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Updated: Jun 19, 2026

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Published on: May 31, 2024
Second-generation antipsychotic long-acting injections: systematic review
1Medical University Innsbruck, Department of Psychiatry and Psychotherapy, Anichstrasse 35, A-6020 Innsbruck, Austria. wolfgang.fleischhacker@i-med.ac.at
Background:
Second-generation antipsychotics (SGAs) represent an advance in the long-term management of schizophrenia.
Aims:
To review the available evidence concerning SGA long-acting injections (LAIs).
Method:
A systematic review of the literature was conducted using PubMed.
Results:
Risperidone long-acting injection was the first licensed SGA-LAI compound and is effective in the long-term management of schizophrenia, with a safety profile similar to that of oral risperidone. Olanzapine pamoate has recently been approved in Europe. In terms of efficacy, at injection intervals of up to 4 weeks it appears comparable to oral olanzapine, although the potential for ;post-injection syndrome' (delirium) calls for additional safety considerations. Paliperidone palmitate is currently under review with the licensing authorities. It also affords the potential advantage of monthly dosing.
Conclusions:
More long-term comparisons of SGA-LAIs with oral SGAs as well as with first-generation antipsychotic LAIs are needed. These studies should include cost-effectiveness data.
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