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December 14, 1994

Depot Neuroleptics: Cost-effective and Underutilized

JAMA. 1994;272(22):1722. doi:10.1001/jama.1994.03520220016013

To the Editor.  —Direct treatment costs of schizophrenia in the United States total more than $10 billion per year.1 Approximately 50% of patients with chronic schizophrenia receiving outpatient treatment relapse within 1 year after discharge as a result of medication noncompliance.2 As a result, medication noncompliance accounts for approximately 33% of the cost of relapse and rehospitalization of patients with chronic schizophrenia.2 Long-acting depot neuroleptics have been shown to enhance medication compliance and thereby reduce the risk of relapse and, consequently, hospital days.3 In the United Kingdom, 50% of patients with schizophrenia receive treatment with long-acting, injectable depot neuroleptic therapy, while in this country only 10% to 20% receive depot therapy.4 If US psychiatrists began to use depot neuroleptics as widely as their European colleagues, millions of dollars in relapse- and rehospitalization-related costs could be saved each year.2Another reason that depot neuroleptics are