Evaluations of muscle echogenicities in patients treated with second generation long acting injectable antipsychotics

Abstract

IntroductionAntipsychotic depots or long-acting injections were introduced in the 1960s as a means of improving medication adherence and thereby enhancing desired clinical outcomes 1) . Several first-generation (FG)-long-acting injectable antipsychotics (LAIs) and three second-generation LAIs (SG-LAIs) are currently available for administration into either the gluteal or deltoid muscle. These LAIs are administered by intramuscular (IM) injection. A single injection effect lasts within the range of 1 week to 3 months, depending on the compound and formulation 2,3) . Our previous study evaluated the B-mode findings of the muscle infiltrated with second generation long acting injectable antipsychotics (SG-LAIs). SG-LAIs were seen as a high-echogenicity mass with marked acoustic shadowing in the gluteus medius muscle. The aim of this study was to examine the echogenicities of the muscle with SG-LAI. This study demonstrated 3 patients with schizophrenia under treatment with risperidone (RLAI), paliperidone (PLAI) and aripiprazole (ALAI) (one case each). Quantitative diagnostic ultrasound imaging has been proposed as a method of estimating muscle quality using echogenicities. Grayscale histogram analysis of Photoshop Premiere Elements 14.0 was used to determine the muscle tissue echogenicity in a region of interest (ROI). The pre-and post-injected SG-LAI echogenicities were analyzed using a paired t-test with a significance level of 5%. Each SG-LAIs could be illustrated as high echogenic masses with acoustic shadowing. The corresponding grayscale histogram values of selected ROI in the injected muscles were significantly increased in all cases. It was considered that the diffusion states of SG-LAIs by ultrasonography were important time course evaluations providing objective evidence. Evaluations of muscle echogenicities in patients treated

Efficacy and Safety in Intramuscular Injection Techniques Using Ultrasonographic Data

“…As such, the current IM injection method has its limitations, featuring a multitude of problems in terms of ensuring medical safety and establishing a proven IM injection technique. The authors' research team has experience in the use of ultrasound diagnostic devices to conduct analysis of drug luminance changes post-IM injection [17], the relationship between injection site reactions and treatment efficacy according to IM injection needle penetration depth [11], and research involving appropriate and safe needle penetration length in IM injections [15] [18] [19] [20]. Data were obtained from 136 patients undergoing treatment with LAI and 83 healthy subjects by ultrasonogra-T. Tanioka et al phy at four psychiatric hospitals and one psychiatric clinic in Japan.…”

Evaluations of echogenicity in gluteal muscle in patients with schizophrenia treated with second generation long-acting injectable antipsychotics: risperidone or aripiprazole

“…In addition, Yasuhara et al 14) suggested that the ultrasonographic findings could be distinguish among RLAI, PLAI and ALAI. The IM LAIs on B-mode scan showed its specific echogenicity in the muscle depending on its physical structures and chemical properties.…”