Akademik Veri Yönetim Sistemi
JOURNAL OF AFFECTIVE DISORDERS, cilt.397, 2026 (SCI-Expanded, SSCI, Scopus)
Background: Bipolar disorder (BD) is a chronic mental disorder characterized by recurrent mood episodes and high rates of functional impairment, hospitalization, and nonadherence to treatment. Long-acting injectable (LAI) antipsychotics offer a potential solution to adherence issues, yet their use in BD remains limited. This study aimed to evaluate the real-world effectiveness of paliperidone palmitate and aripiprazole LAI in clinical outcomes. Methods: A retrospective mirror-image study was conducted on 43 BD patients receiving LAI antipsychotics for at least one year. Data were collected from clinical interviews and medical records, covering hospitalization frequency and duration, psychiatric emergency visits, and mood relapses. Results: Initiation of LAI antipsychotics significantly reduced psychiatric hospitalizations, hospitalization days, emergency visits, and relapses (all p < .001). Both the paliperidone and aripiprazole groups showed significant within-group improvements in all outcomes. In Cox regression, paliperidone palmitate (n = 17) was associated with a lower hazard of hospitalization (HR = 0.326, p = .037) and relapse (HR = 0.273, p = .026), while aripiprazole (n = 25) showed a lower hazard across all outcomes, including hospitalization (HR = 0.154, p < .001), emergency visit (HR = 0.140, p = .011) and relapse (HR = 0.105, p < .001). In the total sample (n = 43), LAI treatment corresponded to a significantly lower hazard of hospitalization (HR = 0.202, p < .001), emergency visits (HR = 0.159, p < .001), and relapse (HR = 0.149, p < .001). Fixed-window analyses confirmed consistent post-treatment benefits. Conclusion: LAI antipsychotics were associated with substantially lower hazards of psychiatric hospitalization, emergency visit, and relapse in BD. Both paliperidone and aripiprazole improved outcomes, and no significant differences were observed between the two agents. These findings support the broader integration of LAIs into long-term management of BD.