***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background Hospitalization is a costly and distressing event associated with relapse during schizophrenia treatment . No information is available on the predictors of psychiatric hospitalization during maintenance treatment with olanzapine long-acting injection ( olanzapine-LAI ) or how the risk of hospitalization differs between olanzapine-LAI and oral olanzapine . This study aim ed to identify the predictors of psychiatric hospitalization during maintenance treatment with olanzapine-LAI and assessed four parameters : hospitalization prevalence , incidence rate , duration , and the time to first hospitalization .  Olanzapine-LAI was also compared with a sub-therapeutic dose of olanzapine-LAI and with oral olanzapine . Methods This was a post hoc exploratory analysis of data from a r and omized , double-blind study comparing the safety and efficacy of olanzapine-LAI ( pooled active depot groups : 405 mg/4 weeks , 300 mg/2 weeks , and 150 mg/2 weeks ) with oral olanzapine and sub-therapeutic olanzapine-LAI ( 45 mg/4 weeks ) during 6 months ’ maintenance treatment of clinical ly stable schizophrenia out patients ( n=1064 ) . The four psychiatric hospitalization parameters were analyzed for each treatment group . Within the olanzapine-LAI group , patients with and without hospitalization were compared on baseline characteristics . Logistic regression and Cox ’s proportional hazards models were used to identify the best predictors of hospitalization . Comparisons between the treatment groups employed descriptive statistics , the Kaplan – Meier estimator and Cox ’s proportional hazards models . Results Psychiatric hospitalization was best predicted by suicide threats in the 12 months before baseline and by prior hospitalization . Compared with sub-therapeutic olanzapine-LAI , olanzapine-LAI was associated with a significantly lower hospitalization rate ( 5.2 % versus 11.1 % , p < 0.01 ) , a lower mean number of hospitalizations ( 0.1 versus 0.2 , p = 0.01 ) , a shorter mean duration of hospitalization ( 1.5 days versus 2.9 days , p < 0.01 ) , and a similar median time to first hospitalization ( 35 versus 60 days , p = 0.48 ) . Olanzapine-LAI did not differ significantly from oral olanzapine on the studied hospitalization parameters . Conclusions In clinical ly stable schizophrenia out patients receiving olanzapine-LAI maintenance treatment , psychiatric hospitalization was best predicted by a history of suicide threats and prior psychiatric hospitalization . Olanzapine-LAI was associated with a significantly lower incidence of psychiatric hospitalization and shorter duration of hospitalization compared with sub-therapeutic olanzapine-LAI . Olanzapine-LAI did not differ significantly from oral olanzapine on hospitalization parameters . Trial registration Clinical Trials.gov : OBJECTIVE Nonadherence for first-episode schizophrenia is a major unsolved challenge . The long-acting injectable route is an appealing strategy , but there are concerns about acceptability . We report on acceptance and initial adherence outcomes with risperidone long-acting injection ( RLAI ) in first-episode schizophrenia patients . METHOD We conducted a prospect i ve r and omized controlled trial in which we enrolled patients defined by appropriate Structured Clinical Interview for DSM-IV diagnosis and < or = 16 weeks of lifetime antipsychotic exposure . Participants were r and omly assigned ( 2:1 ratio ) to a recommendation of changing to RLAI versus continuing on oral therapy ( ORAL ) .  Nonadherence behavior was defined as a medication gap > or = 14 days . Adherence attitudes were determined by the Rating of Medication Influences ( ROMI ) scale . A priori analysis defined treatment groups as intent-to-treat ( ITT ) and as-actually-treated ( AAT ) for the first 12 weeks after initial r and omization . Participants were enrolled from December 2004 to March 2007 . RESULTS Of 46 eligible patients , 37 were r and omly assigned , 11 to ORAL and 26 to RLAI . Nineteen of 26 patients ( 73 % ) accepted the RLAI recommendation . There were no differences in adherence behavior at 12 weeks based on initial r and omization ( Kaplan-Meier survival for ITT : 76 % [ 95 % CI , 35%-90 % ] adherent for RLAI vs 72 % [ 95 % CI , 55%-89 % ] for