Related Experiment Video
Updated: Sep 19, 2025
05:52
Handwriting Analysis Indicates Spontaneous Dyskinesias in Neuroleptic Naïve Adolescents at High Risk for Psychosis
Published on: November 21, 2013
15.0K
Long-Acting Injectable Antipsychotic Use and Discontinuation Rates in Children and Adolescents With Schizophrenia
Taylor M Ward1, Jianing Xu2, Daniel B Hall2
1College of Pharmacy, University of Georgia, Athens, Georgia, USA.
Early Intervention in Psychiatry
|June 17, 2025
Summary
This study analyzed long-acting injectable (LAI) antipsychotic use in children and adolescents. White patients had a lower discontinuation rate for LAI paliperidone palmitate compared to Black patients.
Area of Science:
- Pediatric Psychiatry
- Pharmacology
- Health Disparities
Background:
- Long-acting injectable (LAI) antipsychotics are crucial for managing schizophrenia and related disorders in pediatric populations.
- Understanding prescribing patterns and discontinuation rates of LAI antipsychotics is essential for optimizing treatment adherence and outcomes in children and adolescents.
- Investigating potential racial/ethnic disparities in LAI antipsychotic use and discontinuation is critical for ensuring equitable care.
Purpose of the Study:
- To analyze the prescribing and discontinuation rates of long-acting injectable (LAI) antipsychotics in child and adolescent populations.
- To determine if racial/ethnic differences exist in LAI antipsychotic prescribing and discontinuation rates.
Main Methods:
- Retrospective analysis of children and adolescents (2-17 years) diagnosed with schizophrenia or related disorders who received LAI antipsychotics between 2017-2021.
- Data sourced from the Merative MarketScan Multi-State Medicaid Database.
- Descriptive statistics, Kaplan-Meier survival curves, and Cox regression analyses were used to assess LAI antipsychotic use, discontinuation rates, and associated hazards.
Main Results:
- A total of 1277 patients were included; 94% received LAI second-generation antipsychotics, with paliperidone palmitate and aripiprazole formulations being most common.
- No significant difference in discontinuation rates was found between paliperidone and aripiprazole formulations when controlling for covariates.
- LAI paliperidone palmitate was associated with a 46% lower hazard of discontinuation in White patients compared to Black patients (HR=0.54, p=0.01).
Conclusions:
- This study provides insights into LAI antipsychotic prescribing and discontinuation in pediatric populations.
- Significant racial disparities were observed, with White patients exhibiting lower discontinuation rates for LAI paliperidone palmitate compared to Black patients.
- Further research is warranted to explore the reasons for discontinuation and the economic impact of LAI antipsychotics in this demographic.
Keywords:
adherenceantipsychoticslong‐acting injectablepaediatricsprescribingracial disparityschizophreniaMore Related Videos
Related Concept Videos
01:28Psychosis and Antipsychotic Drugs: Overview
478
The term "psychosis" refers to a spectrum of mental disorders characterized by abnormal thoughts, perceptions, and behaviors. It can manifest as mood disorders, dementia, delirium with psychotic features, substance-induced psychosis with psychotic features, brief psychotic disorder, delusional disorder, schizoaffective disorder, and schizophrenia. Among all these disorders, schizophrenia is the most common psychotic disorder, affecting 1% of the worldwide population. Psychotic...
478
01:28Drug Therapy
107
The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
Antianxiety Medications
Antianxiety Medications
107
01:26Psychosis: Goals of Pharmacotherapy
216
Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
216
01:27Insulin Formulations: Types and Delivery
278
Insulin preparations are categorized by their duration of action into short-acting and long-acting types. Two strategies are used to modify insulin's absorption and pharmacokinetic profile: slowing the absorption post-subcutaneous injection, or altering human insulin's amino acid sequence or protein structure. These changes retain the insulin's ability to bind to the insulin receptor, but alter its behavior in solution or after injection.
Short-acting insulins are divided into...
Short-acting insulins are divided into...
278
01:16Insulin: Dosing Regimen and Adverse Effects
271
Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
The basal dose constitutes about 40%-50% of the total daily dose, with the rest as premeal insulin. The mealtime insulin dose should mirror...
271
01:21Antipsychotic Drugs: Typical and Atypical Agents
345
Antipsychotic drugs are classified into first-generation (typical) drugs including phenothiazines; and second-generation (atypical) drugs. Chlorpromazine hydrochloride (Thorazine), a phenothiazine derivative, broadly impacts the central, autonomic, and endocrine systems. This drug, along with typical agents like haloperidol (Haldol), primarily works by antagonizing D2 receptors, thus reducing dopaminergic neurotransmission. However, typical antipsychotics can cause side effects such as sedation...
345