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Long-acting antipsychotics help cut risk for arrest in patients with schizophrenia

SAN FRANCISCO — After initiation of treatment with long-acting injectable antipsychotics, the incidence of arrest decreased among patients with schizophrenia or schizoaffective disorder and a previous history of arrest during a 2-year follow-up period at a community mental health center, according to a poster presented at APA annual meeting.

There’s limited research available on whether long-acting injectable (LAI) antipsychotics affect the risk for encounters with the criminal justice system among individuals with schizophrenia who receive care at the community level, according to the researchers.

Therefore, Madhav P. Bhatta, PhD, MPH, of Kent State University College of Public Health, Ohio, and colleagues examined the link between LAI antipsychotic use and the risk for arrest over a 2-year period among adults who had a jail record and were receiving care for schizophrenia or schizoaffective disorder in a retrospective study using clinical data derived from a community-based service in Ohio.

Participants were followed for 2 years for a criminal justice system involvement via review of the Summit County, Ohio, jail records. Researchers calculated the risk of an arrest and percent risk reduction one and two years after the initiation of either aripiprazole, fluphenazine decanoate, haloperidol decanoate, once monthly paliperidone palmitate or risperidone.

Overall, 132 and 196 adults with schizophrenia or schizoaffective disorder had an arrest 1 and 2 years before initiation of a LAI. Men were more likely to have an arrest record than women (P < .01).

On average, the number of arrests 1 and 2 years before LAI antipsychotic initiation among patients with a history of criminal justice system involvement were 1.68 and 2.33; however, after medication initiation, the average number of arrests were 0.64 and 1.03 during 1- and 2-year follow-up period, according to the poster.

The post-LAI initiation incidence dropped substantially among those with a previous history of at least one arrest, from 100.0% to 34.8% (P < .001) and 44.9% (P < .001) over the 1- and 2-year follow-up periods, the results showed. The most common antipsychotic was paliperidone palmitate (n = 127). Among patients on paliperidone palmitate, the incidence of an arrest dropped from 100% to 33% (P < .01) and 42.5% (P < .01) 1 and 2 years post-LAI initiation.

These findings show the benefits of LAI treatment, especially paliperidone palmitate, on reducing the risk of arrest among adults with schizophrenia and a history of conviction, according to the researchers. – by Savannah Demko

References:

Bhatta MP, et al. Risk of arrest in patients with schizophrenia or schizoaffective disorder and prior jail detention treated with long-acting antipsychotics at a community mental health center. Presented at: APA Annual Meeting; May 18-22, 2019; San Francisco.

Disclosures: The study was funded by Janssen Scientific Affairs, LLC.