Tackling Myths and Misconceptions about Long-Acting Injectables in Schizophrenia

While antipsychotic treatment is essential to achieving and maintaining remission in schizophrenia, conventional antipsychotic treatments are associated with numerous shortcomings, including non-adherence, inadequate response, and/or medication-related adverse events. Poor response and undesirable effects related to treatment often contribute to patient-initiated and undisclosed treatment discontinuation. Contributing factors for nonadherence to prescribed treatments can also include psychological, social, and logistical challenges within a patient population that is prone to a lack of insight into the condition, disorganization or a lack of a daily routine, and potentially complicated family or societal influence and stigma. Patients with a poor and/or inadequate response to treatment may be disinclined to explore alternative treatment options or administration routes, such as injectable forms that offer numerous advantages over oral treatments, including more consistent effects from a longer-acting formulation. Long-acting injectable (LAI) antipsychotics have been shown to significantly reduce the risk of relapse and the rate of hospitalization when directly compared to oral formulations, providing a potentially powerful treatment option. However, misconceptions continue to limit their optimal use in clinical practice. To overcome barriers to the appropriate implementation of these important therapies, psychiatry and allied clinicians require ongoing education regarding their varied pharmacologic properties and clinical data, implications for individualized patient care, guideline-recommended best-practices, and communication strategies to facilitate patient/care partner education and acceptance of LAIs.