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Long-Acting Injectable Antipsychotic Initiation in Child and Adolescent Patients with Psychiatric Disorders
Christina Sun1, Andreea Temelie1, Hannah Goulding1
1UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania, USA.
Journal of Child and Adolescent Psychopharmacology
|August 24, 2024
Summary
This study examined long-acting injectable antipsychotics (LAIAs) in child and adolescent psychiatric inpatients. Findings reveal dosing variations from adult guidelines and significant readmission rates, highlighting the need for further research.
Area of Science:
- Child and Adolescent Psychiatry
- Pharmacology
- Clinical Research
Background:
- Long-acting injectable antipsychotics (LAIAs) are not FDA-approved for pediatric use but are prescribed off-label.
- Limited data exists on LAIA initiation and dosing in child and adolescent populations.
Purpose of the Study:
- To describe the initiation and maintenance dosing strategies of LAIAs in pediatric psychiatric inpatients.
- To analyze patient demographics and diagnoses associated with LAIA use in this age group.
Main Methods:
- Retrospective chart review of patients under 18 initiated on LAIAs during hospitalization.
- Data collection included demographics, diagnoses, LAIA agents, dosing regimens, length of stay, and readmission rates.
- Descriptive statistics were used for analysis.
Main Results:
- 45 (0.7%) of 6402 pediatric patients were initiated on LAIAs, with an average age of 15.6 years.
- Paliperidone palmitate and aripiprazole monohydrate were the most common LAIAs prescribed for diagnoses including psychotic and bipolar disorders.
- 17 patients (37.8%) received doses differing from adult package inserts, and 31.1% were readmitted within 6 months.
Conclusions:
- This is the first study to detail LAIA dosing strategies in pediatric inpatients.
- Dosing often deviates from adult recommendations, and readmission rates are notable.
- Further research is needed to assess LAIA efficacy and impact on clinical outcomes in children and adolescents.
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