open access

Vol 12, No 3 (2015)
Review paper
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Long-acting injectable (LAI) antipsychotics for schizophrenia treatment: the new treatment standards

Bartosz Łoza, Sławomir Murawiec
Psychiatria 2015;12(3):119-127.

open access

Vol 12, No 3 (2015)
Prace poglądowe - nadesłane

Abstract

Schizophrenia is a neurodegenerative disease associated with frequent, detrimental relapses. To improve the long-term prognosis, it is important to provide patients diagnosed with schizophrenia with the most effective treatment, immediately following their first episode. Long-acting injectable (LAI) antipsychotics, especially atypical LAIs, are one of the best options to improve adherence and decrease relapse risk. Unfortunately, in Poland, very few psychiatrists offer LAI antipsychotics for schizophrenic patients (< 7%), significantly less than in other neighbor countries. Because of that we proposed the new antipsychotic LAI algorithm for schizophrenia treatment. In the present paper, the pros and cons of the proposed standard administration of LAI antipsychotics for schizophrenia were discussed. Indications for second generation antipsychotics in long acting injections in the treatment of schizophrenia can be summarized as follows: incomplete clinical improvement in the course of previous treatment (cognitive deficits and their further deterioration despite the improvement in positive symptoms of the disorder, residual symptoms of schizophrenia affecting patients’ functioning, intolerance of oral dosing, hospitalization exceeding 30 days), incomplete improvement in patients functioning (in all or even one of three domains: the occupational, educational, social and familiar functioning); high risk of relapse — relapse prevention (rehospitalization in less than twelve months after previous hospitalization, nonadherence i.e. patient’s own decision of discontinuation of medication for the period exceeding 2 weeks, clinically relevant affective symptoms manifestations, comorbid alcohol or psychoactive substance misuse and lack of social and/or familiar support) as well as patients own preference of long acting injections antipsychotics in the absence of contraindications for such treatment. Benefit of long acting antipsychotics is the regular contact between patients and treatment teams, which provides the opportunity for greater therapeutic alliance and psychosocial support.

Abstract

Schizophrenia is a neurodegenerative disease associated with frequent, detrimental relapses. To improve the long-term prognosis, it is important to provide patients diagnosed with schizophrenia with the most effective treatment, immediately following their first episode. Long-acting injectable (LAI) antipsychotics, especially atypical LAIs, are one of the best options to improve adherence and decrease relapse risk. Unfortunately, in Poland, very few psychiatrists offer LAI antipsychotics for schizophrenic patients (< 7%), significantly less than in other neighbor countries. Because of that we proposed the new antipsychotic LAI algorithm for schizophrenia treatment. In the present paper, the pros and cons of the proposed standard administration of LAI antipsychotics for schizophrenia were discussed. Indications for second generation antipsychotics in long acting injections in the treatment of schizophrenia can be summarized as follows: incomplete clinical improvement in the course of previous treatment (cognitive deficits and their further deterioration despite the improvement in positive symptoms of the disorder, residual symptoms of schizophrenia affecting patients’ functioning, intolerance of oral dosing, hospitalization exceeding 30 days), incomplete improvement in patients functioning (in all or even one of three domains: the occupational, educational, social and familiar functioning); high risk of relapse — relapse prevention (rehospitalization in less than twelve months after previous hospitalization, nonadherence i.e. patient’s own decision of discontinuation of medication for the period exceeding 2 weeks, clinically relevant affective symptoms manifestations, comorbid alcohol or psychoactive substance misuse and lack of social and/or familiar support) as well as patients own preference of long acting injections antipsychotics in the absence of contraindications for such treatment. Benefit of long acting antipsychotics is the regular contact between patients and treatment teams, which provides the opportunity for greater therapeutic alliance and psychosocial support.

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Keywords

LAI, long-acting injections, depot antipsychotics, schizophrenia treatment standards, treatment compliance

About this article
Title

Long-acting injectable (LAI) antipsychotics for schizophrenia treatment: the new treatment standards

Journal

Psychiatria (Psychiatry)

Issue

Vol 12, No 3 (2015)

Article type

Review paper

Pages

119-127

Bibliographic record

Psychiatria 2015;12(3):119-127.

Keywords

LAI
long-acting injections
depot antipsychotics
schizophrenia treatment standards
treatment compliance

Authors

Bartosz Łoza
Sławomir Murawiec

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