BMJ  2006;333:353 (12 August), doi:10.1136/bmj.333.7563.353

Letter

What works in schizophrenia

Depot preparations may improve outcomes

The first 150 words of the full text of this article appear below.

EDITOR—The study by Tiihonen et al indicates that antipsychotics are not equally effective in treating schizophrenia.¹ After a first admission with schizophrenia, patients treated with clozapine, olanzapine, or perphenazine depot had substantially lower risks of readmission, and discontinuation of treatment for any reason, than patients treated with oral haloperidol.

Credit: BSIP, PIKO/SPL

 

The increased effectiveness of clozapine is understandable in terms of its superior efficacy in treatment resistant schizophrenia.² The increased effectiveness of perphenazine depot presumably derives from its ability to reduce non-compliance, a common problem in schizophrenia that can be overt or covert.³ In the study reported by Tiihonen et al, the less favourable outcome for oral perphenazine, in contrast to the depot preparation, supports this hypothesis.

The effectiveness of clozapine and perphenazine depot may also partly reflect the regular clinical contact and supervision that are integral to both treatments; with a depot this relates to its . . . [Full text of this article]

Bolton, Salford and Trafford Mental Health NHS Trust, Salford M30 0GT Peter.Haddad@bstmht.nhs.uk

Sheffield Care Trust, Fulwood House, Sheffield S10 3TG

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