Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar;25(2):135-149.
doi: 10.1007/s40272-023-00558-x. Epub 2023 Jan 20.

What Role for Long-Acting Injectable Antipsychotics in Managing Schizophrenia Spectrum Disorders in Children and Adolescents? A Systematic Review

Inmaculada Baeza  1   2   3   4 , Adriana Fortea  5   6   7   8 , Daniel Ilzarbe  5   6   7   8 , Gisela Sugranyes  5   6   7   8
Affiliations

What Role for Long-Acting Injectable Antipsychotics in Managing Schizophrenia Spectrum Disorders in Children and Adolescents? A Systematic Review

Inmaculada Baeza et al. Paediatr Drugs. 2023 Mar.

Abstract

Background: Long-acting injectable antipsychotics (LAIAs) are an efficacious and well-tolerated treatment in adults with schizophrenia spectrum disorders (SSD). However, there is less evidence for their use in children and adolescents.

Objectives: The aim of this systematic review was to summarize findings regarding the effectiveness and side effects of LAIA in children and adolescents with SSD.

Methods: Four databases (Web of Science, PubMed, MEDES, and Dialnet) were systematically searched for articles published between inception and 12 March, 2022, with the following inclusion criteria: (1) original articles or case reports; (2) providing data on efficacy/effectiveness or safety/tolerability of LAIA treatment in children and adolescents diagnosed with SSD (schizophrenia, schizoaffective disorder, schizophreniform disorder, non-affective psychotic disorder); (3) mean age of samples ≤ 18 years; and (4) written in English or Spanish. Exclusion criteria were review articles, clinical guides, expert consensus as well as posters or oral communication in conferences. The risk of bias was assessed using the ROBIS tool.

Results: From 847 articles found, 13 met the inclusion criteria. These included seven single case reports or case series, four retrospective chart reviews, a 24-week open-label trial, and one observational prospective study, covering a total of 119 adolescents (aged 12-17 years) with SSD. Almost all the articles described data on second-generation LAIA (53 patients on risperidone [once every other week], 33 on paliperidone palmitate [once monthly], 10 on aripiprazole [once monthly], and two on olanzapine pamoate [once monthly]). Twenty-one patients were reported to be only on first-generation LAIAs. Non-adherence was the main reason for starting an LAIA. In all of the studies, the use of LAIAs was associated with improvement in the patients' symptoms.

Conclusions: There are few studies assessing the use of LAIAs in adolescents with SSD. Overall, these treatments have suggested good effectiveness and acceptable safety and tolerability. However, we found no studies examining their use in children aged < 12 years. The problems and benefits linked to this type of antipsychotic formulation in the child and adolescent population require further study, ideally with prospective, controlled designs.

PubMed Disclaimer

Conflict of interest statement

IB has received honoraria and travel support from Angelini, Otsuka-Lundbeck, and Janssen and grants from the Spanish Ministry of Health, Instituto de Salud Carlos III supported by ERDF Funds from the European Commission (PI18/0242/PI21/0391). AF has received travel and educational support from Janssen Cilag and Otsuka-Lundbeck. DI has received continuing medical education support from Rubió and Angelini. GS has received speaker fees from Angelini, and has received funding from the Alicia Koplowitz Foundation, the Brain and Behaviour Research Foundation and the Instituto de Salud Carlos III supported by ERDF Funds from the European Commission (PI1800976, PI21/00330), the Catalonia Government (2017SGR881, PERIS SLT006/17/00346), and Fundació Clínic Recerca Biomèdica (Ajut a la Recerca Pons Bartran).

Figures

Fig. 1
Fig. 1
Flow diagram of the article screening process
Fig. 2
Fig. 2
Distribution of long-acting injectable antipsychotic agents in the 119 patients included in the studies reviewed
See this image and copyright information in PMC

References

    1. Immonen J, Jääskeläinen E, Korpela H, Miettunen J. Age at onset and the outcomes of schizophrenia: a systematic review and meta-analysis. Early Interv Psychiatry. 2017;11:453–460. doi: 10.1111/eip.12412. - DOI - PMC - PubMed
    1. Jin H, Mosweu I. The societal cost of schizophrenia: a systematic review. Pharmacoeconomics. 2017;35:25–42. doi: 10.1007/s40273-016-0444-6. - DOI - PubMed
    1. Latorre V, Messeni Petruzzelli A, Uva AE, Ranaudo C, Semisa D. Unveiling the actual cost of schizophrenia: an activity-based costing (ABC) approach. Int J Health Plann Manage. 2021 doi: 10.1002/hpm.3405. - DOI - PubMed
    1. McClellan J, Stock S. Practice parameter for the assessment and treatment of children and adolescents with schizophrenia. J Am Acad Child Adolesc Psychiatry. 2013;52:976–990. doi: 10.1016/j.jaac.2013.02.008. - DOI - PubMed
    1. Hegarty JD, Baldessarini RJ, Tohen M, Waternaux C, Oepen G. One hundred years of schizophrenia: a meta-analysis of the outcome literature. Am J Psychiatry. 1994;151:1409–1416. doi: 10.1176/ajp.151.10.1409. - DOI - PubMed

Publication types