A Systemic Review and Experts' Consensus for Long-acting Injectable Antipsychot

Yuan Hwa Chou, Po Chung Chu, Szu Wei Wu, Jen Chin Lee, Yi Hsuan Lee, I. Wen Sun, Chen Lin Chang, Chien Liang Huang, I. Chao Liu, Chia Fen Tsai, Yung Chieh Yen

Research output: Contribution to journalReview articlepeer-review

30 Citations (Scopus)

Abstract

Bipolar disorder (BD) is a major psychiatric disorder that is easily misdiagnosed. Patient adherence to a treatment regimen is of utmost importance for successful outcomes in BD. Several trials of antipsychotics suggested that depot antipsychotics, including long-acting first- and second-generation agents, are effective in preventing non-adherence, partial adherence, and in reducing relapse in BD. Various long-acting injectable (LAI) antipsychotics are available, including fluphenazine decanoate, haloperidol decanoate, olanzapine pamoate, risperidone microspheres, paliperidone palmitate, and aripiprazole monohydrate. Due to the increasing number of BD patients receiving LAI antipsychotics, treatment guidelines have been developed. However, the clinical applicability of LAI antipsychotics remains a global cause for concern, particularly in Asian countries. Expert physicians from Taiwan participated in a consensus meeting, which was held to review key areas based on both current literature and clinical practice. The purpose of this meeting was to generate a practical and implementable set of recommendations for LAI antipsychotic use to treat BD; target patient groups, dosage, administration, and adverse effects were considered. Experts recommended using LAI antipsychotics in patients with schizophrenia, rapid cycling BD, BD I, and bipolar-type schizoaffective disorder. LAI antipsychotic use was recommended in BD patients with the following characteristics: multiple episodes and low adherence; seldom yet serious episodes; low adherence potential per a physician's clinical judgment; preference for injectable agents over oral agents; and multiple oral agent users still experiencing residual symptoms.

Original languageEnglish
Pages (from-to)121-128
Number of pages8
JournalClinical Psychopharmacology and Neuroscience
Volume13
Issue number2
DOIs
Publication statusPublished - Aug 1 2015
Externally publishedYes

Keywords

  • Bipolar disorder
  • Consensus
  • Long-acting injectable antipsychotics
  • Risperidone

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Behavioral Neuroscience
  • Pharmacology (medical)

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