ABSTRACT
Background: Paliperidone palmitate 6-monthly (PP6M) is the first long-acting antipsychotic injectable (LAI) to allow for only two medication administrations per year, though there is presently limited insight into its effectiveness and potential added value in real clinical practice conditions. Objectives: To present our ongoing study and draw its preliminary data on patient characteristics initiating PP6M and adherence during the first year of treatment. Methods: The paliperidone 2 per year (P2Y) study is a 4-year, multicentre, prospective mirror-image pragmatic study taking place at over 20 different sites in Europe. The mirror period covers 2 years either side of the PP6M LAI initiation. Retrospective data for the previous 2 years are collected for each patient from the electronic health records. Prospective data are recorded at baseline, 6, 12, 18 and 24 months of drug administration and also cover information on concomitant psychiatric medication, relapses, hospital admissions, side effects, discontinuation and its reasons. Meanwhile, here we present preliminary data from the P2Y study at basal and 6-month period (first and second PP6M administration). Results: At the point of PP6M initiation, the most frequent diagnosis was schizophrenia (69%), the clinical global impression scale mean score was 3.5 (moderately markedly ill) and the rate of previous hospital admissions per patient and year was 0.21. PP6M was initiated after a median of 3-4 years on previous treatment: 146 (73%) from paliperidone palmitate 3-monthly, 37 (19%) from paliperidone palmitate 1-monthly and 17 (9%) from other antipsychotics. The mean dose of the first PP6M was 1098.9 mg. The retention rate at 6 months and 1 year of treatment on PP6M in our cohort was 94%. Conclusion: Patient and clinician preference for LAIs with longer dosing intervals was the main reason for PP6M initiation/switching resulting in high treatment persistence. Future data are needed to evaluate the full impact of PP6M in clinical practice.
ABSTRACT
Objetivo: Exponer a través de un caso clínico el uso de tiaprida para la desintoxicación de alcohol en un paciente con diagnóstico de trastorno por consumo de alcohol grave 303.90 (F10.20).Caso clínicoUna mujer de 50 años, en seguimiento en la Unidad de Conductas Adictivas desde septiembre de 2016 hasta la actualidad, con diagnósticos de trastorno de adaptación 309.4 (F43.25) con alteración mixta de las emociones o de la conducta, trastorno por consumo de alcohol grave 303.90 (F10.20) y descompensación maniforme, al cual se le instaura el tratamiento con tiaprida.ResultadosLos estudios consultados demuestran la eficacia y seguridad de tiapride para el síndrome de abstinencia a alcohol tanto en ámbito ambulatorio como hospitalario, en monoterapia o en politerapia con benzodiacepinas y/o antiepilépticos, siendo usado también en la agitación y/o la sintomatología psicótica.ConclusionesSe ha observado que en el síndrome de abstinencia a alcohol la tiaprida es eficaz, pudiendo incluso tenerlo en cuenta como tratamiento coadyuvante a benzodiacepinas o anticonvulsivantes. Con vistas a futuro, se deberían tener en cuenta la farmacogenética que afectan al trastorno por consumo de alcohol, con lo que se podría beneficiar de menores efectos adversos una terapia personalizada individualizada. (AU)
Objective: Present a clinical case report on the use of tiapride for alcohol detoxification in a patient with a diagnosis of severe alcohol use disorder 303.90 (F10.20).Clinical case report50 year-old female, under follow-up in the Addictive Behavior Unit from September 2016 to present, with diagnoses of adjustment disorder 309.4 (F43.25)Mixed disturbance of emotions or behavior, severe alcohol use disorder 303.90 (F10.20) and severe decompensation, who is treated with tiapride.ResultsThe studies consulted demonstrate the efficacy and safety of tiapride for alcohol withdrawal syndrome in both outpatient and inpatient settings, in monotherapy or in polytherapy with benzodiazepines and/or antiepileptics, being also used in agitation and/or psychotic symptomatology.ConclusionsIn alcohol withdrawal syndrome, tiapride has been found to be effective and can even be considered as an adjunctive treatment to benzodiazepines or anticonvulsants. With a view to the future, pharmacogenetics affecting alcohol use disorder should be taken into account, so that individualized personalized therapy could benefit from fewer adverse effects. (AU)
Subject(s)
Humans , Female , Middle Aged , Tiapride Hydrochloride/pharmacology , Tiapride Hydrochloride/therapeutic use , Alcoholism/diagnosis , Alcoholism/drug therapy , Alcoholism/pathology , Alcoholism/therapyABSTRACT
Objetivo: Exponer a través de un caso clínico el uso de tiapride para la desintoxicación de alcohol en un paciente con diagnóstico de trastorno por el uso de alcohol.Caso clínicoUna mujer de 50 años, en seguimiento en la Unidad de Conductas Adictivas desde septiembre de 2016 hasta la actualidad, con diagnósticos de trastorno de adaptación con alteración mixta de las emociones, trastorno por consumo de alcohol y descompensación maniforme, ante lo cual se le instaura el tratamiento con tiapride.ResultadosLos estudios consultados demuestran la eficacia y seguridad de tiapride para el síndrome de abstinencia al alcohol, tanto en el ámbito ambulatorio como hospitalario, en monoterapia o en politerapia con benzodiacepinas y/o antiepilépticos, siendo usado también en la agitación y/o sintomatología psicótica.ConclusionesEn el síndrome de abstinencia al alcohol se ha observado que el tiapride es eficaz, pudiendo incluso tenerlo en cuenta como un tratamiento coadyuvante a las benzodiacepinas o los anticonvulsivantes. Con vistas al futuro, se deberían tener en cuenta la farmacogenética que afecta al trastorno por consumo de alcohol, con lo que se podría beneficiar, con menores efectos adversos, a una terapia personalizada individualizada. (AU)
Objective: To present a case report on the use of tiapride for alcohol detoxification in a patient diagnosed with alcohol use disorder.Clinical caseA 50-year-old woman, under follow-up in the Addictive Behaviour Unit from September 2016 to date, with a diagnosis of adjustment disorder with mixed emotional disturbance, alcohol use disorder and mood decompensation, for which treatment with tiapride was initiated.ResultsThe studies consulted demonstrate the efficacy and safety of tiapride for alcohol withdrawal syndrome, in both outpatient and inpatient settings, in monotherapy or in polytherapy with benzodiazepines and/or antiepileptics, and used for agitation and/or psychotic symptoms.ConclusionsTiapride has been found to be effective in alcohol withdrawal syndrome and could even be considered adjunctive treatment to benzodiazepines or anticonvulsants. Looking to the future, pharmacogenetics affecting alcohol use disorder should be considered, and this could result in tailored, personalised therapy, with fewer adverse effects. (AU)
