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Injections May Be Better Than Pills for Schizophrenia

By

Linda Wasmer Andrews

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This content is created or selected by the Healthgrades editorial team and is funded by an advertising sponsor. The content is subject to the Healthgrades medical review process for accuracy, balance and objectivity. The content is not edited or otherwise influenced by the advertisers appearing on this page except with the possible suggestion of the broad topic area. For more information, read the HealthGrades advertising policy.

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Outpatient Treatment Options for Schizophrenia

Finding the right treatment option can go a long way toward helping your loved one stick with their treatment plan.
pills and needles

When you have schizophrenia, antipsychotic medicine can make all the difference in the quality of your life. Taking medicine can reduce your symptoms so that you’re able to do more of the things that matter to you. In contrast, stopping medication is one of the chief reasons for relapse and hospitalization.

So why do as many as 44% of people with schizophrenia quit taking their medicine? Many have trouble remembering to take a pill every day. Others find it hard to stay focused on why they need medication.

That’s where long-acting injectable (LAI) antipsychotics come in. Rather than taking a pill once or twice a day, people on LAIs go to a doctor’s office to get a shot as infrequently as once or twice a month.

Antipsychotic medications can be divided into two groups: older, first-generation drugs and newer, second-generation drugs. Several antipsychotics are now available in LAI form:

Newer antipsychotics

  • Aripiprazole (Abilify Maintena)

  • Olanzapine (Zyprexa Relprevv)

  • Paliperidone (Invega Sustenna)

  • Risperidone (Risperdal Consta)

  Older antipsychotics

  • Fluphenazine (Prolixin)

  • Haloperidol (Haldol)

Lower Risk of Relapse, Higher Functioning

The medication in LAIs is the same as in pills, so the effects are similar as well. Yet several studies have shown that people with schizophrenia who choose LAIs are less likely to be hospitalized in the future than those who take the same medicine by mouth.

4 Tips for Preventing a Schizophrenia Relapse

If your doctor has prescribed psychosocial therapy, make sure you participate.

One study looked at more than 2,500 people who had just been discharged after their first hospitalization for schizophrenia. During the seven-year study period, those who were prescribed LAI antipsychotics had only one-third the risk of being hospitalized again as those who were given the same medicine in pill form.

That’s probably because people treated with LAIs tend to take their antipsychotic medicine more consistently than those on pills. Also, caregivers, family members, and health team members find out when a patient doesn’t show up for an injection appointment and can help address the problem right away. As a result, the patient’s symptoms are less likely to return. Some studies have also shown that LAI treatment is associated with better functioning in daily life and greater patient satisfaction.

Another benefit is that LAIs make it impossible to overdose, either accidentally or on purpose. That’s an important safety feature for people who have trouble keeping track of their medicine or who may be suicidal.

Weighing the Pros and Cons

The idea of getting regular shots may not sound very appealing. Yet researchers have found that people grow much more accepting of the idea once they’ve tried it.

LAIs can cause the same side effects as comparable medicines taken by mouth. In addition, some people develop soreness and swelling around the injection site in the thigh or shoulder. Injection site symptoms usually are mild and go away within a few days.

Not all mental health providers offer LAIs. And not all antipsychotics are available in that form. Still, if you have trouble staying on oral medication or if you prefer taking your medication less often, it’s good to know there’s another option. Talk with your doctor about the potential benefits and risks of LAIs for you.

Key Takeaways:

  • As many as 44% of people with schizophrenia quit taking their medicine, often because they have trouble taking a daily pill.

  • Rather than taking a pill once or twice a day, people on long-acting injectable (LAI) antipsychotics go to a doctor’s office to get a shot a few times a month.

  • Studies show that people who choose LAIs are less likely to be hospitalized in the future than those who take the same medicine by mouth. LAI treatment also is associated with better functioning in daily life.

  • LAIs can cause the same side effects as comparable medicines taken by mouth. Some people also develop mild soreness and swelling around the injection site.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Apr 20, 2016

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

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Medical References

  1. A National Cohort Study of Oral and Depot Antipsychotics After First Hospitalization for Schizophrenia. J. Tiihonen et al. American Journal of Psychiatry, 2011, vol. 168, pp. 603-609.
  2. A Pooled Analysis of Injection Site-Related Adverse Events in Patients with Schizophrenia Treated with Olanzapine Long-Acting Injection. S. Atkins et al. BMC Psychiatry, 2014, vol. 14, art. 7.
  3. Impact of Long-Acting Injectable Antipsychotics on Medication Adherence and Clinical, Functional, and Economic Outcomes of Schizophrenia. G. Kaplan et al. Patient Preference and Adherence, 2013, vol. 7, pp. 1171-1180.
  4. Switching to Olanzapine Long-Acting Injection from Either Oral Olanzapine or Any Other Antipsychotic: Comparative Post Hoc Analyses. A. Ciudad et al. Neuropsychiatric Disease and Treatment, 2013, vol. 9, pp.  1737-1750.

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