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What Are the Pros and Cons of Long-Acting Antipsychotics?

By S. Berger
Updated May 17, 2024
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Schizophrenia is a mental illness characterized by a variety of symptoms including hallucinations, delusions, and disorganized thoughts. Antipsychotics are a class of medications often used to bring these symptoms under control, and long-acting antipsychotics have been developed to help ease the process of taking these medications. Some schizophrenic individuals have difficulties taking medication on a daily basis, with many failing to take daily conventional antipsychotics at all after six months. The logic behind the use of long-acting drugs is that a simplified, monthly process would allow patients to take their medication more regularly.

Regularly taking these drugs produces much greater benefits, as their efficacy decreases when they are only taken sporadically. Long-acting antipsychotics, by controlling symptoms for long periods of time, have shown some advantages in this regard. Studies in the United States have shown that individuals taking these medications tend to have better compliance with their treatments, meaning that they tend to remain on them consistently or years. In turn, this also means that these individuals often have fewer hospital admissions due to behavior that may be perceived as abnormal by non-schizophrenics.

Other advantages have been noticed with long-acting antipsychotics as well. Many times, these long-acting medications are provided in injection form. This route of administration helps to avoid a phenomenon called first pass metabolism, where oral medications are broken down, or metabolized, by the liver before reaching the bloodstream. First-pass metabolism can make some antipsychotic medications less effective. Increased efficacy from long-acting antipsychotics therefore additionally allows lower overall doses of medication to be used, helping to minimize side effects.

Like any type of medication, long-acting antipsychotics have some disadvantages along with their benefits for some people. Individuals may have difficulties dealing with needles or injections, making the process of receiving these drugs somewhat uncomfortable. As with other injections, there may sometimes be tissue reactions around the injection site. Tissue reactions are generally mild, but have a small chance of leading to a more serious allergic reaction.

Occasionally, people with schizophrenia may feel that these long-acting medications are an attempt by others to control their behavior. Such a perception can occasionally lead to non-compliance, or a refusal by the person to receive their usual antipsychotic dose. The idea of going to a treatment center every month to receive these injections may also cause some people to feel as if they are outcasts that are stigmatized by society. Despite these drawbacks, some doctors believe that long-acting antipsychotics could be a viable treatment option for many people with this complex mental disorder.

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