Abstract:
Introduction: Patterns of clinical use of long-acting injectable (LAI) antipsychotic
drugs in many countries, especially in Asia, for treatment of patients diagnosed with
chronic psychotic disorders including schizophrenia are not well established.
Methods: Within an extensive research consortium, we evaluated prescription rates
for first- (FGA) and second-generation antipsychotic (SGA) LAI drugs and their clinical
correlates among 3557 subjects diagnosed with schizophrenia across 15 Asian countries and region.
Results: Overall, an average of 17.9% (638/3557; range: 0.0%-44.9%) of treated subjects were prescribed LAI antipsychotics. Those given LAI vs orally administered
agents were significantly older, had multiple hospitalizations, received multiple antipsychotics more often, at 32.4% higher doses, were more likely to manifest disorganized behavior or aggression, had somewhat superior psychosocial functioning and
less negative symptoms, but were more likely to be hospitalized, with higher BMI,
and more tremor. Being prescribed an FGA vs SGA LAI agent was associated with
male sex, aggression, disorganization, hospitalization, multiple antipsychotics, higher
doses, with similar risks of adverse neurological or metabolic effects. Rates of use of
LAI antipsychotic drugs to treat patients diagnosed with schizophrenia varied by
more than 40-fold among Asian countries and given to an average of 17.9% of
treated schizophrenia patients. We identified the differences in the clinical profiles
and treatment characteristics of patients who were receiving FGA-LAI and SGA-LAI
medications.
Discussion: These findings behoove clinicians to be mindful when evaluating
patients' need to be on LAI antipsychotics amidst multifaceted considerations, especially downstream adverse events such as metabolic and extrapyramidal side effects
