To evaluate the comparative prognosis impact of long acting injectable (LAI) risperidone versus adherence therapy added to oral antipsychotics in chronic schizophrenia.

A group of 30 patients, mean age 38.3, diagnosed with chronic schizophrenia, were admitted in our hospital for acute psychotic episodes related mainly to the insufficient adherence. Patients were either maintained on their prior atypical antipsychotic (n = 14) and adherence enhancement psychotherapy was added or they were switched on risperidone LAI (n = 16). We monitored the evolution of these subjects for 6 months using Positive and Negative Syndrome Scale (PANSS), Clinical Global Impressions (CGI-I/S), Global Assessment of Functioning (GAF), as well as patient and caregiver logs for the drug administration and quality of life.

Patients responded better to the risperidone LAI, as PANSS decreased with 42.2 points at week 24, compared to only 34.3 in the combined antipsychotic/psychotherapy group (p < 0.05). CGI-S decreased with 3.4 points (versus 2.3 in the combined approach group, p < 0.05) and GAF increased with 35.9 points (compared to 28.7, p < 0.05). The percentage of missed doses decreased with 65% in the risperidone LAI group and with only 42% in the combined approach group (p < 0.01), compared to pre-baseline values. The perceived quality of life was constantly evaluated as better by patients and caregivers in the injectable risperidone group.

Risperidone LAI is a useful strategy for adherence enhancement in patients treated previously with oral atypical antipsychotics, with psychotic relapses due to non-adherence and it increases the patients life quality.