olanzapine and fluphenazine-depot

Topics: Adult; Antipsychotic Agents; Appetite; Benzodiazepines; Blood Glucose; Chronic Disease; Delayed-Action Preparations; Female; Fluphenazine; Humans; Insulin; Insulin Resistance; Male; Olanzapine; Reference Values; Risperidone; Schizophrenia; Weight Gain

Medication nonadherence has been associated with persistence of psychotic symptoms, relapse, and hospitalization in patients with schizophrenia. Patients with untreated psychosis are significantly less likely to achieve remission, whereas antipsychotic drug adherence has been associated with recovery. As such, adherence to antipsychotic drug treatment is a key issue for nurses and treatment team members caring for patients who typically are on chronic, progressive disease course. Long-acting injectable (LAI) anti-psychotic drugs, developed to improve adherence and provide and alternative antipsychotic drug treatment fro schizophrenia, have been associated with improved treatment outcomes including reduction of relapse rates approximately 30% and reduction in hospitalizations. However, LAI antipsychotic drugs remain underutilized in the United States despite a growing body of literature supporting positive outcomes of LAI versus oral antipsychotic drugs. Mental health nurses are in a key position to support improved adherence inpatients with schizophrenia through use of practical educational strategies that help patients, family members, and health care providers better understand and manage treatment.

Topics: Antipsychotic Agents; Benzodiazepines; Delayed-Action Preparations; Fluphenazine; Haloperidol; Humans; Injections; Isoxazoles; Medication Adherence; Olanzapine; Paliperidone Palmitate; Palmitates; Risperidone; Schizophrenia

The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of consultations involving the management of psychoses. In this analysis we have included schizophrenia, affective disorders/bipolar, organic psychoses, and senile psychoses, with undefined psychosis and chronic brain syndrome grouped as 'other'. This synopsis provides a backdrop against which the theme articles in this issue of Australian Family Physician can be further considered.

Topics: Adolescent; Adult; Age Factors; Aged; Antimanic Agents; Antipsychotic Agents; Australia; Benzodiazepines; Directive Counseling; Female; Fluphenazine; Humans; Lithium Carbonate; Male; Middle Aged; Olanzapine; Psychotic Disorders; Referral and Consultation; Sex Factors

Decreasing hospital admissions is important for improving outcomes for people with schizophrenia. Second-generation antipsychotics (SGAs) are better tolerated for long-term therapy than traditional medications and may contribute to a lower rehospitalization risk, but have not been compared to depot forms with regard to long-term outcomes. This study evaluates the risk of readmission in patients discharged from six State of Maryland inpatient mental health facilities between Jan. 1, 1997 and Dec. 31, 1997 on clozapine (N = 41), risperidone (N = 149), and olanzapine (N = 103). These patients were compared with those discharged from the two largest state facilities during the same time period on fluphenazine decanoate (N = 59) or haloperidol decanoate (N = 59). One-year readmission risk (measured by Kaplan-Meier survival analysis with Holm's adjustment for multiple comparison on Log Rank tests) were 10% for clozapine, 12% for risperidone, and 13% for olanzapine. These risks were not significantly lower than the readmission risk for fluphenazine decanoate (21%) but were significantly lower than haloperidol decanoate (35%) for all three SGAs. Demographic and clinical variables did not predict readmission for any of the medications. In patients with similar demographic and clinical characteristics, 1-year risk of readmission for patients treated with SGAs were at least comparable to the 1-year risk for patients receiving fluphenazine decanoate and lower than the risk for patients treated with haloperidol decanoate. SGAs may provide better long-term prognoses and outcomes for patients with schizophrenia.

Topics: Adult; Antipsychotic Agents; Benzodiazepines; Clozapine; Data Collection; Delayed-Action Preparations; Female; Fluphenazine; Haloperidol; Humans; Male; Olanzapine; Patient Readmission; Pirenzepine; Risperidone; Schizophrenia; Secondary Prevention; Time Factors; Treatment Outcome