Second-generation long-acting injections anti-psychotics improve executive functions in patients with schizophrenia: a 12-month real-world study

Int J Psychiatry Clin Pract. 2020 Jun;24(2):201-207. doi: 10.1080/13651501.2020.1737134. Epub 2020 Mar 5.

Abstract

Background: The main purpose of this study was to assess possible modifications of cognitive performance among schizophrenia patients treated with long-acting injectable antipsychotics (LAIs) of second generation anti-psychotics (SGAs). Our hypothesis is that the shift from the oral formulation to the LAI formulation of SGAs drugs improves the cognitive performance. The secondary objective was to carry out a head to head comparison of two different SGA-LAI treatments [i.e., 1-month Paliperidone Palmitate (PP1M), monthly Aripiprazole (Ari-LAI)] in our study with an independent and real-world setting.Methods: The sample comprised 32 participants who were consecutively recruited over 12 months. Seventeen patients treated with Ari-LAI and 10 treated with PP1M completed psychopathological, neuropsychological and functional assessments. Group differences were explored through chi-squared and t-tests, as appropriate. GLM Repeated Measures were used to study variations of cognitive performance along 12 months and to test differences between drugs.Results: We found an effect of time on the outcomes investigated but this did not depend on the type of LAI used.Conclusions: In comparison with the previous oral treatment with SGAs, patients showed a significant improvement in neurocognitive function after 12 months of treatment with SGA-LAI. Furthermore, there were no differences between the SGA-LAI regimens.Key pointsThe main purpose of this study was to assess possible modification of cognitive performance of patients with Schizophrenia treated with second generation long-acting injectable antipsychotics (SGA-LAIs).The secondary objective was to carry out a head to head comparison of two different SGA-LAIs: Paliperidone Palmitate 1-Month (PP1M) and Aripiprazole Monthly (Ari-LAI).Patients showed a significant improvement in neurocognitive function after 12 months of treatment with SGA-LAI.There were no differences between the SGA-LAI regimens.From a practical point of view, switching to LAI formulation seems to produce further social and cognitive improvements in patients who had already benefitted from oral SGA therapy.

Keywords: Schizophrenia; antipsychotics; central coherence; executive functions; long-acting injectable.

Publication types

  • Clinical Study
  • Comparative Study

MeSH terms

  • Adult
  • Antipsychotic Agents / administration & dosage
  • Antipsychotic Agents / pharmacology*
  • Aripiprazole / administration & dosage
  • Aripiprazole / pharmacology*
  • Cognitive Dysfunction / drug therapy*
  • Cognitive Dysfunction / etiology
  • Delayed-Action Preparations
  • Executive Function / drug effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care*
  • Paliperidone Palmitate / administration & dosage
  • Paliperidone Palmitate / pharmacology*
  • Prospective Studies
  • Schizophrenia / complications
  • Schizophrenia / drug therapy*

Substances

  • Antipsychotic Agents
  • Delayed-Action Preparations
  • Aripiprazole
  • Paliperidone Palmitate