Examining long-acting injectable antipsychotic (depot) medication in the elderly: a 5-year retrospective cross-sectional study evaluating depot use in an Australian psychogeriatric service

Abstract

Objective: The primary aim was to examine the use of long-acting injectable (LAI) antipsychotic (depot) medication in a cohort of older patients in a community psychogeriatric service. Method: From 2014 to 2018, all patients who were on LAIs each year were analysed for various characteristics including their profile, type of LAI used, dose and relapse rates related to switching, ceasing and community treatment order (CTO) use. Results: A total of 880 patients were managed by the service with 142 recorded cases of LAI use in total over the 5 years (16.1%). Second-generation antipsychotics (SGAs) outnumbered first-generation antipsychotics (FGAs) by 2:1, with a trend of increasing use of SGA LAIs. The most commonly used LAI was Paliperidone monthly injection (PP1M) (50.7%). Lower than usual adult chlorpromazine equivalent daily doses of LAIs were used. The relapse rate while on a LAI was 13.4%. Moreover, 54.9% of the patients on LAIs were on a CTO. Relapse rates were lower on LAIs in combination with a CTO (7.7%). Conclusions: LAIs, especially the SGAs, are increasingly used in our service. In combination with a CTO, LAIs are an effective treatment in reducing relapse rates in the elderly.