Injections of Depot Antipsychotic Medications in Patients Suffering From Schizophrenia: Do They Hurt?
J Clin Psychiatry 2001;62:855-859
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Introduction: Long-acting depot
injections of antipsychotic medications are an important way to
monitor treatment noncompliance in patients suffering from
schizophrenia. Pain and discomfort at the injection site may
result in patients' refusal of depot injections. The present
study is a pilot study that attempts a systematic
characterization of injection site pain.
Method: Thirty-four consecutive
outpatients suffering from DSM-IV-defined schizophrenia or
schizoaffective disorder and treated with depot antipsychotic
medications were evaluated. The pain they suffered from the
injections was quantified using a visual analog scale. This
evaluation was made 5 minutes before the injection, 5 minutes
after, 2 days after, 10 days after, and before the next
injection. Patients were also administered a modified version of
the Rating of Medication Influences scale that included a
specific question on the possible relationship between
injection-associated pain and future compliance to depot
Results: The depot injections cause pain,
which is maximal immediately after the injection, declines
substantially 2 days after, and disappears by the tenth day after
the injection. A correlation exists between reported injection
site pain and the effect it has on patients' attitude toward the
depot injection as reported by the patients. Zuclopenthixol depot
injection is more painful than other depot medications.
Conclusion: Depot injections are painful.
The pain they inflict has a typical course, and medication type
is among the factors that influence this pain. This pain might
have an effect on patients' attitude toward depot injections and
thus is of importance in the management of patients suffering