For people with schizophrenia hospitalized after a psychotic episode, getting a long-acting antipsychotic injection works far better than pills to keep them from returning to hospital care.
That’s the finding of a new study from researchers at Rutgers University in New Brunswick, N.J.
They found that injected antipsychotic meds — which provide continuous treatment from two weeks up to six months — were 75% more effective in reducing rehospitalization, compared to the same meds in pill form.
“I suspect the lower readmission rate that has been observed with long-acting injections has more to do with people forgetting to take a pill each and every day than with any inherent superiority of the injectable medication,” noted study lead author Dr. Daniel Greer, a clinical assistant professor at the Rutgers Ernest Mario School of Pharmacy.
The findings were published recently in the Journal of Clinical Psychopharmacology.
As Greer’s team noted, expert guidance already recommends that people with schizophrenia receive long-acting antipsychotics by injection upon discharge from a hospital, rather than pills.
But many patients, whether due to needle fears or cost issues, may still opt for pills.
That’s a real problem, Greer said, because “other studies on the use of antipsychotic medication have found that roughly three-fourths of patients do not take oral medications exactly as directed.”
Conversely, “it’s much easier to get a shot every few months than it is to take a pill every day, even though the shot requires a trip to the doctor,” he added in a Rutgers news release.
In the new study, Greer’s team tracked 30-day hospital readmission rates for 343 patients with schizophrenia or schizoaffective disorder discharged from a single hospital.
Of that group, 240 opted for antipsychotic meds in pill form while the other 103 received a long-acting injection upon discharge.
At the 30-day mark, only 1.9% of those who got the injection found themselves back in the hospital, compared to 8.3% who had been given pills, according to the study.
The researchers noted that the 30-day window is clinically important, because research has shown that if symptoms of schizophrenia are successfully suppressed for a month, the odds of symptoms returning decline significantly going forward.
One ongoing issue, however, is cost. Injections typically cost more than pills, so many insurers have balked at covering them.
However, that’s slowly changing as insurers begin to realize the longer-term savings.
“The cost of the injections is far lower than the cost of hospital treatments,” Greer noted. “And each additional visit to the hospital increases the odds that there will be more visits in the future. Every time someone experiences psychosis, they lose gray matter and they suffer damage that never heals. That’s why it’s so vital to minimize psychotic episodes.”
Find out more about schizophrenia and its treatments at the Mayo Clinic.
SOURCE: Rutgers University, news release, Jan. 30, 2024
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