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A Pilot Study to Explore the Effect of Long Acting Injectable Antipsychotics on Aggression.
Tiffany M Hopkins1, O Greg Deardorff2, Yifei Liu3
1Hopkins, PharmD, BCPP, Clinical Pharmacy Specialist, South Texas Veterans Health Care System, San Antonio, TX.
Psychopharmacology Bulletin
|March 7, 2024
Summary
Switching to long-acting injectable (LAI) antipsychotics did not significantly alter aggression or self-harm. However, LAI antipsychotics appeared to reduce the need for restraints and seclusion.
Area of Science:
- Psychiatry
- Pharmacology
Background:
- Antipsychotic medications are central to managing severe mental illnesses.
- Long-acting injectable (LAI) antipsychotics offer an alternative administration route to oral formulations.
- Understanding the impact of switching from oral to LAI antipsychotics is crucial for patient care.
Purpose of the Study:
- To evaluate the effects of transitioning from oral antipsychotics to LAI antipsychotics.
- To assess changes in aggression, interventions, self-harm, seclusion/restraint, medication refusal, and PRN antipsychotic use.
Main Methods:
- Retrospective chart review at a state forensic psychiatric facility.
- Inclusion criteria: minimum 6 months on oral antipsychotics followed by 6 months on LAI antipsychotics.
- Data collected over an 80-month period.
Main Results:
- Eighteen patients were included in the study.
- Aggression incidents showed mixed results: two increased, three decreased, two unchanged.
- Interventions decreased by 30.6% after switching to LAI antipsychotics.
- Restraint/seclusion use decreased, while medication refusal and PRN antipsychotic use showed varied changes.
Conclusions:
- Switching to LAI antipsychotics did not significantly increase or decrease aggression or self-injurious behavior.
- LAI antipsychotics appeared to reduce the requirement for restraints and seclusions.
- Further research may be needed to fully elucidate the impact on all measured outcomes.
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