August CPE Article Review of Long-Acting Injectable Antipsychotics Authors: Houston T. Williams, PharmD Candidate 2022; Hannah E. Johnson, PharmD, BCPS, BCPP; Kenneth E. Record, PharmD The authors declare that there are no financial relationships that could be perceived as real or apparent conflicts of interest. Universal Activity #0143-0000-21-008-H08-P&T Contact Hour 1.0 Expires: 8/5/2024
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Learning Objectives: At the conclusion of this knowledge-based article, the reader should be able to: 1.
Describe the mechanism of action and adverse drug effect profiles of first- and secondgeneration antipsychotics
2. Discuss the indications and place for long-acting injectable antipsychotics in therapy 3. Review the administration and storage of long-acting injectable antipsychotics 4. Identify the pharmacists’ role in access and administration of long-acting antipsychotics Introduction of Antipsychotics Since the early 1950’s, antipsychotics have played an important role in treating patients with mental health disorders. After the discovery of oral first-generation antipsychotics, such as chlorpromazine, a decline in hospitalizations and an increase in long-term psychiatric facility discharges was observed [1]. Soon after, long-acting injectable antipsychotics were being developed to help patients with adherence and reduce relapse from medication discontinuation [2]. In the 1980’s, oral second-generation antipsychotics emerged and long-acting injectable formulations of these were created shortly after [3]. Today, antipsychotics are used to help treat a variety of conditions including schizophrenia spectrum disorders, psychotic disorders, bipolar disorder, major depressive disorder, tic disorders, and autism spectrum disorder [4]. In the treatment of schizophrenia, both oral and long-acting injectable antipsychotics have shown efficacy, tolerability, and safety [5]. Schizophrenia Schizophrenia is a chronic disease that impacts the brain by affecting how a person feels, thinks, and behaves [6]. Chronic disease often requires medical assistance and is defined as a condition that persists long-term, may inhibit the ability to do everyday activities, and impact one’s quality of life (QOL) [7]. The median lifelong prevalence of schizophrenia is around 0.72%. The incidence of schizophrenia is higher in males with a ratio for males-to-females of 1.4:1. Males also develop symptoms earlier than females. Schizophrenia reduces life expectancy and increases the risk of mortality 2-3-fold [8]. In the United States, the total economic burden of schizophrenia is estimated to be 155.7 billion dollars annually. Patients who suffer from schizophrenia have an average cost of $44,773 per year [9]. |24| Kentucky Pharmacists Association | July/august 2021
