Schizophrenia is a spectrum of brain disorders that affects about 1 percent of the population. The spectrum of schizophrenia is characterized by hallucinations, delusions, paranoia and other chronic psychotic features that are sometimes disabling. Effective treatments are available that promote safety, functionality and quality of life. These treatments vary by provider, but generally include antipsychotic medications and psychosocial therapy.
Historically, people with schizophrenia experienced exacerbations and remissions of symptoms. Acute exacerbations of psychosis can result in very negative consequences for patients in every aspect of their lives. Furthermore, acute exacerbations also result in increased health care costs and utilization. But today, new long-acting injectable (LAI) antipsychotic medication may help reduce acute exacerbations.
Antipsychotic pills became available in the 1950s, but even then many patients did not take their medication. First-generation LAI antipsychotics began to appear in the late 1960s. More recently, second generation antipsychotics were developed and found to have fewer adverse effects (except for weight gain and metabolic syndrome). LAI formulations of these newer antipsychotics are now being assessed for safety and effectiveness.
Safety and efficacy of LAIs
The National Alliance on Mental Illness offers a factsheet on LAIs from 2013, although a more recent list of the advantages and disadvantages of LAIs was published in 2014 based on a thorough review of available research.
Basically, the advantages include more consistent dosing, lower relapse rates, lower overdose risk, better follow-up with the health care team and no need to take medication one to three times a day. Disadvantages include a longer time to adjust the dose, delayed disappearance of distressing side effects, pain from injections and the need to travel to receive the injection every two to four weeks.
A recent report published in the April 2016 edition of Psychiatric and Clinical Neurosciences added that LAI antipsychotics may result in shorter hospital stays for patients with schizophrenia. Furthermore, there is some evidence that starting LAIs during first-episode psychosis may prevent cognitive decline by improving the trajectory of myelin development.
Attitudes toward LAIs
Patients in general have reportedly been more negative than relatives and psychiatrists toward LAIs, often perceiving them as coercive and stigmatizing. However, others have preferred LAIs over oral medications, stating that they felt better, had a more normal life and found the injections easier to remember.
Patients should always stay informed about what treatments are available and be able to choose which ones they feel may be right for them. At Sovereign Health, we ensure that all of our patients fully understand their condition and treatments that are currently available so that they can be an active part of the treatment team. Likewise, family members and other caregivers are also included so that the transition home can be as seamless as possible.
The Sovereign Health Group treats individuals with mental illness, substance use disorders and dual diagnosis. We use multimodal diagnostic assessment and treatment to provide optimal long-term outcomes. Comprehensive treatment and ongoing aftercare provide the support patients need to recover and successfully manage their lives. To learn more about specialized programs at Sovereign Health, please call us at our 24/7 helpline.
About the author
Dana Connolly, Ph.D., is a senior staff writer for the Sovereign Health Group, where she translates current research into practical information. She earned her Ph.D. in research and theory development from New York University and has decades of experience in clinical care, medical research and health education. The Sovereign Health Group is a health information resource and Dr. Connolly helps to ensure excellence in our model. For more information and other inquiries about this article, contact the author at firstname.lastname@example.org.