Use of long-acting antipsychotic medications: practical issues

L’uso di farmaci antipsicotici long-acting nella pratica clinica

M. Ragusa, S. Patriarca, P. Stratta, A. Collazzoni, A. Rossi

Dipartimento di Scienze Cliniche e Biotecnologie (DISCAB), Sezione di Neuroscienze, Università de L’Aquila

Summary

Introduction
Non-adherence to therapy is a significant problem in treatment of patients with a diagnosis of schizophrenia; the rate of non-adherence in psychiatric patients varies from 24% to 90%, with average of about 60%. This may be due to the lack of awareness of the disorder, weak conviction of the utility of therapy by the patient or family, complexity of treatment, or severity of side effects. To increase adherence to treatment formulations of extended- release injectable antipsychotics (long-acting injectable, LAI) have been developed that ensure a continuous supply of the drug with stable blood concentrations.

Objective
The objective of this review is to evaluate the advantages and disadvantages of LAI antipsychotics, the main guidelines, and attitudes of the physician and patient to their prescription and administration.

Methods
Review of the literature using PubMed. The keywords “antipsychotic long-acting”, “LAI”, “schizophrenia”, “poor compliance” and “antipsychotic depot” were used.

Conclusions
Many authors agree on the poor use of LAI in clinical practice due to the lack of knowledge of the type of drug by both physicians and patients. A careful examination of guidelines may help to identify the ideal profile of patients who can benefit from LAI.

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