Clinical guideline recommendations for antipsychotic long-acting injections.
BACKGROUND
Long-acting injections (LAIs) of antipsychotic drugs were developed over 40 years ago in an attempt to improve the long-term treatment of schizophrenia.


OBJECTIVE
To review existing guidelines concerning antipsychotic use generally, and LAIs in particular, and how patients might be identified as potential candidates for LAI treatment.


METHODS
Literature review.


RESULTS
Currently several first-generation and one second-generation antipsychotic LAIs are available, with others under development. Although the use of LAIs is widespread around the world, patterns of use vary widely. Important considerations regarding the use of LAIs include the indications for long-term pharmacotherapy in schizophrenia in general, the indications for LAIs, the risks associated with LAIs, the need to update guidelines and the issue of cost.


CONCLUSIONS
The use of these injections in first-episode psychosis and treatment-refractory schizophrenia is not currently a focus of recommendations, but should be considered. Long-acting injections remain an underutilised option in many countries despite frequent non-adherence with oral medication and subsequent relapse.
Kane
John M
JM
Department of Psychiatry, Zucker Hillside Hospital, 75-59 263 Street, Glen Oaks, NY 11004, USA. psychiatry@lij.edu
Garcia-Ribera
Carlos
C
D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D003692:Delayed-Action Preparations / Q000008:administration & dosage* / Q000627:therapeutic use; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007267:Injections; D055118:Medication Adherence; D017410:Practice Guidelines as Topic; D011618:Psychotic Disorders / Q000188:drug therapy*
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations