Pharmacotherapy for schizophrenia: Long-acting injectable antipsychotic drugs
- John Lauriello, MD
John Lauriello, MD
- Professor of Psychiatry
- University of Missouri
- Austin R Campbell, PharmD, BCPP
Austin R Campbell, PharmD, BCPP
- Adjunct Clinical Assistant Professor of Psychiatry
- University of Missouri School of Medicine and University of Missouri - Kansas City School of Pharmacy
The unpleasant adverse effects of antipsychotic drugs combined with patients’ disbelief of having an illness, which is common among individuals with schizophrenia, result in high rates of nonadherence to antipsychotics in the treatment of schizophrenia.
Long-acting injectable (LAI) antipsychotics are a pharmacologic strategy for treating patients with schizophrenia who relapse due to nonadherence to antipsychotic medication. Rather than the daily pill-taking required with oral antipsychotics, LAI antipsychotics are administered by injection at two to four week intervals.
This topic addresses the use of LAI antipsychotics in the treatment of schizophrenia. The pharmacology, administration, comparative side effects and treatment of schizophrenia with standard (non-LAI) antipsychotics are discussed separately as is the management of antipsychotic side effects. The epidemiology, clinical manifestations, and diagnosis of schizophrenia are discussed separately. (See "Pharmacotherapy for schizophrenia: Acute and maintenance phase treatment" and "First-generation antipsychotic medications: Pharmacology, administration, and comparative side effects" and "Second-generation antipsychotic medications: Pharmacology, administration, and side effects" and "Pharmacotherapy for schizophrenia: Side effect management" and "Schizophrenia in adults: Clinical manifestations, course, assessment, and diagnosis" and "Schizophrenia in adults: Epidemiology and pathogenesis".)
LONG-ACTING INJECTABLE ANTIPSYCHOTICS
Six antipsychotic medications are currently available in the United States (US) as long-acting injections. Naming conventions vary among agents. As listed below, this topic uses the format: medication name followed by “LAI.”
●Aripiprazole extended release (aripiprazole-LAI)
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- LONG-ACTING INJECTABLE ANTIPSYCHOTICS
- ANTIPSYCHOTIC NONADHERENCE
- Aripiprazole lauroxil-LAI
- Paliperidone 12-week-LAI
- ADVERSE EVENTS
- Postinjection delirium sedation syndrome
- SUMMARY AND RECOMMENDATIONS