Long-acting atypical injectable antipsychotics in the treatment of schizophrenia: safety and tolerability review.
BACKGROUND
Although atypical antipsychotics have beneficial efficacy and tolerance, non-adherence and partial adherence remain in patients treated for schizophrenia. Long-acting injectable or depot atypical antipsychotics offer better medication adherence and tolerability advantages. Currently, two drugs are available for the treatment of schizophrenia, risperidone long-acting injectable (RLAI) and olanzapine pamoate (OP).


METHODS
Short- and long-term safety and tolerability data on RLAI and OP from January 2006 through September 2009 were reviewed by performing Medline and PubMed searches, reviewing abstracts and poster presentations, and viewing available material from the FDA and European Medicines Agency.


RESULTS
RLAI and OP show good short- and long-term safety when treating patients with schizophrenia, with uncommon discontinuation due to adverse effects. RLAI and OP data show rare problems with injection site reactions and patients exposed to injectable treatments prefer to continue injections. Infrequent but serious post-injection delirium sedation syndrome occurred after 1% of OP injections. Weight gain was generally higher among patients treated with OP versus RLAI.


CONCLUSIONS
Healthcare providers, patients and family members should be made aware of the safety and benefits of long-acting injectable atypical antipsychotics in order to diminish the unnecessary restrictions of these therapies for patients with schizophrenia.
Cañas
Fernando
F
Hospital Dr. Rodríguez Lafora, Department of Psychiatry, Cra. De Colmenar Viejo km 13,8, Madrid, Spain. fcanasd@hotmail.com
Möller
Hans-Jürgen
HJ
D000284:Administration, Oral; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D001569:Benzodiazepines / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D003692:Delayed-Action Preparations; D050171:Dyslipidemias / Q000139:chemically induced; D006801:Humans; D006943:Hyperglycemia / Q000139:chemically induced; D006966:Hyperprolactinemia / Q000139:chemically induced; D007267:Injections; D055118:Medication Adherence; D009069:Movement Disorders / Q000209:etiology; D000077152:Olanzapine; D010146:Pain / Q000139:chemically induced; D016032:Randomized Controlled Trials as Topic; D018967:Risperidone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy*; D015430:Weight Gain / Q000187:drug effects
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine