Long-Acting Injectable Antipsychotics: Recommendations for Clinicians

Malla, Ashok; Tibbo, Philip G.; Chue, Pierre; Levy, Ellen K.; Manchanda, Rahul; Teehan, Michael D.; Williams, Richard L.; Iyer, Srividya N.; Roy, Marc‐André

doi:10.1177/088740341305805s05

Cited by 43 publications

(31 citation statements)

References 6 publications

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“…Despite their potential advantages, most treatment guidelines advise limiting the use of LAI APs to multiple‐episode or non‐adherent patients, with controversy in relation to their role in early schizophrenia (Kim et al ., ); however, recommendations for LAI AP use early in the disease course are emerging, not least during the first two to five years following diagnosis (Malla et al ., ) and as maintenance treatment following the initial episode (Llorca et al ., ). Using LAI APs as the initial therapeutic treatment can reduce relapse rates and improve prognosis (Viala et al ., ), and many first‐episode patients taking oral antipsychotics will accept a recommendation of the corresponding LAI therapy (Weiden et al ., ).…”

Section: Resultsmentioning

confidence: 99%

Recommendations for the optimal care of patients with recent‐onset psychosis in the Asia‐Pacific region

Warden²,

et al. 2016

Asia-Pacific Psychiatry

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Providing optimal care to patients with recent‐onset psychosis can improve outcomes and reduce relapse. However, there is a lack of consistency of the implementation of guidelines for such patients across the Asia‐Pacific region. We determined a pragmatic set of recommendations for use on a day‐to‐day basis to help provide optimal care at this crucial stage of illness. The recommendations were developed over a series of meetings by an international faculty of 15 experts from the Asia‐Pacific region, Europe, and South Africa. A structured search of the PubMed database was conducted. This was further developed based on the faculty's clinical experience and knowledge of the literature into 10 key aspects of optimal care for patients during the first five years of a diagnosis of a psychotic disorder, with particular relevance to the Asia‐Pacific region. Several common principles emerged: adherence to antipsychotic medications is crucial; substance abuse, psychiatric and medical comorbidities should be addressed; psychosocial interventions play a pivotal role; and family members can play a vital role in overall patient care. By following these recommendations, clinicians may improve outcomes for patients with recent‐onset psychosis.

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Section: Resultsmentioning

confidence: 99%

Recommendations for the optimal care of patients with recent‐onset psychosis in the Asia‐Pacific region

Warden²,

et al. 2016

Asia-Pacific Psychiatry

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“…Comparisons of oral antipsychotics to LAIs are still inconsistent (60,79,80). In a Korean study (80), relapse rates of FEP patients treated with LAI or oral risperidone were compared.…”

Section: Discussionmentioning

confidence: 99%

Aripiprazole Long-Acting Injection During First Episode Schizophrenia—An Exploratory Analysis

Giordano¹,

Tomassini²,

Cuomo

et al. 2020

Front. Psychiatry

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Background: Long-acting injectable (LAI) aripiprazole was found to be efficacious in schizophrenia. In common clinical practice, the use of LAIs is often restricted to chronic patients with frequent relapses and poor adherence. Recently, some investigators advanced the idea of early LAI use also in young people with schizophrenia at their first psychotic episode (FEP). Objective: Our study aimed to assess the effect of LAI aripiprazole once monthly (AOM) in the treatment of FEP in patients aged 18-26 years. Methods: We included 50 patients with DSM-5 schizophrenia as assessed with SCID, and used the Clinical Global Impressions Scale-Severity of Illness (CGI-S) and the Positive and Negative Syndrome Scale (PANSS) to assess symptom severity and the World Health Organization Quality of Life (WHOQOL), the Short Form Health Survey (SF-36) and the Personal and Social Performance Scale (PSP) to assess quality of life (QoL) and global health perception at baseline and 3, 6, 9, and 12 months after the first AOM injection. Results: AOM was associated with a progressive improvement, compared to baseline, of both positive (p < 0.001) and negative (p < 0.001) symptoms and in general psychopathology (p < 0.001) and decrease in global severity (p < 0.001). We also observed progressive improvement in QoL and social and personal functioning. Treatment adherence was 78% at study endpoint. Our results support that AOM may improve psychotic symptoms, QoL and social functioning in young FEP patients. Further studies should compare AOM to its oral formulation in the treatment of young patients with schizophrenia at the outset of their illness.

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“…However, recent guidelines for the use and management of LAI antipsychotics in clinical practice evoke the possibility of using this formulation for patients with first-episode or recent-onset schizophrenia [8,9,10,11,12]. Although most clinicians regard them as effective, reported LAI antipsychotic prescribing rates are low [13] and vary widely between countries (6%–30%) [14].…”

Section: Introductionmentioning

confidence: 99%

Clinical Decision-Making in the Treatment of Schizophrenia: Focus on Long-Acting Injectable Antipsychotics

Samalin

Garnier

Auclair³

et al. 2016

IJMS

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The purpose of this study was to identify clinician characteristics associated with higher prescription rates of long-acting injectable (LAI) antipsychotics, as well as the sources that influence medical decision-making regarding the treatment of schizophrenia. We surveyed 202 psychiatrists during six regional French conferences (Bordeaux, Lyon, Marseille, Nice, Paris, and Strasbourg). Data on the characteristics of practice, prescription rates of antipsychotic, and information sources about their clinical decisions were collected. Most psychiatrists used second-generation antipsychotics (SGAs), and preferentially an oral formulation, in the treatment of schizophrenia. LAI SGAs were prescribed to 30.4% of schizophrenic patients. The duration and type of practice did not influence the class or formulation of antipsychotics used. The clinicians following the higher percentage of schizophrenic patients were associated with a higher use of LAI antipsychotics and a lower use of oral SGAs. Personal experience, government regulatory approval, and guidelines for the treatment of schizophrenia were the three main contributing factors guiding clinicians’ decision-making regarding the treatment of schizophrenia. The more clinicians follow schizophrenic patients, the more they use LAI antipsychotics. The development of specialized programs with top specialists should lead to better use of LAI antipsychotics in the treatment of schizophrenia.

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Long-Acting Injectable Antipsychotics: Recommendations for Clinicians

Cited by 43 publications

References 6 publications

Recommendations for the optimal care of patients with recent‐onset psychosis in the Asia‐Pacific region

Recommendations for the optimal care of patients with recent‐onset psychosis in the Asia‐Pacific region

Aripiprazole Long-Acting Injection During First Episode Schizophrenia—An Exploratory Analysis

Clinical Decision-Making in the Treatment of Schizophrenia: Focus on Long-Acting Injectable Antipsychotics

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