Risperidon und Olanzapin in Depotformulierung – Effekte und spezifische Nebenwirkungen

Bisher standen in Deutschland fast ausschließlich typische Neuroleptika in Depotform zur Verfügung. Seit 2002 ist in Deutschland und Europa mit Risperidon in Depotform (Risperdal® Consta®) das erste atypische Neuroleptikum in Depotformulierung erhältlich. Die Zulassung eines weiteren langwirksamen atypischen Neuroleptikums (Olanzapin long–acting Injection, OLAI) ist nun ebenfalls erteilt. Erste Langzeitdaten stellte Holland C. Detke et al. auf dem 26^th Collegium Internationale Neuro–Psychopharmacologicum (CINP) im Juli 2008 in München vor. Eine Übersichtsarbeit zu Wirksamkeit und Sicherheit von OLAI ist vor Kurzem im International Journal of Clinical Practice erschienen. Direkte Vergleichsdaten zwischen den Substanzen stehen noch aus. Angesichts der grundsätzlichen Bedeutung langwirksamer Injektionsformen von atypischen Neuroleptika ist jedoch eine frühe Betrachtung der beiden Substanzen in Depotformulierung schon jetzt wichtig. Vergleicht man die Ergebnisse unter OLAI mit den vorliegenden Ergebnissen unter Risperidon in Depotform, ist eine erste vorsichtig vergleichende Abschätzung sowohl hinsichtlich Wirksamkeit als auch Verträglichkeit und spezifischer Nebenwirkungen durchaus möglich.

Until recently, long–acting injectable formulations of antipsychotics have been available in Germany only for older, conventional treatments. Since 2002, the only approved long–acting injection developed for an atypical antipsychotic has been long–acting risperidone (Risperdal® Consta®). The approval of another long–acting atypical antipsychotic (olanzapine long–acting injection, OLAI) is now also granted. First long–term data were presented by Detke C. Holland et al. on the 26^th Collegium Internationale Neuro–Psychopharmacologicum (CINP) in July 2008 in Munich. A review on efficacy and safety of OLAI has recently been published in the International Journal of Clinical Practice. Direct comparison data between the two drugs are missing. Given the fundamental importance of long–acting injection forms of atypical antipsychotics, however, an early consideration of the two substances in depot formulation is already important. Results under OLAI and long–acting risperidone allow a first careful comparative assessment with regard to both efficacy and tolerability and specific possible side effects.

Key words

long–acting injectable risperidone - olanzapine long–acting injection - side effects - remission - relapse - schizophrenia

Literatur

• 1 Altamura AC, Bobo WV, Meltzer HY.. Factors affecting outcome in schizophrenia and their relevance for psychopharmacological treatment.  Int Clin Psychopharmacol. 2007;  22 249-267
• 2 Schooler NR.. Relapse prevention and recovery in the treatment of schizophrenia.  J Clin Psychiatry. 2006;  67 19-23
• 3 Haro JM, Novick D, Suarez D. et al. . Remission and relapse in the outpatient care of schizophrenia: three–year results the Schizophrenia Outpatient Health Outcomes study.  J Clin Psychopharmacol. 2006;  26 571-578
• 4 Llorca PM.. Partial compliance in schizophrenia and the impact on patient outcomes.  Psychiatry Res. 2008;  161 235-247
• 5 Kane JM.. Review of treatments that can ameliorate nonadherence in patients with schizophrenia.  J Clin Psychiatry. 2006;  67 9-14
• 6 Adams CE, Fenton MKP, Quraishi S, David AS.. Systematic meta–review of depot antipsychotic drugs for people with schizophrenia.  Br J Psychiatry. 2001;  179 290-299
• 7 Hogarty GE, Schooler NR, Ulrich R, Mussare F, Ferro P, Herron E.. Fluphenazine and social therapy in the aftercare of schizophrenic patients. Relapse analyses of a two–year controlled study of fluphenazine decanoate and fluphenazine hydrochloride.  Arch Gen Psychiatry. 1979;  36 1283-1294
• 8 Medori R. et al. .Relapse Prevention And Effectiveness in Schizophrenia with Risperidone Long–acting Injectable (RLAI) Versus Quetiapine. Poster präsentiert auf dem 161. Jahrestreffen der American Psychiatric Association (APA) in Washington, DC, USA, 2008. Abstract NR 4-094
• 9 Citrome L.. Olanzapine pamoate: a stick in time?. Int J Clin Pract [Epub ahead of print]
• 10 Detke HC. et al. .160–week Interim Results From an Open–Label Extension Trial of Olanzapine Long–Acting Injection. Poster präsentiert auf dem 26th Collegium Internationale Neuro–Psychopharmacologicum (CINP) in München, 2008. Abstract P– 02-77
• 11 Detke HC. et al. .Olanzapine Long–Acting Injection for the Maintenance Treatment of Schizophrenia: A 24–Week, Randomized, Double–Blind Trial. Poster präsentiert auf dem 26th Collegium Internationale Neuro–Psychopharmacologicum (CINP) in München, 2008. Abstract P– 02-78
• 12 Möller HJ, Llorca PM, Sacchetti E. et al. . Efficacy and safety of direct transition to risperidone long–acting injectable in patients treated with various antipsychotic treatments.  Int Clin Psychopharmacol. 2005;  20 121-130
• 13 Citrome L, Yeomans D.. Do guidelines for severe mental illness promote physical health and well–being?.  J Psychopharmacol. 2005;  19 102-109
• 14 Gulliver A. et al. .Comparison of metabolic parameters during treatment for schizophrenia with olanzapine intramuscular long–acting injection versus olanzapine oral formulation. Poster präsentiert auf dem 26th Collegium Internationale Neuro–Psychopharmacologicum (CINP) in München, 2008. Abstract 88
• 15 Möller HJ.. Long–acting risperidone: focus on safety.  Clin Ther. 2006;  28 633-651
• 16 Gulliver A. et al. .Injection–related adverse events observed with olanzapine long–acting injection. Poster präsentiert auf dem 26th Collegium Internationale Neuro–Psychopharmacologicum (CINP) in München, 2008. Abstract 81
• 17 Nisbet AC.. Intramuscular gluteal injections in the increasingly obese population: retrospective study.  BMJ . 2006;  332 637-638
• 18 Ning X, Thyssen A, Quiroz J. et al. .Tolerability and safety of long–acting injectable risperidone in chronic schizophrenia subjects using deltoid muscle as an alternative injection site. Poster präsentiert auf dem 161st Annual American Psychiatric Association Annual Meeting; 3.–8. Mai 2008 in Washington, DC, USA. 
• 19 Thyssen A, Ning X, Herben V. et al. .Pharmacokinetics of long–acting injectable risperidone injected in deltoid muscle compared to gluteal muscle in subjects with schizophrenia. Poster präsentiert auf dem 161st Annual American Psychiatric Association Annual Meeting; 3.–8. Mai 2008 in Washington, DC, USA. 

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