Are Depot Anti-psychotics Associated with Longer Persistence in Treatment Compared with Oral Antipsychotics among Patients with Schizophrenia?

Abstract

Aim: Non-adherence with antipsychotics is associated with poor outcomes in patients with schizophrenia. It was anticipated that drop-out from treatment due to non-compliance with oral anti-psychotics could be abated with the use of depot antipsychotics. However previous studies are divergent regarding the association between persistence in treatment and the use of depot antipsychotics. This study aimed to compare treatment persistence among out-patients with schizophrenia receiving depot versus oral antipsychotics in Lagos, Nigeria. Methodology: Relevant clinical data of out-patients with schizophrenia (n=160) were retrieved one year post-hospitalisation at a public psychiatric facility in Nigeria. Treatment persistence (time to all cause treatment discontinuation) among the cohort of patients was determined using the Kaplan-Meier Survival analyses. Persistence in treatment between patients receiving depot versus oral antipsychotic medications alone was compared using the log rank test. Results:  Nearly half (49.1%) of the cohort dropped out of treatment within one month of discharge, while 18.2% persisted for one year. There was no significant difference (p=0.727) in the mean duration of treatment persistence between patients receiving depot antipsychotics (17.4(±2.4) weeks), and those receiving oral medications alone (19.4 (±2.2) weeks). Conclusion: There is a high rate of drop-out from treatment among patients with schizophrenia, after discharge from in-patient care. Prescription of depot medications was not associated with longer persistence treatment in the studied cohort. This finding highlights the need to develop interventions to facilitate treatment persistence among patients with schizophrenia.