Systematic meta-review of depot antipsychotic drugs for people with schizophrenia

Background Long-acting depot antipsychotic medication is a widely used treatment for schizophrenia. Aims To synthesise relevant systematic Cochrane reviews. Method The Cochrane Database was searched and summary data were extracted from randomised controlled clinical trials of depots. Results Standard dose depot v. placebo resulted in significantly less relapse but more movement disorders. Those on depots (v. oral drugs) showed more global change on one outcome measure; relapse and adverse effects showed no difference. Comparisons showed no convincing advantages for one depot over another. Conclusions Depot antipsychotics are safe and effective. They may confer a small benefit over oral drugs on global outcome. Those for whom depots are most indicated may not be represented. Large studies are required to discern differences in relapse rates and long-term adverse effects, and data on satisfaction, quality of life and economics. Declaration of interest Funded by the NHS Health Technology Assessment programme. A.S.D. is participating in a trial funded by Janssen-Cilag and has been an advisor for them. The Cochrane Schizophrenia Group has received funding from pharmaceutical companies, the NHS and Department of Health.