The role of long-acting injectable antipsychotics in schizophrenia: a critical appraisal
Open accessAbstract
Despite their widespread use, long-acting injectable (LAI) antipsychotics (APs) are often regarded with some negativity because of the assumption of punishment, control and insufficient evolution towards psychosocial development of patients. However, LAI APs have proved effective in schizophrenia and other severe psychotic disorders because they assure stable blood levels, leading to a reduction of the risk of relapse. Therapeutic opportunities have also arisen after introduction of newer, second-generation LAI APs in recent years. Newer LAI APs are more readily dosed optimally, may be better tolerated and are better suited to integrated rehabilitation programmes. This review outlines the older and newer LAI APs available for the treatment of schizophrenia, with considerations of past and present pharmacological and therapeutic issues. Traditional, evidence-based approaches to systematic reviews and randomized clinical trials are of limited utility in this area so this paper’s blending of experimental trials with observational research is particularly appropriate and effective.
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Because of the slow dose titration and extended time to reach steady state characteristic of older LAIs, initial oral antipsychotic supplementation may be required with haloperidol decanoate.
“Because of the slow dose titration and extended time to reach steady state, which are characteristic of older LAIs, initial oral antipsychotic supplementation may be required [56].”
From Pharmacokinetic Characteristics of Long-Acting Injectable Antipsychotics for Schizophrenia: An Overview (2021) · cites this paper as [56]
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References 208 · Cited by 297
- Authors
- Brissos, S., Veguilla, M. R., Taylor, D., & Balanzá-Martinez, V.
- Affiliations
- Psychiatrist, Lisbon’s Psychiatric Hospitalar Centre, Rua Conde de Redondo, nº 8 3º dt., Lisbon, 1150, Portugal
- Grupo Psicosis y Neurodesarrollo, Instituto de Biomedicina de Sevilla (IBIS), Hospital Universitario Virgen del Rocio /CSIC/Universidad de Sevilla, Unidad de Hospitalizacion de Salud Mental, Sevilla, Spain
- South London and Maudsley NHS Foundation Trust (GB)
- Catarroja Mental Health Unit, University Hospital Doctor Peset, FISABIO, Valencia; and Section of Psychiatry, University of Valencia, CIBERSAM, Valencia, Spain
- Venue
- Therapeutic Advances in Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2014-07-02
- Volume
- 4
- Issue
- 5
- Pages
- 198-219
- ISSN
- 2045-1253 (ISSN-L)
- 2045-1261
- PMC
- PMC4212490
- OpenAlex
- W2047241207
- Cited by
- 297
- References
- 208
- Citations by year
- 2026: 15 · 2025: 26 · 2024: 21 · 2023: 27 · 2022: 36 · 2021: 33 · 2020: 15 · 2019: 34 · 2018: 29 · 2017: 31 · 2016: 25 · 2015: 4
- FWCI
- 2.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Therapeutic Advances in Psychopharmacology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- Funders
- Bristol-Myers Squibb
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Social Sciences › Psychology › Clinical Psychology › Historical Psychiatry and Medical Practices
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Keywords
- long-acting injectable antipsychotics, schizophrenia, atypical antipsychotics, relapse prevention, medication adherence, pharmacokinetics, psychosocial rehabilitation, tolerability
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