{"id":11120,"date":"2017-12-12T00:31:26","date_gmt":"2017-12-11T21:31:26","guid":{"rendered":"http:\/\/seragpsych.com\/wordpress\/?p=11120"},"modified":"2017-12-12T00:31:26","modified_gmt":"2017-12-11T21:31:26","slug":"long-acting-injectable-antipsychotics","status":"publish","type":"post","link":"https:\/\/seragpsych.com\/wordpress\/long-acting-injectable-antipsychotics\/","title":{"rendered":"Long-Acting Injectable Antipsychotics:"},"content":{"rendered":"<p><em><strong>Who should receive LAIs?<\/strong><\/em><\/p>\n<p>&nbsp;<\/p>\n<p>Consider LAIs for patients with recent-onset schizophrenia and those with risk factors for medication nonadherence:<br \/>\nhistory of non-adherence, severe symptoms, comorbid substance use, cognitive impairment,<br \/>\nambivalence or negative attitudes towards medications, and poor insight.<\/p>\n<p>&nbsp;<\/p>\n<p><em><strong>Are the newer LAIs more effective?<\/strong><\/em><\/p>\n<p>&nbsp;<\/p>\n<p>The effectiveness of newer LAIs (aripiprazole, olanzapine, paliperidone and risperidone) and older LAIs<br \/>\n(haloperidol,fluphenazine, flupenthixol) is similar.<br \/>\nPractical considerations<\/p>\n<p><em><strong>Abilify Mantenna<\/strong><\/em><br \/>\n\uf0b7 Aripiprazole monohydrate requires a period of overlap of 2 weeks with oral aripiprazole.<br \/>\n\uf0b7 Available as a lyophilized powder which needs to be reconstituted.<\/p>\n<p><strong><em>Aristada<\/em><\/strong><br \/>\n\uf0b7 Aripiprazole lauroxil requires a period of overlap of 3 weeks with oral aripiprazole.<br \/>\n\uf0b7 Available as a prefilled syringe that does not require reconstitution.<\/p>\n<p><strong><em>Zyprexa Relprevv<\/em><\/strong><\/p>\n<p>\uf0b7 Olanzapine pamoate does not need overlap with oral olanzapine.<br \/>\n\uf0b7 It has a small risk of post-injection syndrome (0.07% of injections):<br \/>\no Symptoms include sedation, confusion, agitation, anxiety, aggressiveness, dizziness, ataxia and<br \/>\nextrapyramidal symptoms<br \/>\no This risk limits use olanzapine pamoate use<br \/>\no After injection, the patient must be monitored for three hours by a healthcare professional<br \/>\no In the US, prescribers who administer Zyprexa Relprevv must enroll in a national registry that<br \/>\ndocuments the incidence of this adverse effect<\/p>\n<p><em><strong>Invega Sustenna<\/strong><\/em><br \/>\n\uf0b7 Paliperidone palmitate does not need overlap with oral paliperidone.<br \/>\n\uf0b7 Requires two separate loading dose injections during the first week.<\/p>\n<p>&nbsp;<\/p>\n<p><em><strong>Invega Trinza<\/strong><\/em><\/p>\n<p>\uf0b7 The 3-month paliperidone palmitate (PPM\u20133) formulation can only be used if the patient has been receiving 1-<br \/>\nmonth paliperidone palmitate injections for at least 4 months.<br \/>\n\uf0b7 It is administered 4 times a year, providing the longest interval of any approved LAI.<\/p>\n<p><em><strong>Risperdal Consta<\/strong><\/em><br \/>\n\uf0b7 Risperidone microspheres requires a period of overlap of 3 weeks with oral risperidone.<br \/>\n\uf0b7 It has a 2-week dosing interval.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Who should receive LAIs? &nbsp; Consider LAIs for patients with recent-onset schizophrenia and those with risk factors for medication nonadherence: history of non-adherence, severe symptoms, comorbid substance use, cognitive impairment, ambivalence or negative attitudes towards medications, and poor insight. &nbsp; Are the newer LAIs more effective? &nbsp; The effectiveness of newer LAIs (aripiprazole, olanzapine, paliperidone [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[427,458,151],"tags":[],"class_list":["post-11120","post","type-post","status-publish","format-standard","hentry","category-427","category-458","category-151","entry"],"_links":{"self":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/11120","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/comments?post=11120"}],"version-history":[{"count":1,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/11120\/revisions"}],"predecessor-version":[{"id":11121,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/posts\/11120\/revisions\/11121"}],"wp:attachment":[{"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/media?parent=11120"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/categories?post=11120"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/seragpsych.com\/wordpress\/wp-json\/wp\/v2\/tags?post=11120"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}