What is known about long acting injectable (LAI) antipsychotic medications in the treatment of schizophrenia or bipolar disorder?

Long Acting Injectable (LAI) antipsychotic medications are an important, yet underused, treatment option for schizophrenia. These are also sometimes used in bipolar disorder. These medications offer the convenience of only needing to take medication infrequently, with intervals ranging from every 2 weeks to every month to longer periods. Other advantages of LAIs include that they help with earlier identification of non-adherence, reduce the risk of partial adherence or overdose, and can produce lower peak plasma levels, which may help reduce some side effects. In some studies, they have substantially improved patient outcomes, and are among the more effective medications when large populations of people with schizophrenia are studied.

Challenges to use of LAI medications include that they take longer to reach a steady therapeutic blood level, offer less flexibility in dosage adjustment, and require travel to a clinic or pharmacy for administration. There are practical considerations when using LAI medications. LAIs offer a very important treatment option for patients. Many patients may not be aware of these options, and many clinicians may not be thinking of these often enough. More information on LAIs can be found in this presentation (Serious Mental Illness: Injectable Antipsychotics).

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