Use of Depot Antipsychotic Medications for Medication Nonadherence in Schizophrenia

Objectives: To describe factors associated with initiation of depot antipsychotic medications in psychiatric outpatients with schizophrenia and recent medication nonadherence. Methods: A national sample of psychiatrists reported on adult outpatients with schizophrenia who were nonadherent with oral antipsychotic medications in the last year. Results: In total, 17.6 % of psychiatrists initiated depot an-tipsychotic injections. Initiation was significantly and pos-itively associated with public insurance, prior inpatient admission, proportion of time nonadherent, average or above average intellectual functioning, and living in a men-tal health residence. Use was inversely associated with us-ing second-generation antipsychotics and other oral psychotropic medications prior to medication nonadher-ence. Psychiatrists who were male, nonwhite, and more op-timistic about managing nonadherence were more likely to initiate depot injections. Conclusions: Initiation of depot injections is a joint function of patient, physician, treat-ment, and setting factors. Use of long-acting preparations in this population is uncommon despite clinical recommen-dations urging their use. Key words: nonadherence/depot/antipsychotic