Depot injection

A depot injection is a term for an injection formulation of a medication which releases slowly over time to permit less frequent administration of a medication. They are designed to increase medication adherence and consistency, especially in patients who commonly forget to take their medicine. Depot injections can be created by modifying the drug molecule itself, as in the case of prodrugs, or by modifying the way it is administered, as in the case of oil/lipid suspensions. Depot injections can have a duration of action of one month or greater and are available for many types of drugs, including antipsychotics and hormones. Depot injections provide longer duration drug action through slow absorption into the bloodstream. They are usually administered in the muscle, into the skin, or under the skin. The injected medication slowly releases the medication into the bloodstream. It may be used in patients who forget to take their medication; some doctors and patients consider the use of a depot injection to be coercion, and are opposed to their use for that reason. Drugs may be modified to be slowly activated by the body, or be absorbed slowly by the body. Many are dissolved in an organic oil, as the compound is lipophilic due to the addition of functional groups to provide slow action. An example of this is adding a functional group such as decanoate. The combination of an oil base and modification to decrease metabolic activation prevent medications from being fully released. This can result in length of activity of 2–4 weeks or more. The alteration of the pharmacokinetics of the drug (the absorption and activation) does not change the side effect profile of the medication; thus, atypical antipsychotics are still preferred over typical antipsychotics. The first long-acting (depot) injections were antipsychotics fluphenazine and haloperidol. The concept of a depot injection arose before 1950, and originally was used to describe antibiotic injections that lasted longer to allow for less frequent administration.