Practical management of schizophrenia: the role of long-acting Antipsychotics

The management of schizophrenia remains a clinical challenge, despite improvements in drug therapy, the availability of psychosocial treatments and family and community interventions. High rates of impaired adherence play a substantive role in promoting poor outcomes. Long-acting injectable (LAI) antipsychotics have been developed with the aim of enhancing treatment adherence and improving the long-term treatment outcomes of schizophrenia. Second-generation LAIs combine the favourable features of an atypical antipsychotic with the improved pharmacokinetic profile of a long-acting formulation (e.g., improved bioavailability and assured medication delivery). Therefore, LAI antipsychotics may have clinical utility as a potential treatment strategy in many patients. Second-generation LAIs minimise the risk of relapse, improve global outcomes, and may contribute to helping patients improve their level of recovery. Given the relatively recent introduction of these agents, and the promising results of current clinical trials it is anticipated that future well conducted studies will lend support to the more widespread use of these agents in a broader range of patients.