A systematic review and meta-analysis of the effect of depot antipsychotic frequency on compliance and outcome

Kisely, Steve, Sawyer, Emily, Robinson, Gail and Siskind, Dan (2015) A systematic review and meta-analysis of the effect of depot antipsychotic frequency on compliance and outcome. Schizophrenia Research, 166 1-3: 178-186. doi:10.1016/j.schres.2015.04.028

Author Kisely, Steve
Sawyer, Emily
Robinson, Gail
Siskind, Dan
Title A systematic review and meta-analysis of the effect of depot antipsychotic frequency on compliance and outcome
Journal name Schizophrenia Research   Check publisher's open access policy
ISSN 1573-2509
Publication date 2015-02-05
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.schres.2015.04.028
Open Access Status Not yet assessed
Volume 166
Issue 1-3
Start page 178
End page 186
Total pages 9
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Language eng
Formatted abstract
Background: Depot antipsychotics are commonly used to improve adherence and clinical outcomes such as relapse and readmission. Dosing regimens vary but are commonly two- and four-weekly. To date, the effect of administration at two-weekly or four-weekly intervals on outcome has not been examined in a meta-analysis.

Aims: A systematic review and meta-analysis on whether the frequency of depot antipsychotic administration (e.g., two- vs four-weekly) makes any difference to compliance and outcome.

Methods: A systematic search of Medline, EMBASE and PsycInfo for RCTs that compared the frequency of depot administration (e.g., two- vs four-weekly) for an equivalent dose. Outcomes were compliance, psychiatric symptomatology, quality of life, adverse drug reactions (ADRs), patient preference, admission rates, bed-days and costs.

Results: Seven studies from eight papers (n = 3994) were found covering olanzapine, paliperidone, risperidone, haloperidol and fluphenazine enanthate/decanoate with follow-up of up to one year. Meta-analyses were possible for psychotic symptoms and ADRs. There were no differences in psychotic symptoms or quality of life between two- and four-weekly doses. Health service use was not reported. For ADRs, the only significant difference detected was that two-weekly injections were less likely to lead to site pain (RR 0.16, 95% CI 0.07–0.38; 2 studies n = 1667). There were no differences in other ADRs.

Conclusions: There were surprisingly little data on the effect of dosing frequency for an equivalent dose on clinical outcomes. There is a need for long-term studies of a wide range of outcomes including cost-effectiveness. Claims for advantages of new preparations over others require careful evaluation.
Keyword Depot antipsychotic
Dosing frequency
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Medicine Publications
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