Kane JM, Schooler NR, Marcy P, Correll CU, Achtyes ED, Gibbons RD, Robinson DG. Effect of Long-Acting Injectable Antipsychotics vs Usual Care on Time to First Hospitalization in Early-Phase Schizophrenia: A Randomized Clinical Trial. JAMA Psychiatry. 2020 Dec 1;77(12):1217-1224. doi: 10.1001/jamapsychiatry.2020.2076. Erratum in: JAMA Psychiatry. 2020 Dec 1;77(12):1310. PMID: 32667636; PMCID: PMC7364341.

Effect of Long-Acting Injectable Antipsychotics vs Usual Care on Time to First Hospitalization in Early-Phase Schizophrenia

Previous research has shown that over 1/3 of patients admitted for their first hospitalization with schizophrenia stopped taking their antipsychotic within 30 days of discharge and over 1/2 discontinued their antipsychotics within 60 days of discharge. The authors here address the need for interventions to enhance adherence for patients with early-phase schizophrenia. Long-acting injectable (LAI) antipsychotics have been considered usually for patients with repeated hospitalizations/relapses. Therefore, this study aimed to focus on how long-acting injectable antipsychotic may help those in early phase schizophrenia before the potential frequent hospitalizations begin. This was a cluster randomized clinical trial of 489 participants. All were diagnosed with schizophrenia and were considered to be in the early phase of their condition. One group received LAI aripiprazole, monthly (234). The other group received standard care, with or without oral antipsychotics (255).  These patients were followed for 2 years. The primary outcome was time to first psychiatric hospitalization. The mean survival time until first hospitalization was 613.7 days for monthly aripiprazole injection participants and 530.6 days for standard care participants. The LAI aripiprazole option was associated with a 36% decrease in rate for total hospitalizations, but the difference was not statistically significant. In the injectable group, number needed to treat to prevent 1 hospitalization was 7. Therefore, this delay in time to hospitalization suggests that long-acting injectable antipsychotic use in patients with early phase schizophrenia may be beneficial to patients and economically useful.

Effect of Long-Acting Injectable Antips…alization in Early-Phase Schizophrenia (1)