Antipsychotic long-acting injections

Antipsychotic long-acting injections

by Peter Haddad, Tim Lambert, John Lauriello

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Antipsychotic long-acting injections (LAIs) were introduced in the 1960s to improve treatment adherence in schizophrenia. Subsequently, first-generation antipsychotic LAIs became widely used in many countries. Recently there has been a resurgence of interest in LAIs that partly reflects the introduction of several second-generation antipsychotic LAIs.

This book


Antipsychotic long-acting injections (LAIs) were introduced in the 1960s to improve treatment adherence in schizophrenia. Subsequently, first-generation antipsychotic LAIs became widely used in many countries. Recently there has been a resurgence of interest in LAIs that partly reflects the introduction of several second-generation antipsychotic LAIs.

This book brings together clinical and research findings on LAIs in a comprehensive volume, with chapters being written by international experts. Though the book concentrates on the use of LAIs in schizophrenia, the emerging evidence base for the use of LAIs in bipolar disorder is also discussed. A repeated theme throughout the book is the importance of prescribing decisions - whether for oral medication or an LAI, reflecting a shared decision making process by the prescriber and patient. The authors stress that antipsychotic LAIs are not suitable for all patients and are only one possible solution to adherence problems.

Providing a synthesis and broad picture of the place of LAIs in current clinical practice, and looking at both their advantages and disadvantages, this book will be valuable for psychiatrists, psychopharmacologists, and pharmacists.

Editorial Reviews

Doody's Review Service
Reviewer: Aaron Plattner, MD (Pine Rest Christian Mental Health Services)
Description: This book examines where long-acting antipsychotic injections fit into the treatment of various psychiatric patients by providing up-to-date data on both older and newer long-acting antipsychotic injections compared to oral medications.
Purpose: With the recent introduction of several second-generation, long-acting antipsychotic medications as well as other factors, there has been an increased interest in and important research on long-acting antipsychotic medications. This book is the first to properly educate mental health providers on this new information.
Audience: The editors identify the intended audience as psychiatrists, psychiatric nurses, psychopharmacologists, and pharmacists, who would all benefit from this book. In addition, nurse practitioners and physician assistants, particularly those in the area of community psychiatry, would find this book helpful.
Features: Most of the clinical use, and thus research, of long-acting antipsychotic medication is focused on schizophrenia, which is reflected in large sections of this book, but the book also reviews the clinical and research findings of long-acting antipsychotics in the treatment of bipolar disorder and early psychosis. Also addressed are the issues of adherence and attitudes of patients and providers to long-acting antipsychotic medications compared to oral antipsychotic medications. Throughout, the book reviews the benefits, adverse effects, and risks of first- and second-generation oral antipsychotic medications compared to first- and second- generation long-acting injections. Helpful tables, graphs, references, and an index are also present.
Assessment: This book accomplishes the difficult task of condensing a great deal of clinical experience and research data into one complete, unbiased book. It does so through the contributions of a variety of internationally known psychiatrists, which also leads to some redundancy and discussions of medications that may not be available to providers in the United States. In an effort to present the large amount of new data, some sections can be extremely dense and would benefit from using more charts and/or graphs to convey the information. Perhaps this will be accomplished in a later version, which will be needed as more second-generation, long-acting antipsychotic medications are produced. Still, this is a well-written book, particularly the sections on the newer second-generation, long-acting antipsychotic medications and the utility of long-acting antipsychotic injections for bipolar disorder and early psychosis. The editors should be praised for addressing the importance of the attitudes and convictions of patients and providers regarding oral versus long-acting injection medications.

Product Details

Oxford University Press
Publication date:
Product dimensions:
6.10(w) x 9.10(h) x 0.60(d)

Meet the Author

Dr Haddad graduated with honours degrees in both Medicine and Medical Biochemistry from the University of Manchester, UK. He received his MD for research regarding the relationship between affective disorder in cancer patients and their partners. He is a Consultant in Community Psychiatry in Salford and an Honorary Senior Lecturer at the University of Manchester. His clinical and research interests include the pharmacological treatment of affective disorders and schizophrenia.

Dr Haddad has authored many publications including original research papers, review papers and book chapters. He was a member of the Development Group for the NICE Bipolar Guideline published in 2006 and the NICE Medicines Adherence Guideline published in 2009. He is an active member of the British Association of Psychopharmacology and has contributed to several of the Association's Guidelines. He is a member of the editorial board of the journal 'Human Psychopharmacology'.

Tim Lambert is Professor and Head of Psychiatry at Concord Clinical School at the University of Sydney in Australia. He also holds an appointment as Head of Schizophrenia Treatment and Outcomes Research at the Brain & Mind Research Institute in Sydney. In addition, he fulfils clinical duties for the SSWAHS in Sydney as Director of the Centre of Excellence in Relapse Prevention in Psychosis and at the Concord Centre for Cardiometabolic Health in Psychosis.

Professor Lambert has a portfolio of interests spanning clinical psychosis research, outcomes research, training, and education. His current interests focus on the clinical pharmacology of depot antipsychotics (first and second generation) and of the second-generation antipsychotics, particularly risk-benefit aspects and the applied clinical pharmacology of antipsychotic switching; physical comorbidities of psychotic disorders, especially metabolic syndrome; incomplete recovery, and services research (pharmacoepidemiology).

Dr. Lauriello specializes in the diagnosis and treatment of psychotic disorders, most notably schizophrenia. In June 2009, he became only the third permanent chair of the MU department of psychiatry in its 50 year history. Dr. Lauriello also serves as the founding Executive Medical Director of the University of Missouri Psychiatric Center. Prior to coming to the University of Missouri Dr. Lauriello was the clinical Vice Chair at the University of New Mexico. There he directed the UNM Schizophrenia Research Group, which focused on clinical trials and neuroimaging. He was Executive Medical Director of the UNM Psychiatric Center for nearly a decade, and he served as a UNM site principal investigator for the Mental Illness and Neuroscience Discovery (MIND) Institute, a consortium of universities, schools of medicine, brain research institutions and laboratories in Minnesota, Massachusetts and New Mexico.

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