Long-Acting Injectable Antipsychotics in Children and Adolescents

Abstract

This literature review suggests that LAI use in youth with serious mental illness may improve clinical outcomes and adherence. Side effects of LAIs among youth appear are similar to oral preparations. However, there is a paucity of data despite issues with nonadherence in youth and the fact that they have much to lose and much to gain. Existing reports have substantial methodological limitations, and research is needed to guide the use of LAIs in children and adolescents.

A 6-Month Prospective Trial of a Personalized Behavioral Intervention + Long-Acting Injectable Antipsychotic in Individuals With Schizophrenia at Risk of Treatment Nonadherence and Homelessness

“…Additionally, CAE-L used first-generation LAI (haloperidol deaconate), which while affordable, is associated with akathisia in 40% of people. To increase potential generalizability, the CAE-L intervention was modified to be delivered by social workers and featured a second-generation LAI (paliperidone palmitate) (6–8). This prospective 6-month, non-controlled trial of modified CAE-L assessed multiple domains of recovery outcomes in 30 homeless or recently homeless individuals with schizophrenia or schizoaffective disorder.…”

Predictive factors of overall functioning improvement in patients with chronic schizophrenia and schizoaffective disorder treated with paliperidone palmitate and aripiprazole monohydrate

“…Our data are consistent with an early introduction of LAIs after psychoses onset, be it schizophrenia or schizoaffective disorder, but the same could be apply in the future for bipolar disorder, as ARI was found to delay time to relapse more than placebo (Calabrese et al, ). Since the first solicitations for using LAIs early in the course of schizophrenia (Stip, Abdel‐Baki, Bloom, Grignon, & Roy, ; Zhornitsky & Stip, ), the appropriateness of starting young patients earlier on LAIs is increasingly advanced (Brugnoli et al, ; Karson, Duffy, Eramo, Nylander, & Offord, ; Lytle, McVoy, & Sajatovic, ; Manchanda et al, ; Stevens, Dawson, & Zummo, ).…”

Antiretroviral adherence for adolescents growing up with HIV: understanding real life, drug delivery and forgiveness

“…Whilst lessons learnt from, and linkage to, LA contraceptive services may improve outcomes for young women, whether this is translatable to young men is unknown, however early data on the use of LA- ART antipsychotics in adolescents (80% male) suggests improvement in adherence and clinical outcome measures. 80 Even with injection intervals extended to 8 weeks delivery and managing cessation, this will remain a challenge for both adherence and healthcare provision in many settings and longer-acting agents are required, perhaps comparable with the contraceptive implant or intrauterine system. 81 Ultra-LA drug-delivery systems that deliver ART but are removable have considerable potential advantages, particularly in reducing the risk of acquiring resistance mutations on cessation and are currently being developed in animal models.…”