Artículo que, tras realizar un repaso de los % que se han publicado en relación a la no adherencia de los pacientes con esquizofrenia y su graves consecuencias, realiza una revisión del papel fundamental de los antipsicóticos de larga duración: no sólo en favorecer la adherencia al tratamiento, sino también en la reducción de rehospitalizaciones, el beneficio de su uso en fases iniciales, menor utilización de recursos sanitarios y aumento de calidad de vida. Una vez realizada la revisión sobre los beneficios en cada una de estas variables, se incluye un apartado sobre las barreras que continúan existiendo y que dificultan un uso más extendido de los antipsicóticos de larga duración (fundamentalmente percepciones erróneas o prejuicios que no se demuestran cuando tanto el psiquiatra como el paciente tienen experiencia en estos tratamientos.

 

Schizophrenia is a debilitating chronic disease that requires lifelong medical care and supervision. Even with treatment, the majority of patients relapse within 5 years, and suicide may occur in up to 10% of patients. Poor adherence to oral antipsychotics is the most common cause of relapse. The discontinuation rate for oral antipsychotics in schizophrenia ranges from 26% to 44%, and as many as two-thirds of patients are at least partially nonadherent, resulting in increased risk of hospitalization. A very helpful approach to improve adherence in schizophrenia is the use of long-acting injectable (LAI) antipsychotics, although only a minority of patients receive these. Reasons for underutilization may include negative attitudes, perceptions, and beliefs of both patients and health care professionals. Research shows, however, significant improvements in adherence with LAIs compared with oral drugs, and this is accompanied by lower rates of discontinuation, relapse, and hospitalization. In addition, LAIs are associated with better functioning, quality of life, and patient satisfaction. A need exists to encourage broader LAI use, especially among patients with a history of nonadherence with oral antipsychotics. This paper reviews the impact of nonadherence with antipsychotic drug therapy overall, as well as specific outcomes of the schizophrenia patient, and highlights the potential benefits of LAIs.