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Título:	Long-acting injectable antipsychotics (LAIs) for maintenance treatment of bipolar and schizoaffective disorders: A systematic review
Autor/a:	Pacchiarotti, Isabella; Tiihonen, Jari; Kotzalidis, Georgios D.; Verdolini, Norma; Murru, Andrea; Goikolea, José Manuel; Valentí Ribas, Marc; Aedo, Alberto; Vieta i Pascual, Eduard, 1963-
Notas:	Long-Acting Injectable Antipsychotics (LAIs) are used to overcome non-compliance in psychoses, mainly schizophrenia spectrum disorders. We aimed to summarize available evidence of studies comparing the efficacy of LAIs to placebo or oral medications for Bipolar Disorder (BD) and/or Schizoaffective Disorder (SAD). We searched six databases from inception to 28-March-2018, using the strategy: long-acting antipsychotics AND (bipolar disorder OR schizoaffective disorder OR mania OR manic OR bipolar depression). We included peer-reviewed double-blind comparisons of LAIs for any clinical outcome occurrence in BD, or open mirror studies with same prospective as retrospective assessment periods. We excluded studies reporting on mixed schizophrenia/SAD populations without reporting results separately. The pooled records amounted to 642. After duplicate removal and inclusion/exclusion criteria application, we included 15 studies, 6 double-blind and 9 open, 13 assessing BD and 2 SAD. Depot neuroleptics prevented manic, but not depressive recurrences and may worsen depressive symptoms. Risperidone long-acting injectable was found to be effective in protecting from any mood/manic symptom compared to placebo, but not from depressive recurrences. Add-on or monotherapy paliperidone palmitate in SAD patients protected from psychotic, depressive, and manic symptoms. In patients with BD-I with a manic episode at study enrolment, aripiprazole monohydrate significantly delayed time to recurrence of manic episodes without inducing depressive episodes. LAIs are effective and well-tolerated maintenance treatments for BD and SAD. They showed better efficacy in preventing mania than depression. LAIs may be first-line for BD-I and SAD patients with a manic predominant polarity and with non-adherence problems.
Materia(s):	-Antipsicòtics -Trastorn bipolar -Esquizofrènia -Antipsychotic drugs -Manic-depressive illness -Schizophrenia
Derechos:	cc-by-nc-nd (c) Elsevier B.V., 2019 http://creativecommons.org/licenses/by-nc-nd/3.0/es
Tipo de documento:	Artículo Artículo - Versión aceptada
Editor:	Elsevier B.V.
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