Types of drug therapies

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There are two main types of drugs available for the treatment of schizophrenia: oral drugs and injections.

What are the advantages of these two types of therapies?

Oral drugs	Long-acting injections
Easy to use	Can reduce the risk of relapse¹⁶
Conventional	Long lasting effect
Seems familiar	It allows thinking about the disease and the therapy only four times a year, monthly or every two weeks
It creates the feeling of independence and control	Less conflicts with relatives related to verifying whether the patient took the drugs or not
	Regular contacts with the doctor

What are the disadvantages of these two types of therapies?

Oral drugs	Injections
The patient has to think of taking the drug every day	Possible pain and swelling at the injection site
The patient may forget to take the drug	If there is any side effect, which require switching therapies, this could take longer
The patient is at higher risk of deterioration and hospitalization compared to long-action injections²⁶

References

1. APA Clinical Guidelines. American Psychiatric Association. Practice guidelines for the treatment of patients with schizophrenia. 2004
2. Falkai P et al. World J Biol Psychiatry 2005; 6: 132-191.
3. Kendler KS et al. Arch Gen Psychiatry 1996; 53: 1022-1031.
4. World Health Organization. The World Health Report: 2001: Mental health: new understanding, new hope.
5. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th Edition Text Revision (DSM-IV-TR). Arlington: American Psychiatric Publishing Inc. 2000.
6. Lieberman JA et al. J Clin Psychiatry 1996; 57(suppl 9): 5-9.
7. Breier A et al. Am J Psychiatry 1994; 151: 20-26.
8. Robinson DG et al. Am J Psychiatry 1999; 156: 544-549.
9. National Institute for Clinical Excellence. National Clinical Practice Guidelines Number 82.
10. Howard R et al. Am J Psychiatry 2000; 157: 172-178.
11. Angermeyer MC et al. Schizophr Bull 1990; 16: 293-307.
12. Murray RM and Fearon P. J Psychiatr Res 1999; 33: 497-499.
13. Lang UE et al. Cell Physiol Biochem 2007; 20: 687-702.
14. Harrigan SM et al. Psychol Med 2003; 33: 97-110.
15. Bottlender R et al. Schizophr Res 2003; 62: 37-44.
16. Lynn Starr h. et al: Comparison of long-acting and oral antipsychotic treatment effects in patients with schizophrenia, comorbid substance abuse, and a history of recent incarceration: An exploratory analysis of the PRIDE study; Schizophr Res. 2018 Apr;194:39-46. doi: 10.1016/j.schres.2017.05.005. Epub 2017 Jun 7
17. Awad AG et al. Pharmacoeconomics 2008; 26: 149-162.
18. Keith SJ et al. Psychiatr Serv 2004; 55: 997-1005.
19. Lieberman JA et al. Pharmacol Rev 2008; 60: 358-403.
20. Tandon R et al. Psychoneuroendocrinology 2003; 28(suppl 1): 9-26.
21. Wyatt RJ. Schizophr Bull 1991; 17: 325–351
22. Robinson DG et al. Arch Gen Psychiatry 1999; 56: 241-247.
23. Weiden PJ et al. Psychiatr Serv 2004; 55: 886-891.
24. Koen L et al. Psychosomatics 2007; 48: 128-134.
25. Novick D et al. Psychiatry Res 2010; 176: 109-113.
26. Kozma CM et al. Changes in schizophrenia-related hospitalization and ER use among patients receiving paliperidone palmitate. Current Medical Research and Opinion. 2011.27;1603-1611

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Types of drug therapies

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