Relapse and Rehospitalization: Comparing Oral and Depot Antipsychotics

A review of studies that compared conventional oral and depot antipsychotic medications highlightedthe following points. Mirror-image studies in which patients served as their own controls providedevidence of substantial benefit for depot injectable medications. The randomized clinical trialsdid not, in general, support the findings of significant decrease in relapse rates between these 2 routesof administration. Across the studies reviewed, the 1-year relapse rate for long-acting depot medicationwas 27% compared with 42% for patients who received oral medication. The 27% risk of relapsein patients who received guaranteed depot medication suggests that relapse is not always driven bynoncompliance. In the only study that lasted for 2 years, the risk of relapse decreased substantially inthe depot-treated patients, suggesting that risk of noncompliance may be a more important factor inrelapse over extended periods of time. A recent formal meta-analytic review of depot medicationsconcluded that this route of administration resulted in clinical advantages in terms of global outcome.