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Review
. 2014 Oct;4(5):198-219.
doi: 10.1177/2045125314540297.

The role of long-acting injectable antipsychotics in schizophrenia: a critical appraisal

Sofia Brissos  1 , Miguel Ruiz Veguilla  2 , David Taylor  3 , Vicent Balanzá-Martinez  4
Affiliations
Review

The role of long-acting injectable antipsychotics in schizophrenia: a critical appraisal

Sofia Brissos et al. Ther Adv Psychopharmacol. 2014 Oct.

Abstract

Despite their widespread use, long-acting injectable (LAI) antipsychotics (APs) are often regarded with some negativity because of the assumption of punishment, control and insufficient evolution towards psychosocial development of patients. However, LAI APs have proved effective in schizophrenia and other severe psychotic disorders because they assure stable blood levels, leading to a reduction of the risk of relapse. Therapeutic opportunities have also arisen after introduction of newer, second-generation LAI APs in recent years. Newer LAI APs are more readily dosed optimally, may be better tolerated and are better suited to integrated rehabilitation programmes. This review outlines the older and newer LAI APs available for the treatment of schizophrenia, with considerations of past and present pharmacological and therapeutic issues. Traditional, evidence-based approaches to systematic reviews and randomized clinical trials are of limited utility in this area so this paper's blending of experimental trials with observational research is particularly appropriate and effective.

Keywords: adherence; atypical; clinical trial; depot; history; long-acting injections; pharmacology; treatment; typical.

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Conflict of interest statement

Conflict of interest statement: S.B. was Medical Affairs Manager at Janssen Pharmaceutical from April 2010 to August 2013. Since then, she has served as consultant/advisor for Janssen on a sporadic basis. M.R.-V. has received grants and served as advisor or Continuing Medical Education (CME) speaker for the following entities: Bristol-Myers-Squibb; Janssen; Juste; Otsuka; Spanish Ministry of Science and Innovation; Consejería de Salud de la Junta de Andalucía; Plan Nacional de Drogas; and Fundación Alicia Koplowitz. D.T. has received research funding from and undertaken paid consultancy with Janssen, Servier, Otsuka and AstraZeneca. V.B.-M. has received grants and served as consultant, advisor or CME speaker during the last three years for the following entities: Almirall; Angelini; AstraZeneca; Bristol-Myers-Squibb; Janssen; Juste; Lundbeck; Otsuka; Spanish Ministry of Science and Innovation (CIBERSAM); and Fundación Alicia Koplowitz.

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