ORAL ; log-rank P = .78 ) , but patients accepting RLAI were significantly more likely to be adherent than patients staying on ORAL ( AAT : 89 % [ 95 % CI , 64%-97 % ] adherent for RLAI vs 59 % [ 95 % CI , 32%-78 % ] for ORAL ; log-rank P = .035 ) . There were no ROMI attitude differences between either treatment group comparison at 12 weeks . CONCLUSIONS Most first-episode patients taking oral antipsychotics will accept a recommendation of RLAI therapy . On the basis of initial r and omization status , an RLAI recommendation did not affect adherence behavior at 12 weeks . However , acceptance of RLAI was associated with significantly better adherence . Regardless of whether RLAI is recommended or accepted , there is no adverse impact on subsequent medication attitudes at 12 weeks . These results support the feasibility and acceptability of introducing RLAI as a treatment option for first-episode schizophrenia patients . TRIAL REGISTRATION clinical trials.gov Identifier : NCT00220714 BACKGROUND Long-acting injectable formulations of antipsychotics are treatment alternatives to oral agents . AIMS To assess the efficacy of aripiprazole once-monthly compared with oral aripiprazole for maintenance treatment of schizophrenia . METHOD A 38-week , double-blind , active-controlled , non-inferiority study ; r and omisation ( 2:2:1 ) to aripiprazole once-monthly 400 mg , oral aripiprazole ( 10 - 30 mg/day ) or aripiprazole once-monthly 50 mg ( a dose below the therapeutic threshold for assay sensitivity ) . ( TRIAL REGISTRATION clinical trials.gov , NCT00706654 . ) RESULTS A total of 1118 patients were screened , and 662 responders to oral aripiprazole were r and omised . Kaplan-Meier estimated impending relapse rates at week 26 were 7.12 % for aripiprazole once-monthly 400 mg and 7.76 % for oral aripiprazole . This difference ( -0.64 % , 95 % CI -5.26 to 3.99 ) excluded the predefined non-inferiority margin of 11.5 % . Treatments were superior to aripiprazole once-monthly 50 mg ( 21.80 % , P < or = 0.001 ) . CONCLUSIONS Aripiprazole once-monthly 400 mg was non-inferior to oral aripiprazole , and the reduction in Kaplan-Meier estimated impending relapse rate at week 26 was statistically significant v. aripiprazole once-monthly 50 mg Background Because wide variations in mental health care utilization exist throughout the world , determining long-term effectiveness of psychotropic medications in a real-world setting would be beneficial to physicians and patients . The purpose of this analysis was to describe the effectiveness of injectable risperidone long-acting therapy ( RLAT ) for schizophrenia across countries . Methods This was a pragmatic analysis of data from two prospect i ve observational studies conducted in the US ( Schizophrenia Outcomes Utilization Relapse and Clinical Evaluation [ SOURCE ] ; Clinical Trials.gov registration number for the SOURCE study : NCT00246194 ) and Spain , Australia , and Belgium ( electronic Schizophrenia Treatment Adherence Registry [ eSTAR ] ) . Two separate analyses were performed to assess clinical improvement during the study and estimate psychiatric hospitalization rates before and after RLAT initiation . Clinical improvement was evaluated using the Clinical Global Impressions-Severity ( CGI-S ) and Global Assessment of Functioning ( GAF ) scales , and change from baseline was evaluated using paired t tests . Psychiatric hospitalization rates were analyzed using incidence densities , and the bootstrap resampling method was used to examine differences between the pre-baseline and post-baseline periods . Results The initial sample comprised 3,069 patients ( US , n = 532 ; Spain , n = 1,345 ; Australia , n = 784 ; and Belgium , n = 408 ) . In all , 24 months of study participation , completed by 39.3 % ( n = 209 ) , 62.7 % ( n = 843 ) , 45.8 % ( n = 359 ) , and 64.2 % ( n = 262 ) of patients from the US , Spain , Australia , and Belgium , respectively , were included in the clinical analysis . Improvements compared with baseline were observed on both clinical assessment s across countries ( P < 0.001 at all post-baseline visits ) . The mean improvement was approximately 1 point on the CGI-S and 15 points on the GAF . A total of 435 ( 81.8 % ) , 1,339 ( 99.6 % ) , 734 ( 93.6 % ) , and 393 ( 96.3 % ) patients from