J Korean Neuropsychiatr Assoc.  2019 Feb;58(1):29-37. 10.4306/jknpa.2019.58.1.29.

The Long-Acting Injectable Antipsychotics in Clinical Practice

• Lee K

• KMID: 2439025
• DOI: http://doi.org/10.4306/jknpa.2019.58.1.29

Abstract

Symptomatic relapse is observed frequently and often associated with social and/or occupational decline that can be difficult to reverse in patients with schizophrenia. Several atypical antipsychotics, including risperidone, olanzapine, paliperidone, and aripiprazole, have become available as long-acting injectable antipsychotics (LAIs), and new evidence has been accumulating. LAIs appear to have a significant role in at least a group of schizophrenia patients. Improving the adherence, continuous availability, managing changes in receptor sensitivity, and lowering the requirement of cumulative doses are some of the major advantages of LAIs. Patients with first episode psychosis, dopamine super-sensitivity syndromes, and comorbid substance abuse might particularly benefit. Delaying the initiation of LAI until the establishment of non-adherence is not recommended. The results of clinical trials comparing LAIs with oral antipsychotics (OAPs) are inconsistent because they are influenced considerably by the study design. On the other hand, several barriers to LAIs use in current practice include clinical lack of knowledge, and negative attitudes about LAIs. This article tries to help clinicians better characterize the role of LAIs in the treatment of schizophrenia.

Keyword

Schizophrenia; Long-acting injections; Antipsychotics; Medication adherence

MeSH Terms

Antipsychotic Agents*
Aripiprazole
Dopamine
Hand
Humans
Medication Adherence
Paliperidone Palmitate
Psychotic Disorders
Recurrence
Risperidone
Schizophrenia
Substance-Related Disorders
Antipsychotic Agents
Aripiprazole
Dopamine
Paliperidone Palmitate
Risperidone