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Long-acting injectable antipsychotics: what, when, and how

Published online by Cambridge University Press:  15 March 2021

Leslie Citrome Open the ORCID record for Leslie Citrome [Opens in a new window]
Leslie Citrome*
Affiliation:
Department of Psychiatry and Behavioral Sciences, New York Medical College, Valhalla, New York, USA
*
*Author for correspondence: Leslie Citrome, MD, MPH Email: citrome@cnsconsultant.com
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Abstract

Current guidelines for the treatment of patients with schizophrenia advocate that patients receive treatment with a long-acting injectable (LAI) antipsychotic medication if they prefer such treatment or if they have a history of poor or uncertain adherence. Available LAI formulations in the United States include first-generation antipsychotics (fluphenazine decanoate and haloperidol decanoate), risperidone/paliperidone containing products (risperidone microspheres, paliperidone palmitate, and risperidone subcutaneous), aripiprazole containing products (aripiprazole monohydrate and aripiprazole lauroxil), and olanzapine pamoate. LAI antipsychotics can address the guesswork about adherence status and patients may prefer them if they are offered this as a choice, including individuals early in their disease course. Additional approved indications in the United States for LAI antipsychotics include bipolar I disorder maintenance treatment for risperidone microspheres and aripiprazole monohydrate, and schizoaffective disorder for paliperidone palmitate once monthly. Differences and similarities among the different products are discussed, including guidance regarding optimal treatment selection. Tips are provided to enhance effective patient communication to maximize the likelihood of acceptance of this treatment modality.

Keywords

Depotlong-acting injectable antipsychoticschizophreniaschizoaffective disorderbipolar disorder
Type
CME Review Article
Information
CNS Spectrums , Volume 26 , Issue 2 , April 2021 , pp. 118 - 129
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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Footnotes

This activity is supported by unrestricted educational grants from Indivior and Alkermes.

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