Clinical and Demographic Characteristics in Schizophrenia Patients with and without a History of Taking Long-acting...

Poor adherence to oral antipsychotics is an important challenge in schizophrenia, highlighting long-acting injectables (LAIs) as an alternative. This study aimed to compare the clinical and demographic profiles of patients with schizophrenia with prior LAI exposure versus those maintained exclusively on oral antipsychotics.

This cross-sectional, observational study enrolled eligible schizophrenia inpatients aged 18-65 diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, 5^th Edition criteria from June 2022 to October 2023. Participants were divided into two groups: those with prior LAI exposure and those who had maintained only oral antipsychotics. Demographic data, clinical history, and baseline laboratory parameters were collected. The primary outcome was the severity of psychotic symptoms, assessed using the Positive and Negative Syndrome Scale (PANSS) and Clinical Global Impression Severity (CGI-S) Scale upon admission.

A total of 70 patients were included in the final analysis, with 36 patients having a history of LAI and 34 on only oral treatment. Demographically, both groups were comparable across most characteristics. Baseline PANSS score and its subscales, CGI-S scores, and laboratory markers showed no statistical difference. However, the LAI group showed a significantly longer duration of illness (P = 0.017), more hospitalizations (P < 0.001), and greater prior exposure to first-generation antipsychotics (P < 0.001) with higher chlorpromazine equivalent doses (P < 0.001) compared to the oral-only group.

This study highlights treatment patterns among Iranian schizophrenia patients, showing that patients on LAIs generally have a history of longer illness durations, more hospitalizations, and more expose to first generation antipsychotics. Further studies should be conducted to investigate the efficacy of early versus delayed initiation of LAI and their long-term outcomes.