Tuesday, November 4, 2014

Psychiatrists Discuss Advantages of Long-Acting Injectable Antipsychotics

With studies showing schizophrenia to be treatment refractory in one-fifth of those affected, psychiatrists are exploring other options to the delivery of effective treatment. At APA’s Institute on Psychiatric Services in San Francisco, some of the leading experts in psychopharmacology led a research symposium on the benefits of long-acting injectable (LAI) antipsychotic medications.

“Psychiatrists who were trained during my time of training, think that long-acting injectable antipsychotics should be used for the most refractory, noncompliant, and difficult to treat patients,” Steven Potkin, M.D., director of clinical research at the University of California, Irvine, said at the symposium. “[However] there is accumulating evidence that very early in the course [of illness] that this should be offered as an option, since half of the patients with first-episode psychosis discontinue medication after they are discharged from a hospital.”

Research on part of the “accumulating evidence” on long-acting injectable antipsychotics was presented by Keith Nuechterlein, Ph.D., a distinguished professor of psychiatry at the University of California, Los Angeles, who led a randomized study comparing LAI risperidone with oral rispiderone in 83 individuals who had a first psychotic episode within the two years prior to the study. The results showed that after one year of treatment, participants who received the daily oral form of risperidone had a 33%relapse rate, compared with 5% in those treated weekly with LAI risperidone. In addition, individuals in the oral risperidone cohort were four times more likely to be hospitalized than those taking the LAI version.

"We were struck [by the fact] that these were among the most dramatic results that have occurred for long-acting injectables—and it was in first-episode patients," said Nuechterlein, during an interview with Psychiatric News. Nuechterlein added that not only did patients experience advantages regarding outcomes associated with LAIs, but the patients accepted LAI medication quite readily. (The study was funded by the National Institutes of Health and Janssen Pharmaceuticals.)

“This symposium was an invitation for psychiatrists to rethink when is it appropriate to offer patients long-acting injectable medication,” Potkin told Psychiatric News. “Should it be reserved only for refractory patients, or should it be offered to people earlier in the course [of illness]… or at any stage of illness? Of course, LAIs are not for everyone, but our patients should definitely be given options,” he concluded.

Improve Your Treatment Skills for Military Patients

In observance of Veterans Day, APA is cosponsoring a webinar that will help APA members and other health care professionals provide more effective care to members of the military and veterans. The free webinar, "Military Culture Counts: Assisting Service Members and Veterans," will be held on Monday, November 10, from noon to 1 p.m. The organizations partnering with APA are the Association of American Medical Colleges and Joining Forces, a public-private partnership created by First Lady Michelle Obama and Jill Biden, Ed.D. Register now.

(Image: Psychiatric News/Vabren Watts)


The content of Psychiatric News does not necessarily reflect the views of APA or the editors. Unless so stated, neither Psychiatric News nor APA guarantees, warrants, or endorses information or advertising in this newspaper. Clinical opinions are not peer reviewed and thus should be independently verified.