Long-Acting Injectable Antipsychotic Medications in Schizophrenia Management




  • Rajender R Aparasu
  • Sanika Rege


Antipsychotic medications are indicated for the treatment of schizophrenia and other psychiatric disorders including bipolar disorder. However, oral antipsychotics are associated with a number of issues including poor treatment adherence. Long Acting Injectable (LAI) antipsychotics were designed to address these issues with oral antipsychotics. LAI antipsychotics offer several advantages including less frequent dose administration, better adherence and tolerability, and relapse prevention, which in turn help in improving patients’ quality of life. Recent development of atypical antipsychotics has the advantages over typical antipsychotics in terms of improved efficacy and tolerability. This review highlights the advantages and disadvantages of LAI antipsychotics, outlines the currently available LAIs and their indications, and real-world evidence for LAIs based on the observational st


Download data is not yet available.


Metrics Loading ...


Antipsychotics, Injectables, efficacy, tolerability, quality of life




How to Cite

Aparasu RR, Rege S. Long-Acting Injectable Antipsychotic Medications in Schizophrenia Management . Scopus Indexed [Internet]. 2016 Nov. 30 [cited 2024 Jun. 20];10(6):3507-11. Available from: https://www.ijpsnonline.com/index.php/ijpsn/article/view/887


Agid O, Foussias G, and Remington G (2010). Long-acting injectable antipsychotics in the treatment of schizophrenia: their role in relapse prevention. Expert Opin Pharmacother 11: 2301-2317.
APP Pharmaceuticals (2010). Fluphenazine decanoate Injection USP. Available at http://www.accessdata.fda.gov/ drugsatfda_ docs/label/2010/071413s019lbl.pdf. Accessed 3rd November 2016.
Avon and Wiltshire (2014). Mental Health Partnership NHS Trust, Aripiprazole long acting injection (Abilify Maintena), Guidance for prescribing and administration, Prescribing Guidelines V1.1 BLS.
Baser O, Xie L, Pesa J, and Durkin M (2015). Healthcare utilization and costs of Veterans Health Administration patients with schizophrenia treated with paliperidone palmitate long-acting injection or oral atypical antipsychotics. J Med Econ 18: 357-365.
Brissos S, Veguilla MR, Taylor D, and Martinez VB (2014). The role of long-acting injectable antipsychotics in schizophrenia: a critical appraisal. Ther Adv Psychopharmacol 4:198-219.
Broder MS et al (2012). Association between second-generation antipsychotic medication half-life and hospitalization in the community treatment of adult schizophrenia. J Med Econ 15: 105-111.
CG (2005). Canadian guidelines. Clinical practice guidelines. Treatment of schizophrenia. Can J Psychiatry 50: 7S-57S.
Curry S, Whelpton R, de Schepper P, Vranckx S, and Schiff A (1979). Kinetics of fluphenazine after fluphenazine dihydrochloride, ethanthate and decanoate administration to man. Br J Clin Pharmacol 7: 325-331.
Gefvert O, Eriksson B, Persson P, Helldin L, Bjorner A, and Mannaert E (2005). Pharmacokinetucs and D2 receptor occupancy of long-acting injectable risperisone (Risperdal Consta) in patients with schizophrenia. Int J Neuro-psychopharmacol 8: 27-36.
Gilday E and Nasrallah H (2012). Clinical pharmacology of paiperidone palmitate a parenteral long-acting formulation for the treatment of schizophrenia. Rev Recent Clin Trials 7: 2-9.
Jaaskelainen E, Juola P, and Hirvonen N (2013). A systematic review and meta-analysis of recovery in schizophrenia. Schizophr Bull 39: 1296-1306.
JP (2016a). Janssen Pharmaceuticals, Inc Invega Sustenna (paliperidone palmitate) extended-release injectable suspension, for intramuscular use, Highlights of prescribing information. 2009. Available at https://www.janssencns.com/shared/ product/invegasustenna/prescribing-information.pdf. Accessed 4th November 2016.
JP (2016b). Janssen Pharmaceuticals, Inc., Risperdral Consta (risperidone) long-acting injection, Highlights of prescribing information. 2007. Available atttp://www.janssencns.com/shared/ product/risperdalconsta/prescribing-information.pdf. Accessed 4th November 2016.
