Long-acting injectable antipsychotics: recommendations for clinicians.
A major source of limitation to the real effectiveness of antipsychotics is the high rate of patient nonadherence or, more frequently, partial adherence. Using long-acting injectable (LAI) formulations is likely to reduce the impact of such adherence problems. Conversely, the use of LAIs in Canada remains low relative to many other jurisdictions. Based on effectiveness data from randomized control trials and other, less rigorous, studies, as well as our 2 qualitative studies exploring numerous issues around the use of LAIs, including their low use, we put forward 10 different recommendations for consideration by clinicians. These are also based on the experience of many clinicians and clinician scientists. These recommendations address mostly clinical challenges associated with the use of LAIs. Their application in clinical settings is illustrated in our report through several case examples highlighting the large variation across patients and different phases of illness. It is recommended that LAIs should be considered as a treatment option for psychotic disorders across all phases, including the first 2 to 5 critical years.
Department of Psychiatry, McGill University, Montreal, Quebec. ashok.malla@douglas.mcgill.ca
Ashok
A
Malla
Phil
P
Tibbo
Pierre
P
Chue
Emmanuelle
E
Levy
Rahul
R
Manchanda
Michael
M
Teehan
Richard
R
Williams
Srividya
S
Iyer
Marc-André
MA
Roy
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage* / Q000145:classification; D003692:Delayed-Action Preparations / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006760:Hospitalization; D006801:Humans; D007273:Injections, Intramuscular / Q000523:psychology; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D054539:Medication Therapy Management / Q000458:organization & administration; D008875:Middle Aged; D012559:Schizophrenia / Q000188:drug therapy*; D012565:Schizophrenic Psychology; D055502:Secondary Prevention; D012944:Social Support; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D003692:Delayed-Action Preparations
adherence; antipsychotics; long-acting injection; recommendations; utilization