title: Second-generation long-acting injectable antipsychotic agents: an overview.
abstract: For over 40 years, antipsychotic drugs have been used as long-term maintenance treatment to control symptoms and reduce relapse rates in patients with schizophrenia. 'First-generation' oral agents such as haloperidol and chlorpromazine are associated with high levels of unwanted neurological effects and poor rates of patient adherence.1,2 Long-acting ('depot') injections of antipsychotics were developed to try to improve adherence. 'Second-generation' antipsychotic agents (also known as atypical antipsychotics) were introduced into clinical practice over 16 years ago. Although these agents have a lower propensity to cause extrapyramidal side effects, they are associated with a range of other unwanted effects (e.g. weight gain and its sequelae).1,3,4 Initially, second-generation agents were only available as orally administered medicines. Three long-acting injectable formulations of second-generation antipsychotics are now available in the UK: olanzapine embonate injection (ZypAdhera), paliperidone injection (Xeplion) and risperidone injection (Risperdal Consta). In this article we review the evidence for these agents and discuss the practical implications of their use.
mesh_terms: D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000191:economics; D001569:Benzodiazepines / Q000008:administration & dosage / Q000191:economics; D003692:Delayed-Action Preparations; D016527:Drug Costs; D006801:Humans; D007267:Injections; D007555:Isoxazoles / Q000008:administration & dosage / Q000191:economics; D008991:Monitoring, Physiologic / Q000191:economics / Q000379:methods; D000077152:Olanzapine; D000068882:Paliperidone Palmitate; D017410:Practice Guidelines as Topic; D011743:Pyrimidines / Q000008:administration & dosage / Q000191:economics; D018967:Risperidone / Q000008:administration & dosage / Q000191:economics; D012559:Schizophrenia / Q000188:drug therapy* / Q000191:economics
chemical_list: D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations; D007555:Isoxazoles; D011743:Pyrimidines; D001569:Benzodiazepines; D018967:Risperidone; D000077152:Olanzapine; D000068882:Paliperidone Palmitate