Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-29T20:21:23.823Z Has data issue: false hasContentIssue false

Assessing the infrequent oral supplementation of olanzapine long-acting injection in the treatment of schizophrenia

Published online by Cambridge University Press:  16 April 2020

H. Ascher-Svanum*
Affiliation:
Lilly Corporate Center, DC 4133, Eli Lilly and Company, Indianapolis, IN 46285, USA
X. Peng
Affiliation:
Lilly Corporate Center, DC 4133, Eli Lilly and Company, Indianapolis, IN 46285, USA
W. Montgomery
Affiliation:
Eli Lilly Australia Pty Ltd, 112, Wharf Road, West Ryde NSW 2114, Australia
D.E. Faries
Affiliation:
Eli Lilly and Company, Lilly Corporate Center, Drop Code 5024, Indianapolis, IN 46285, USA
A.H. Lawson
Affiliation:
Lilly Corporate Center, DC 4133, Eli Lilly and Company, Indianapolis, IN 46285, USA
M.M. Witte
Affiliation:
Lilly USA, LLC, Lilly Corporate Center, DC 4133, Indianapolis, IN 46285, USA
D. Novick
Affiliation:
Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH, United Kingdom
N. Jemiai
Affiliation:
Eli Lilly and Company Limited, Lilly Research Centre, Erl Wood Manor, Sunninghill Road, Windlesham, Surrey, GU20 6PH, United Kingdom
E. Perrin
Affiliation:
Eli Lilly and Company Limited, 13, rue Pagès, 92158 Suresnes cedex France
D.P. McDonnell
Affiliation:
Eli Lilly and Company Limited, Cork ELCL, DC 6158, United Kingdom
*
*Corresponding author. Tel.: +317-277-8713; Fax: +317-276-7100. E-mail address: [email protected] (H. Ascher-Svanum).
Get access

Abstract

Objective

Adding another antipsychotic to a treatment regimen was previously used in evaluating the medication's efficacy. Supplementation of depot antipsychotics with oral antipsychotics is particularly meaningful because depot formulations are typically chosen for patients struggling with adherence to oral antipsychotics. This post-hoc analysis assessed supplementation of olanzapine long-acting injection (olanzapine-LAI) with oral olanzapine.

Subjects and methods

We used 12 months of data from an open-label, single-arm extension study of patients with schizophrenia or schizoaffective disorder (N = 931) treated with olanzapine-LAI. The prevalence, duration, time to first supplementation, and best predictors of oral supplementation were assessed.

Results

Oral supplementation occurred in 21% of patients for a median of 31 days with mean modal dose of 10.8 mg/day. Mean time to first supplementation was shorter for patients who were at least moderately ill at baseline compared to less ill patients (47 vs. 97 days, p < 0.001). Best predictors of oral supplementation included a more severe illness profile at baseline, lower olanzapine-LAI dose prior to oral supplementation, supervised living arrangements, and being African-American.

Conclusion

Supplementation of olanzapine-LAI appears to be infrequent, of relatively short duration, and reserved for more severely ill patients who may require a targeted rescue medication due to signs of impending relapse.

Type
Original article
Copyright
Copyright © Elsevier Masson SAS 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ascher-Svanum, H.Faries, D.E.Zhu, B.Ernst, F.R.Swartz, M.S.Swanson, J.W.Medication adherence and long-term functional outcomes in the treatment of schizophrenia in usual care. J Clin Psychiatry 2006; 67: 453460CrossRefGoogle ScholarPubMed
Barnes, T.R.Curson, D.A.Liddle, P.F.Patel, M.The nature and prevalence of depression in chronic schizophrenic in-patients. Br J Psychiatry 1989; 154: 486491CrossRefGoogle ScholarPubMed
Cramer, J.A.Rosenheck, R.Compliance with medication regimens for mental and physical disorders. Psychiatr Serv 1998; 49: 196201CrossRefGoogle ScholarPubMed
Citrome, L.Patient perspectives in the development and use of long-acting antipsychotics in schizophrenia: focus on olanzapine long-acting injection. Patient Prefer Adherence 2009; 3: 345355CrossRefGoogle ScholarPubMed
Davis, J.M.Matalon, L.Watanabe, M.D.Blake, L.Depot antipsychotic drugs. Place in therapy. Drugs 1994; 47: 741773CrossRefGoogle ScholarPubMed
Detke, H.C.McDonnell, D.Kane, J.Naber, D.Sethuraman, G.Lin, D.Olanzapine long-acting injection for the maintenance treatment of schizophrenia: a 24-week, randomized, double-blind trial. Schizophr Res 1021-3 (Suppl. 2)2008 262263CrossRefGoogle Scholar
Ereshefsky, L.Mascarenas, C.A.Comparison of the effects of different routes of antipsychotic administration on pharmacokinetics and pharmacodynamics. J Clin Psychiatry 2003; 64(Suppl. 16): 1823Google ScholarPubMed
Gilmer, T.P.Dolder, C.R.Lacro, J.P.Folsom, D.P.Lindamer, L.Garcia, P., et al.Adherence to treatment with antipsychotic medication and health care costs among Medicaid beneficiaries with schizophrenia. Am J Psychiatry 2004; 161: 692699CrossRefGoogle ScholarPubMed
Guy, W.ECDEU Assessment manual for psychopharmacology 338 Washington, DC: US Department of Health, Education, and Welfare; 1976.p. 218–22Google Scholar
Guy, W.ECDEU Assessment manual for psychopharmacology 338 Washington, DC: US Department of Health, Education, and Welfare; 1976.p. 534–37Google Scholar
Heinrichs, D.W.Hanlon, T.E.Carpenter, W.T. Jr.The Quality of Life Scale: an instrument for rating the schizophrenic deficit syndrome. Schizophr Bull 1984; 10: 388398CrossRefGoogle ScholarPubMed
Kalali, A.Patient satisfaction with, and acceptability of, atypical antipsychotics. Curr Med Res Opin 1999; 15: 135137CrossRefGoogle ScholarPubMed
Kane, J.M.Aguglia, E.Altamura, A.C.Ayuso Gutierrez, J.L.Brunello, N.Fleischhacker, W.W., et al.Guidelines for depot antipsychotic treatment in schizophrenia. European Neuropsychopharmacology Consensus Conference in Siena, Italy. Eur Neuropsychopharmacol 1998; 8: 5566CrossRefGoogle ScholarPubMed
Kane, J.M.Eerdekens, M.Lindenmayer, J.P.Keith, S.J.Lesem, M.Karcher, K.Long-acting injectable risperidone: efficacy and safety of the first long-acting atypical antipsychotic. Am J Psychiatry 2003; 160: 11251132CrossRefGoogle ScholarPubMed
Kay, S.R.Fiszbein, A.Opler, L.A.The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13: 261276CrossRefGoogle Scholar
Lauriello, J.Lambert, T.Andersen, S.Lin, D.Taylor, C.C.McDonnell, D.An 8-week, double-blind, randomized, placebo-controlled study of olanzapine long-acting injection in acutely ill patients with schizophrenia. J Clin Psychiatry 2008; 69: 790799CrossRefGoogle ScholarPubMed
Law, M.R.Soumerai, S.B.Ross-Degnan, D.Adams, A.S.A longitudinal study of medication nonadherence and hospitalization risk in schizophrenia. J Clin Psychiatry 2008; 69: 4753CrossRefGoogle Scholar
Lehman, A.F.Lieberman, J.A.Dixon, L.B.McGlashan, T.H.Miller, A.L.Perkins, D.O., et al.American Psychiatric Association (APA). Practice Guideline for the treatment of patients with schizophrenia, 2nd Ed. Am J Psychiatry 2004; 161(9): 17171718Google Scholar
Lieberman, J.A.Stroup, T.S.McEvoy, J.P.Swartz, M.S.Rosenheck, R.A.Perkins, D.O., et al.Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N Engl J Med 2005; 353: 12091223CrossRefGoogle ScholarPubMed
Leucht, S.Kane, J.M.Kissling, W.Hamann, J.Etschel, E.Engel, R.R.What does the PANSS mean? Schizophr Res 2005; 79: 231238CrossRefGoogle ScholarPubMed
Lindenmayer, J.P.Eerdekens, E.Berry, S.A.Eerdekens, M.Safety and efficacy of long-acting risperidone in schizophrenia: a 12-week, multicenter, open-label study in stable patients switched from typical and atypical oral antipsychotics. J Clin Psychiatry 2004; 65: 10841089CrossRefGoogle ScholarPubMed
Lindenmayer, J.P.Khan, A.Eerdekens, M.Van Hove, I.Kushner, S.Long-term safety and tolerability of long-acting injectable risperidone in patients with schizophrenia or schizoaffective disorder. Eur Neuropsychopharmacol 2007; 17: 138144CrossRefGoogle ScholarPubMed
McDonnell, D.P.Andersen, S.W.Detke, H.C.Watson, S.B.160-week interim results from an open-label extension trial of olanzapine long-acting injection. Int J Neuropsychopharmacol 11Suppl. 12008 151Google Scholar
McEvoy, J.P.Risks versus benefits of different types of long-acting injectable antipsychotics. J Clin Psychiatry 2006; 67(Suppl. 5): 1518Google ScholarPubMed
Naber, D.Moritz, S.Lambert, M.Pajonk, F.G.Holzbach, R.Mass, R., et al.Improvement of schizophrenic patients’ subjective well-being under atypical antipsychotic drugs. Schizophr Res 2001; 50: 7988CrossRefGoogle ScholarPubMed
Olfson, M.Marcus, S.C.Ascher-Svanum, H.Treatment of schizophrenia with long-acting fluphenazine, haloperidol, or risperidone. Schizophr Bull 2007; 33: 13791387CrossRefGoogle ScholarPubMed
Schooler, N.R.Keith, S.J.Severe, J.B.Matthews, S.M.Bellack, A.S.Glick, I.D., et al.Relapse and rehospitalization during maintenance treatment of schizophrenia. The effects of dose reduction and family treatment. Arch Gen Psychiatry 1997; 54: 453463CrossRefGoogle ScholarPubMed
Simpson, G.M.Angus, J.W.A rating scale for extrapyramidal side effects. Acta Psychiatr Scand Suppl 1970; 212: 1119CrossRefGoogle ScholarPubMed
Sun, S.X.Liu, G.G.Christensen, D.B.Fu, A.Z.Review and analysis of hospitalization costs associated with antipsychotic nonadherence in the treatment of schizophrenia in the United States. Curr Med Res Opin 2007; 23: 23052312CrossRefGoogle ScholarPubMed
Valenstein, M.Copeland, L.A.Blow, F.C.McCarthy, J.F.Zeber, J.E.Gillon, L., et al.Pharmacy data identify poorly adherent patients with schizophrenia at increased risk for admission. Med Care 2002; 40: 630639CrossRefGoogle ScholarPubMed
Ware, J.E. Jr.Sherbourne, C.D.The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473483CrossRefGoogle ScholarPubMed
Weiden, P.J.Kozma, C.Grogg, A.Locklear, J.Partial compliance and risk of rehospitalization among California Medicaid patients with schizophrenia. Psychiatr Serv 2004; 55: 886891CrossRefGoogle ScholarPubMed
West, J.C.Marcus, S.C.Wilk, J.Countis, L.M.Regier, D.A.Olfson, M.Use of depot antipsychotic medications for medication nonadherence in schizophrenia. Schizophr Bull 2008; 34: 9951001CrossRefGoogle Scholar
Submit a response

Comments

No Comments have been published for this article.