Jarema M (2015). Practical Guidelines for the use of long-acting injectable second-generation antipsychotics. Psychiatr Pol 49: 225-241.
Joshi K, Pan X, Wang R, Yang E, and Benson C (2016). Healthcare resource utilization of second-generation long-acting injectable antipsychotics in schizophrenia: risperidone versus paliperidone palmitate. Curr Med Res Opin 32: 1873-1881.
Ju PC (2014). Long-acting injectables for rehospitalization among patients with schizophrenia in the home care program in Taiwan. J Clin Psychopharmacol 34: 23-29.
Kissling W, Moller H, Walter K, Wittmann B, Krueger R, and Trenk D (1991). Double-blind comparison of haloperidol decanoate and fluphenazine decanoate effectiveness, side-effects, dosage and serum levels during a six months’ treatment for relapse prevention. Pharmacopsychiatry 18: 240-245.
Lehman A, Lieberman J, Dixon L, McGlashan T, Miller A, and Perkins D (2004). American Psychiatric Association; Steering Committee on Practice Guidelines, Practice Guideline for the treatment of patients with schizophrenia, second edition. Am J Psychiatry 161 (2 Suppl.): 1-56.
Leucht S, Tardy M, and Komossa K (2012). Antipsychotic drugsversus placebo for relapse prevention in schizophrenia: a systematic review and meta-analysis. Lancet 379: 2063-2071.
Lin J, Wong B, Offord S, and Mirski D (2013). Healthcare cost reductions associated with the use of LAI formulations of antipsychotic medications versus oral among patients with schizophrenia. J Behav Health Serv Res 40: 355-66.
Lindenmayer JP (2010). Long-acting injectable antipsychotics: focus on olanzapine pamoate.Neuropsychiatr Dis Treat 6: 261-267.
LAIA (2015). Long-acting Injectable Antipsychotics: Haloperidol and fluphenazine decanoate, aripiprazole (Abilify Maintena), risperidone (Risperdal Consta), and paliperidone (Invega Sustenna), Criteria for use and evidence summary, VA Pharmacy Benefits Management Services 2015, Available at http://www.pbm.va.gov, accessed 29th October 2016.
Marcus (2015). Antipsychotic adherence and rehospitalization in schizophrenia patients receiving oral versus long-acting injectable antipsychotics following hospital discharge. J Mang Care Spec Pharm 21: 754-68.
Mauri MC, Paletta S, Maffini M, Colasanti A, Dragogna F, Di Pace C, and Altamura AC (2014). Clinical pharmacology of atypical antipsychotics: an update. Excli J 13: 1163-1191.
McEvan JP (2016). Hospital readmission rates among patients with schizophrenia treated with long-acting injectables or oral antipsychotics. Psychiatr Serv 67: 1183-1188.
Nahata T and Saini T (2009). Formulation optimization of long-acting depot injection of aripiprazole by using D-optimal mixture design. PDA J Pharm Sci Technol 63: 113-122.
Offord S, Wong B, Mirski D, Baker RA, and LinJ (2013). Healthcare resource usage of schizophrenia patients initiating long-acting injectable antipsychotics vs oral. J Med Econ 16: 231-239.
Pesa JA (2015). Costs and Resource Utilization among Medicaid patients with schizophrenia treated with paliperidone palmitate or oral atypical antipsychotics. Drugs Real World Outcomes 2: 377-385.
Reyntijens A, Heykants J, Woestenborghs R, Gelders Y and Aerts T (1982). Pharmacokinetics of haloperidol decanoate. Int Pharmacopsychiatry 17: 238-246.
Rosaria D and Alice B (2010). Profile of olanzapine long-acting injection for the maintenance treatment of adult patients with schizophrenia. Neuropsychiatr Dis Treat 6: 573-581.
Sacchetti E (2015). Long-acting injection antipsychotic medications in the management of schizophrenia. Evidence-based Psychiatric Care 1: 27-36.
Thyssen A, Rusch S, Herben V, Quiroz J and Mannaert E (2010). Risperidone long-acting injection: pharmacokinetics following administration in deltoid versus gluteal muscle in schizophrenic patients. J Clin Pharmacol 50: 1011-1021.
Voss EA, Ryan PB, Stang PE, Hough D and Alphs L (2015). Switching from risperidone long-acting injectable to paliperidone long-acting injectable or oral antipsychotics: analysis of Medicaid claims database. Int Clin Psychopharmacol 30: 151-157.