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In 2015, the removal of Pipotiazine Palmitate depot injection (also known as Piportil) from the UK market sparked a significant shift in the mental health treatment landscape. This article examines the repercussions of this withdrawal, focusing on the experiences of patients switching from Pipotiazine and the factors affecting the effectiveness of substitute medications.
Objective
The main objective was to identify a group of patients who were forced to switch from Pipotiazine due to its market withdrawal and to examine the factors associated with the effectiveness of the new medication and subsequent utilization of acute care services.
Methodology
A retrospective cohort study was conducted in Sussex, United Kingdom, using a naturalistic approach. Patients who stopped using Pipotiazine solely due to its market withdrawal were identified using electronic patient databases and manual searching.
To explore the associations between available baseline variables and the discontinuation of the next prescribed medication and admission to acute mental health services within the next year, multivariate logistic regression analyses and survival analyses were utilized.
Results
Patient Identification
From a total of 205 patients receiving Pipotiazine in October 2014, 137 were forced to switch from this medication due to its market withdrawal.
Discontinuation and Acute Care
Analysis revealed that 31.5% of these patients discontinued the medication to which they were switched within the next year. Further, 19% required acute care during this period.
Medication Switching
The class of drug switched to - whether a typical depot, atypical long-acting injection (LAI), or atypical oral - had no significant association with discontinuation. However, switching to an atypical LAI was significantly associated with the need for acute care, as compared to a typical depot.
Analysis by Diagnosis
Patients diagnosed with schizophrenia were significantly less likely to discontinue the switched medication or to need acute care, compared to those diagnosed with schizoaffective disorder.
Gender Differences
Women were significantly more likely to discontinue the switched medication than men.
Acute Care
Of those requiring acute care, only 38% had required this in the previous 2 years.
Conclusion
The withdrawal of an antipsychotic medication from the market can have tangible negative clinical implications, necessitating careful clinical management. The increase in rates of acute care among those switched to an atypical LAI from Pipotiazine suggests lower effectiveness or possible withdrawal effects.
The lack of significant difference between depots, LAIs and oral medications regarding discontinuation underscores the importance of a collaborative, fully informed approach when deciding on next treatment options.
"Increased acute care rates in those receiving an atypical LAI versus a typical depot following pipotiazine suggests lower effectiveness or possible withdrawal effects."
References
Further Reading
Disclaimer: This article is for informational purposes only and is not intended as medical advice.
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