. Lauriello is with the Department of Psychiatry, University of Missouri, Columbia. Dr. Manschreck is with the Department of Psychiatry, Harvard Medical School, Fall River, Massachusetts. Dr. Mendelowitz is with the Department of Psychiatry and Dr. Kane is with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York. Dr. Miller is with the Department of Psychiatry Research, University of Iowa Hospital, Iowa City. Dr. Wilson is with the Department of Psychiatry, University of Florida Health Science Center, Jacksonville. Dr. Bustillo is with the Department of Psychiatry, University of New Mexico Health Sciences Center, Albuquerque.
This study found that subsequent relapse rates were similar between patients receiving long-acting injectable or oral antipsychotics. Frequent clinical contact, regardless of medication type, may help prevent relapses.
Area of Science:
- Psychiatry
- Clinical Psychology
- Pharmacology
Background:
- Schizophrenia and schizoaffective disorder require ongoing management to prevent relapse.
- Previous studies show similar first relapse rates between oral and long-acting injectable antipsychotics.
Purpose of the Study:
- To compare subsequent relapse rates in patients with schizophrenia or schizoaffective disorder who had previously relapsed.
- To investigate the impact of long-acting injectable versus oral second-generation antipsychotics on successive relapses.
Main Methods:
- Pragmatic clinical trial examining patients from the PROACTIVE study who experienced a first relapse.
- Analysis of subsequent relapse rates and time to relapse between long-acting injectable and oral antipsychotic groups.
Main Results:
- 11% of patients experienced two relapses, and 4% experienced three relapses.
- No significant difference in the rate or timing of successive relapses between the injectable and oral antipsychotic groups.
Conclusions:
- Subsequent relapse rates were low in this pragmatic trial.
- Frequent clinical contact, potentially linked to medication administration schedules, may be a key factor in relapse prevention.
- Maintaining regular patient-provider contact is a viable psychosocial relapse prevention strategy.
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IV Infusion to Oral Dosing: Conversion Methods

