Long-acting injectable antipsychotics as first-line treatment

Agnė Sipavičiūtė1

1 Faculty of Medicine, Vilnius University, Vilnius, Lithuania




            Non-adherence remains a significant problem in schizophrenia treatment. Discontinuation of treatment results in relapse and therefore leads to poor long-term prognosis. Long-acting injectable (LAI) antipsychotics (AP) are used to address non-adherence and to maintain consistent long-term treatment, which is recommended to be continued for 2-5 years. Depot APs are under prescribed and frequently used for patients that are non-adherent to oral antipsychotics and have already experienced multiple psychotic episodes. This is mostly associated with clinicians’ attitudes towards depot medication. Long-acting APs are related to lower relapse and hospitalization rates compared to oral treatment. Therefore, LAI would be most beneficial in early schizophrenia treatment, with the aim to avoid relapse and poor long-term prognosis. Adherence and LAI prescription rates might also be improved by enhanced patient involvement in treatment choice.


Keywords: antipsychotic long-acting injections, depot antipsychotics, long-acting injectable antipsychotics, schizophrenia, early psychosis, first episode psychosis.