the US , Spain , Australia , and Belgium , respectively , had ≥1 post-baseline visit and were included in the analysis of psychiatric hospitalization rates . Hospitalization rates decreased significantly in all countries regardless of hospitalization status at RLAT initiation ( P < 0.0001 ) and decreased significantly in the US and Spain ( P < 0.0001 ) when the analysis was limited to out patients only . Conclusions RLAT in patients with schizophrenia was associated with improvements in clinical and functional outcomes and decreased hospitalization rates in the US , Spain , Australia , and Belgium , despite differences in health care delivery systems OBJECTIVE The superiority of risperidone long-acting injection ( RLAI ) over oral typical and atypical antipsychotics demonstrated in previous studies may be related to the improved drug compliance . The aim of the 12-week r and omized , single-blind study was to test whether the superiority of RLAI remained among hospitalized patients that drug compliance could be optimally controlled . METHODS Fifty hospitalized stable schizophrenic patients , who had maintained on oral risperidone for more than 3 months , were r and omized to the RLAI and oral risperidone group . Finally 49 patients ( 98 % ) completed the study , and no dose change of oral risperidone , or RLAI was noted among all patients . RESULTS The RLAI group showed significantly increased positive score of Positive and Negative Syndrome Scale ( PANSS ) than the risperidone group ( 0.72 + /- 3.52 vs. -1.24 + /- 3.81 , p = 0.022 ) , but without significance difference for the PANSS total , negative and general psychopathology scores . The RLAI group also showed a significantly improved Udvalg for Kliniske Undersogelser ( UKU ) Scale ( p = 0.037 ) , social life domains of Short-Form Health Survey ( SF-36 ) ( p = 0.011 ) , and reduced prolactin level ( p = 0.001 ) . CONCLUSION The results indicated that with optimal controlling of drug compliance among hospitalized patients , RLAI showed no benefit of efficacy over oral risperidone , but with advantages of improved side-effect profiles , social life ratings , and reduced prolactin levels BACKGROUND Because long-acting injectable ( LAI ) antipsychotics are largely reserved for persistently ill patients , little is known about the use of LAIs early in the course of illness for first-episode out patients . METHOD A prospect i ve , open-label , r and omized controlled trial was conducted in which out patients with first-episode DSM-IV schizophreniform disorder , schizophrenia , or schizoaffective disorder were enrolled from December 2004 to March 2007 . Participants were r and omly assigned at a 2:1 ratio to a recommendation of changing to LAI risperidone microspheres ( RLAI ) ( n = 26 ) or continuing oral antipsychotic treatment ( n = 11 ) for up to 104 weeks . Primary outcomes were time until initial nonadherence ( medication gap of ≥ 14 days ) and medication attitudes as assessed with the Rating of Medication Influences scale . Patients r and omly assigned to an RLAI recommendation could decline the recommendation , so analysis defined treatment groups by intent-to-treat and as-actually-treated . RESULTS Eighty-one percent of patients ( 30/37 ) stopped medication within 104 weeks . There was a trend toward an initial adherence benefit favoring RLAI acceptors at 12 weeks ( P = .058 ) , but no significant difference between RLAI and oral antipsychotic treatment in time to initial nonadherence during the overall study ( P = .188 ) . Medication attitudes did not differ between groups . CONCLUSIONS Acceptance of RLAI was associated with an initial adherence benefit that was not sustained over time . Early introduction of LAI therapy did not adversely affect adher 
    Output:
    
The group treated with LAI SGAs was characterized by significantly lower relapse rates , longer times to relapse and fewer hospital days , but also by a higher occurrence of extrapyramidal syndrome and prolactin-related symptoms than that in the group treated with oral SGAs .
Our findings demonstrate that there is moderate to high level of evidence suggesting that in the treatment of schizophrenia , LAI SGAs have higher efficacy and are associated with higher rates of extrapyramidal syndrome and prolactin-related symptoms .