Key Points Question Is use of long-acting injectable antipsychotics (LAIs) in patients with newly diagnosed schizophrenia associated with decreased mortality? Findings This cohort study included 2614 patients with schizophrenia who switched to LAIs, and 2614 propensity-matched patients who continued receiving oral antipsychotics (OAPs) of the same compounds. Patients who switched to LAIs had lower mortality and fewer suicide attempts compared with patients who continued receiving the corresponding OAPs, and patients who switched to LAIs within the first 2 years of OAP initiation exhibited a 47% reduction in the risk of suicide mortality compared with patients who continued receiving OAPs. Meaning These findings suggest that LAI use in patients with newly diagnosed schizophrenia should be encouraged because of its association with lower premature mortality.

BackgroundSubstance misuse is associated with cognitive dysfunction. We used a stop signal task to examine deficits in cognitive control in individuals with opioid dependence (OD). We examined how response inhibition and post-error slowing are compromised and whether methadone maintenance treatment (MMT), abstinence duration, and psychiatric comorbidity are related to these measures in individuals with OD.MethodsTwo-hundred-and-sixty-four men with OD who were incarcerated at a detention center and abstinent for up to 2 months (n = 108) or at a correctional facility and abstinent for approximately 6 months (n = 156), 65 OD men under MMT at a psychiatric clinic, and 64 age and education matched healthy control (HC) participants were assessed. We computed the stop signal reaction time (SSRT) to index the capacity of response inhibition and post-error slowing (PES) to represent error-related behavioral adjustment, as in our previous work. We examined group effects with analyses of variance and covariance analyses, followed by planned comparisons. Specifically, we compared OD and HC participants to examine the effects of opioid dependence and MMT and compared OD sub-groups to examine the effects of abstinence duration and psychiatric comorbidity.ResultsThe SSRT was significantly prolonged in OD but not MMT individuals, as compared to HC. The extent of post-error slowing diminished in OD and MMT, as compared to HC (trend; p = 0.061), and there was no difference between the OD and MMT groups. Individuals in longer abstinence were no less impaired in these measures. Furthermore, these results remained when psychiatric comorbidities including misuse of other substances were accounted for.ConclusionsMethadone treatment appears to be associated with relatively intact cognitive control in opioid dependent individuals. MMT may facilitate public health by augmenting cognitive control and thereby mitigating risky behaviors in heroin addicts.