Initiating/Maintaining long-Acting Injectable Antipsychotics in Schizophrenia/Schizoaffective or Bipolar Disorder – Expert Consensus Survey Part 2

Authors

Martha Sajatovic, Case Western Reserve UniversityFollow

Author ORCID Identifier

Martha Sajatovic

Document Type

Article

Publication Date

6-8-2018

Abstract

Objective: The aim of this study was to provide recommendations on initiating and maintaining long-acting injectable antipsychotics (LAIs) in individuals with schizophrenia/schizoaffective or bipolar disorder. Methods: A 50-question survey comprising 916 response options was completed by 34 expert researchers and high prescribers with extensive LAI experience, rating relative appropriateness/importance on a 9-point scale. Consensus was determined using chi-square test of score distributions. Results of 21 questions comprising 339 response options regarding LAI initiation, maintenance treatment, adequate trial definition, identifying treatment nonresponse, and switching are reported. Results: Experts agreed that the most important LAI selection factor was patient response/tolerability to previous antipsychotics. An adequate therapeutic LAI trial was defined as the time to steady state ± 1–2 injection cycles. Experts suggested that oral efficacy and tolerability should be established before switching to an LAI, without consensus on the required time, and that the time for oral supplementation and next injection interval should be determined by the time to attainment of therapeutic LAI levels. Most experts agreed that ≥1 adequate LAI trial is needed to identify the lack of efficacy. There was little agreement about strategies for switching between LAIs. Conclusion: Expert guidance may aid clinicians in their decisions regarding initiating/maintaining LAIs in individuals with schizophrenia/schizoaffective or bipolar disorder.

Keywords

bipolar disorder, expert consensus, long-acting injectable antipsychotics, schizoaffective disorder, schizophrenia

Language

English

Publication Title

Neuropsychiatric Disease and Treatment

Rights

© The Author(s) 2018.This is an open access article under the CC BY-NC license (https://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

Recommended Citation

Sajatovic M, Ross R, Legacy SN, Byerly M, Kane JM, DiBiasi F, Fitzgerald H, Correll CU. Initiating/maintaining long-acting injectable antipsychotics in schizophrenia/schizoaffective or bipolar disorder - expert consensus survey part 2. Neuropsychiatr Dis Treat. 2018 Jun 8;14:1475-1492. doi: 10.2147/NDT.S167485. PMID: 29922063; PMCID: PMC5997122.