What is an example of long-acting injectable second-generation antipsychotics?

From the Guidelines

Long-acting injectable second-generation antipsychotics include medications such as risperidone, paliperidone palmitate, aripiprazole monohydrate, aripiprazole lauroxil, and olanzapine pamoate. These medications are administered at different intervals depending on the specific formulation, for example, Risperdal Consta is given every 2 weeks, Invega Sustenna monthly, Invega Trinza every 3 months, and Invega Hafyera every 6 months 1. The use of long-acting injectable antipsychotics is recommended to rule out "pseudo-resistance" due to inadequate treatment adherence, and at least one failed trial with a long-acting injectable antipsychotic, given for at least 6 weeks after it has achieved steady state, is suggested 1. Some key points to consider when using LAIs include:

• They are particularly beneficial for patients with adherence issues, as they eliminate the need for daily oral medication and ensure consistent medication levels in the bloodstream.
• LAIs can lead to better symptom control and reduced relapse rates in conditions like schizophrenia and bipolar disorder.
• When initiating LAIs, most require an initial oral medication overlap period to establish therapeutic levels.
• Regular monitoring for side effects such as metabolic changes, movement disorders, and injection site reactions is essential for optimal patient care 1. It's worth noting that guidelines suggest considering long-acting injection antipsychotic medication for patients with recurrent relapses related to partial or full nonadherence, and that the oral form of the same medication is the logical choice for initial treatment 1.

From the Research

Long Acting Injectable Second Generation Antipsychotics

• Examples of long acting injectable second generation antipsychotics include:
  • Paliperidone 2
  • Aripiprazole 2, 3, 4, 5, 6
  • Olanzapine 2
  • Risperidone 2

Specific Formulations

• Aripiprazole monohydrate and aripiprazole lauroxil are two different long-acting injectable formulations of aripiprazole 4
• Aripiprazole lauroxil is available in 441 mg, 662 mg, or 882 mg strengths and can be administered once monthly or every 6 weeks 3, 4, 6
• Paliperidone palmitate is available in a 3-monthly injection formulation 2