Influence of antipsychotic treatment type and regimen on the functionality of patients with schizophrenia

Background: Enhanced functionality is a major goal in the treatment of schizophrenia. However, possible differences in the effectiveness of first-vs. second-generation antipsychotics or between depot/long-acting injectable (D/LAI) vs. D/LAI plus oral antipsychotics are not clear. Aims: This study was designed to evaluate possible differences between the effects of different antipsychotic treatment types or regimens on the functionality of patients with schizophrenia. Methods: 85 outpatients with schizophrenia, who were being treated with D/LAI antipsychotics co-administered or not with oral antipsychotics-and had been adherent to the treatment during the previous year were evaluated. Socio-demographic, clinical, treatment-related, global severity and functionality variables were evaluated. Patients were grouped according to the type of antipsychotic drug (first-vs. second-generation) or according to the co-administration (or not) of oral antipsychotics. Results: No differences were found between first- and second-generation antipsychotics in terms of global functionality. Patients treated with LAI risperidone showed better global functionality and better performance in their habitual social activities and personal social relationships than patients treated with risperidone plus oral second-generation antipsychotics. Better functionality was also found to be associated with higher education level, paranoid subtype of schizophrenia, harmful use of nicotine, adherence to oral treatment and absence of concomitant oral anticholinergic or psychopharmacological treatment. Conclusions: Our results suggest that D/LAI antipsychotic treatments should be administered in monotherapy whenever possible and that the treatment schedule should be simple, in order to achieve better functionality.