The British Journal of Psychiatry (2009) 195: S29-S36. doi: 10.1192/bjp.195.52.s29
© 2009 The Royal College of Psychiatrists
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Submit an eLetter
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Scopus
Google Scholar
Right arrow Articles by Fleischhacker, W. W.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Fleischhacker, W. W.

REVIEW ARTICLES

Second-generation antipsychotic long-acting injections: systematic review

W. Wolfgang Fleischhacker, Professor of Psychiatry

Medical University Innsbruck, Department of Psychiatry and Psychotherapy, Anichstrasse 35, A-6020 Innsbruck, Austria. Email: wolfgang.fleischhacker{at}i-med.ac.at

Declaration of interest

W.W.F. has received research grants from Janssen-Cilag, Servier, Eli Lilly and BMS/Otsuka. He has received honoraria for educational programmes from Pfizer and AstraZeneca, speaking fees from AstraZeneca, Pfizer, Janssen-Cilag, BMS/Otsuka and advisory board honoraria from BMS/Otsuka, Wyeth, Janssen-Cilag and AstraZeneca.

Background

Second-generation antipsychotics (SGAs) represent an advance in the long-term management of schizophrenia.

Aims

To review the available evidence concerning SGA long-acting injections (LAIs).

Method

A systematic review of the literature was conducted using PubMed.

Results

Risperidone long-acting injection was the first licensed SGA–LAI compound and is effective in the long-term management of schizophrenia, with a safety profile similar to that of oral risperidone. Olanzapine pamoate has recently been approved in Europe. In terms of efficacy, at injection intervals of up to 4 weeks it appears comparable to oral olanzapine, although the potential for `post-injection syndrome' (delirium) calls for additional safety considerations. Paliperidone palmitate is currently under review with the licensing authorities. It also affords the potential advantage of monthly dosing.

Conclusions

More long-term comparisons of SGA–LAIs with oral SGAs as well as with first-generation antipsychotic LAIs are needed. These studies should include cost-effectiveness data.