Long-acting injectable antipsychotics in first-episode schizophrenia.

Abstract

Long-acting injectable antipsychotics (LAIAs) may improve adherence to treatment and reduce the rate of relapse and rehospitalization in first-episode or recent-onset schizophrenia (e.g., less than 2 years of illness duration). However, despite their potential advantages, LAIAs are underutilised in clinical practice and the place of LAIAs in the early phases of schizophrenia is still a controversial clinical issue. For example, negative attitudes toward LAIAs in first-episode schizophrenia among psychiatrists are common, and the place of LAIAs for first-episode psychoses (FEPs) remains uncertain in the current clinical guidelines for the pharmacological treatment of schizophrenia. Moreover, a recent paper published in the New England Journal of Medicine by Rosenheck et al. [1] reported negative results of LAI risperidone (RLAI) on relapse prevention, although this was in a multiepisode sample. The recent and forthcoming availability of additional second-generation LAIAs (SG-LAIAs), namely, olanzapine pamoate, paliperidone palmitate, aripiprazole, and iloperidone depot, will add interest to this clinical debate for practicing clinicians and researchers interested in this timely topic.