Predictors of long-acting injectable antipsychotic prescription at discharge in patients with schizophrenia and other psychotic disorders

Abstract

Long-acting injectable antipsychotics (LAIs) increase drug compliance and offer a reliable treatment option with stable pharmacokinetics. The aim of our study is to examine the rate and predictors of LAIs' prescription at discharge in inpatients with schizophrenia and other psychotic disorders. This retrospective study included 400 inpatients. Sociodemographic and clinical characteristics of the patients, the treatments applied in the past and prescribed at discharge were obtained from the hospitalization files. We compared these characteristics of those who were given LAI treatment at discharge to the patients who were given oral treatments. Thirty-nine percent of the patients were prescribed a LAI at discharge. Duration of illness was longer, and number of previous hospitalizations was higher in the LAI group. Nonadherence to the antipsychotics before the hospitalization, the previous history of LAI use, lack of insight at the admission and no previous antidepressant use were found as independent contributors to LAI prescription as the treatment of discharge in logistic regression analysis. Our study showed that LAIs are used at a high rate in our clinic; however, they are still initiated at a later stage, mostly in chronic patients with a lack of insight and compliance at admission.

High Rate of Discontinuation during Long-Acting Injectable Antipsychotic Treatment in Patients with Psychotic Disorders

“…In contrast with international clinical guidelines advocating for a broader and earlier use of LAI antipsychotics [30], our finding emphasizes that these formulations seem to be still underused by a significant proportion of practicing psychiatrists [31]. Nevertheless, this substantially expands the results of recent studies reporting that LAI antipsychotics are still mainly reserved to chronic patients, with multiple hospitalizations and long duration of illness [32]. Indeed, according to different surveys conducted to better understand the reasons of the low prescription of LAI formulations, the interviewees reported that LAIs persist to have an image problem, in particular in terms of coercion, exacerbated by the main use of these medications for the most stigmatized and chronically ill patients [33].…”

Clinical Utility of Fluid Biomarker in Depressive Disorder

“…Biomarker investigations spanned across a large range of possible targets. Peripheral biomarkers, which is mainly the topic of the present paper, mainly include analyses on blood samples, such as DNA variants and Polygenic Risk Scores, gene expression, mRNA, non coding RNA, DNA methylation, proteins/peptides (e.g., immunological and metabolic factors), but we should also mention analyses not on body fluids such as post mortem tissues, imaging, electroencephalogram, cognitive, neuropsychological and clinical features [11,[14][15][16][17][18][19][20]. Those are not discussed in the present review but will probably be used in combination with peripheral biomarkers, as will be shown later.…”

Interplay of environmental and clinical factors in psychiatric disorders

“…Long-acting injectable antipsychotics (LAIs) are a widely used treatment option for patients with schizophrenia and bipolar disorder. While LAIs have been shown to be superior in managing these conditions when compared to oral administration (Meyer, 2017; Şahin et al ., 2021), their use has also been associated with significant cardiovascular risk factors and metabolic syndrome (Pillinger et al ., 2020). LAIs have been associated with several cardiovascular risk factors, including weight gain, elevated lipid levels, and insulin resistance.…”