New approaches to antipsychotic medication adherence–safety, tolerability and acceptability

Sharon Taub*, Amir Krivoy, Eromona Whiskey, Sukhi S. Shergill

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Antipsychotic pharmacotherapy is considered a first-line treatment in schizophrenia-related disorders and is associated with favorable prognosis and lower mortality rates. However, low adherence rates present a major clinical challenge. In this paper, we will review contemporary approaches to improve adherence to antipsychotic treatment, considering their mechanism of action, safety, tolerability and acceptability. Areas covered: Novel pharmacological delivery methods included different routes of administration of registered medications (such as intramuscular clozapine preparation and transdermal asenapine), modifications of existing compounds (such as 3-monthly injectable formulation of paliperidone palmitate), and increased interest in oral long-acting medication formulations (such as with penfluridol). In addition, we reviewed innovative technology to monitor adherence, based on the use of electronic digital medicine systems and ingestible sensors. Expert opinion: All of these diverse approaches were clinically relevant in enhancing treatment adherence and found to be safe and tolerable. The place of each approach is predicated on a personalized approach in each patient, and future research could usefully use large comparative studies to establish robust treatment guidelines. The implementation of new and varied approaches to antipsychotic treatment adherence is welcomed and have the potential to make a significant impact on morbidity in this often difficult-to-treat population.

Original languageEnglish
Pages (from-to)517-524
Number of pages8
JournalExpert Opinion on Drug Safety
Volume21
Issue number4
DOIs
StatePublished - 2022

Keywords

  • Schizophrenia
  • adherence
  • asenapine
  • clozapine
  • intramuscular
  • paliperidone palmitate
  • penfluridol
  • transdermal

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