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Antipsychotic switching in schizoaffective disorder: A systematic review

Author(s) :

Andrea MURRU, Diego HIDALGO, Miquel BERNARDO, Julio BOBES, Jerónimo SAIZ-RUIZ, Cecilio ÁLAMO5 & Eduard VIETA

Abstract :

Objectives: To systematically review the evidence about the switching of antipsychotics in SZA in acute and maintenance treatment. Methods. A systematic review following the PRISMA statement identifying studies specifically conducted on, or including, SZA patients. Results. One analysis considered uniquely a SZA population, 13 more studies including an adequate SZA subsample were considered. Most of the studies were aimed at switching antipsychotic treatments to improve toler- ability issues. Despite the absolute lack of trials specifically conducted on SZA populations, we found limited evidence on the use of aripiprazole, lurasidone, and, to a lesser extent, risperidone and ziprasidone as possible agents to substitute previous treatments whereas efficacy or, more frequently, tolerability issues arise. Evidence supports also the switch to risperidone long-acting injectable when the adherence to oral treatment may be a concern. Conclusions. Antipsychotic switching in SZA is a neglected topic that would need better profiling. Clinicians should keep in mind the receptor bind- ing characteristics of drugs in order to optimize transitions. Evidence supports the switch to aripiprazole and lurasidone, less strongly to risperidone and ziprasidone. The switch to risperidone long-acting injectable is supported, especially in patients with limited treatment adherence to oral therapy.

The World Journal of Biological Psychiatry, 2015; 1-19 - Source link

Collège Méditerranéen de Psychiatrie