Publications (2)11.6 Total impact
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Article: Risperidone long-acting injection: a prospective 3-year analysis of its use in clinical practice.
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ABSTRACT: To evaluate outcomes of clinical use of risperidone long-acting injection (RLAI) and determine factors predicting continuation with treatment. This prospective, 3-year follow-up of consecutive patients started on treatment with RLAI in normal clinical practice between August 2002 and September 2003 obtained demographic and clinical data from case notes, prescription charts, and hospital computer records. To determine predictors of continuation, a proportional hazards regression (Cox) model was constructed. The study included 211 evaluable patients. Over 3 years, 84% of subjects discontinued RLAI; 27.7% of these switched to oral risperidone. The Cox model showed that younger age (p = .001), longer duration of illness (p = .001), inpatient status at initiation (p = .002), and an RLAI dose of 25 mg/2 weeks (p < .001) predicted greater probability of discontinuation. A small proportion of patients initiated on treatment with RLAI continued for 3 years. Outcome is likely to be improved by targeting RLAI treatment at specific patient groups and by using a dose of more than 25 mg/2 weeks.The Journal of Clinical Psychiatry 12/2008; 70(2):196-200. · 5.80 Impact Factor -
Article: Outcome following clozapine discontinuation: a retrospective analysis.
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ABSTRACT: Clozapine is uniquely effective in refractory schizophrenia, but treatment attrition is high. There has been minimal formal study of the outcomes of stopping clozapine, beyond published observations of the time period immediately after cessation. Our aim was to establish medium-term outcome in patients stopping clozapine in normal clinical practice. This study was a retrospective analysis of all subjects registered with Clozaril Patient Monitoring Service and treated in South London and Maudsley National Health Service (NHS) Trust who stopped clozapine between March 2002 and March 2005 after at least 1 year's treatment. Case note review was performed to determine relevant information for 1 year before and 1 year after discontinuation of clozapine, including subject details, reasons for stopping, and clinical outcome 1 year after discontinuation. The primary outcome measure was the Global Assessment of Functioning scale. Thirty-five patients met inclusion criteria. Twelve had died while receiving clozapine. Of those followed up for 1 year after cessation (N = 23), mean Global Assessment of Functioning scores fell by 15 points (95% CI = 6.6 to 24.3; p = .002). Days spent in hospital rose from a mean of 74.1 (SD = 137.3) to 119.8 (SD = 143.5) (p = .214). Discontinuation of clozapine has a marked negative impact on clinical status. Death is a common cause of clozapine cessation.The Journal of Clinical Psychiatry 08/2007; 68(7):1027-30. · 5.80 Impact Factor
