The safe administration of long-acting depot antipsychotics

Injectable long-acting antipsychotics are a well-established and common treatment for schizophrenia and other mental health problems. While these medicines have traditionally been injected into the dorsogluteal muscle, the primacy of this site has been challenged over recent years, both through the emergence of the deltoid muscle as a less intrusive alternative, and through a groundswell of opinion raising concerns over the safety of injecting into the gluteal muscle. As these concerns have included calls for the dorsogluteal site to no longer be considered suitable for the administration of injections, there is a need to clarify the basis of such claims and the appropriateness of continued use of this area. Review of relevant literature allowed exploration of the evidence used in supporting these claims and identified that UK licencing agreements for these medicines fails to support such wholesale change and that there are considerable inconsistencies in the evidence presented. Recommendations are made for further study in this area and for measured change to practice if required, particularly around use of the deltoid site and for review of the licencing agreements for these medicines.