The role of long-acting risperidone in antipsychotic polypharmacy: Retrospective study in a brief hospitalization unit

Introduction:Despite the use of antipsychotics as monotherapy is considered to be the standard treatment for schizophrenia and other psychotic disorders, many studies prove that antipsychotic polypharmacy (AP) is more frequent than expected in accordance to the experts' guidelines.Objective:To analyze the prescription of long-acting risperidone (LAR) for schizophrenic patients discharged after being admitted in our BHU and its relationship with the AP.Material and methods:This retrospective study reviews the antipsychotics prescribed to those discharged patients diagnosed as schizophrenic who were admitted in our BHU during 2005. A total of 209 patients are included. The data are analyzed in relation to the prescription of antipsychotics for discharged patients on LAR and the antipsychotic combinations for those patients discharged on another antipsychotic regime, both as a complementary treatment and to cover the LAR therapeutic window.Results:57 patients (27%) were discharged on LAR. 42% were treated with benzodiazepines, 56% with anticholinergics and 16% with mood stabilizers. 79% of patients treated with LAR were discharged with another antipsychotic in combination: oral risperidone (58%), followed by amisulpiride (18%). Similar dosages were used in patients discharged only on LAR and those used in patients prescribed with more than one antipsychotic (p>0.05).Conclusions:LAR could be an efficient strategy both to enable the treatment compliance and to achieve a monotherapy treatment. Despite LAR is frequently combined with another antipsychotic, in most cases oral risperidone is used, consequently avoiding the use of two antipsychotics of different kind in the same patient.