summary
background People suffering from a psychotic disorder show limited compliance with the prescribed regimen of antipsychotics. Insufficient compliance and insufficient insight into their illness are important contributing factors predicting recurrence of psychotic symptoms.
aim To discuss what contribution long-acting, mainly intramuscular (depot) antipsychotics can make in reducing the chance of a psychotic relapse. Also, we suggest procedures for switching from oral to depot antipsychotics.
method The currently available depot antipsychotics in the Netherlands are compared with each other, desired and undesired treatment effects are discussed. Also, the possible role of depot antipsychotics in limiting compliance problems is discussed. Expected developments in depot antipsychotics in the near future are presented.
results A review of the literature shows that there are insufficient studies supporting an evidence-based choice for oral versus depot antipsychotics in different clinical situations. A choice for depot antipsychotics does not solve all compliance problems, but it does make them manifest.
conclusion The choice for oral or depot administration of an antipsychotic will have to be based on the patient’s particular circumstances, including the medical history and insight in his/ her illness, risks to patients and others and the personal preferences of both patient and clinician. The choice for switching to depot antipsychotics in order to reduce compliance problems needs to be part of an overall treatment plan that includes psychosocial support.