Individuals with bipolar disorder who received long-acting injectable antipsychotics (LAIAs) had a lower risk of hospitalization and recurrence of manic or mixed episodes than those receiving oral antipsychotics, according to a
report in
The American Journal of Psychiatry.
Why It’s Relevant
Studies in patients with schizophrenia highlight many health benefits of LAIAs, but comparable guidance for bipolar disorder is lacking. For this study, researchers used national electronic health record data to examine health care utilization, illness relapse, and safety issues among 2,086 individuals with bipolar disorder in Hong Kong who received prescriptions for both LAIAs and oral antipsychotics between 2004 and 2023.
By the Numbers
- Compared to periods when they were taking oral antipsychotics, individuals had a 15% lower risk of all-cause emergency department visits and a 21% lower risk of all-cause hospitalization when taking LAIAs.
- Patients on LAIAs had a 49% lower risk of hospitalization for manic episodes and a 69% reduced risk of hospitalization for mixed episodes.
- LAIAs were not superior to oral antipsychotics for hospitalization for depressive episodes or non-psychiatric hospitalizations.
What’s More
Individuals receiving LAIAs did not have any increased risk of hospitalization for cardiovascular problems compared with oral antipsychotics. While LAIAs were associated with an early increased risk of extrapyramidal symptoms (EPS), the risk was no longer significant after 90 days.
The Other Side
Key variables that might influence the results, such as illness severity, medication adherence, bipolar disorder subtype, or accompanying psychosocial interventions, were unavailable. Additionally, doses for oral antipsychotics and LAIAs were recorded differently in the health records.
Takeaway Message
Researchers said that the findings support use of LAIAs among people with bipolar disorder, accompanied by close monitoring for EPS, particularly during the initiation phase.
Related Information
Source
Eunice Kehui Deng, et. al. Comparison of long-acting injectable and oral antipsychotics in bipolar disorder.”
TheAmerican Journal of Psychiatry. Published September 9, 2026. doi:
doi.org/10.1176/appi.ajp.202507
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