Long-Acting Injectable Second-Generation Antipsychotics Improve Negative Symptoms and Suicidal Ideation in Recent Diagnosed Schizophrenia Patients: A 1-Year Follow-up Pilot Study

Abstract

Long-acting injectable second-generation antipsychotics (LAI-SGA) are typically used to maintain treatment adherence in patients with chronic schizophrenia. Recent research suggests that they may also provide an effective treatment strategy for patients with early-phase disease. The aim of this study is to evaluate clinical and psychosocial outcomes among recent and long-term diagnosed schizophrenia outpatients treated with LAI-SGA during a follow-up period of 12 months. Stable schizophrenia patients receiving LAI-SGA with 5 or less years of illness duration (n = 10) were compared to those with more than 5 years of illness duration (n = 15). Clinical data was assessed through the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning (GAF), the Columbia Suicide Severity Rating Scale (C-SSRS), the Recovery Style Questionnaire (RSQ), and the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) Managing Emotion branch. Recently diagnosed patients showed greater improvement versus patients diagnosed for more than 5 years in adjusted mean GAF score, in PANSS factor score for negative and depressive symptoms, and in severity and intensity of suicidal ideation. Our preliminary findings support the hypothesis that LAI-SGA may influence the course of the illness if administered at the early phase of the illness. However, replicate studies are needed, possibly with larger samples.

Comparison of Long-Acting Injectable Antipsychotics With Oral Antipsychotics and Suicide and All-Cause Mortality in Patients With Newly Diagnosed Schizophrenia

“…Our findings suggest that LAI users had a lower suicide attempt risk and that patients who switched to LAIs within 2 years of OAPs treatment had decreased suicide mortality compared with those who continued receiving OAPs. These results are consistent with a previous study 38 that revealed that the use of second-generation LAIs for recent-onset schizophrenia reduced suicidal ideation compared with chronic schizophrenia. However, we did not observe a decrease in suicide mortality among patients who switched to LAIs more than 2 years after OAP treatment.…”

“…Hence, active early intervention and even the early application of LAIs to reduce risks of relapse, suicide attempts, and suicide mortality in the early stage have been proposed. 36 , 37 , 38 , 39 …”

Adding Suicide Prevention to the Triple Advantages of Injectable Long-Acting Second-Generation Antipsychotics

“…With the advent of new treatment perspectives for schizophrenic patients, long-acting injectable antipsychotics promise to provide relapse prevention, neuroprotection, and lower mortality rates (1). In preliminary studies, scholars have also indicated that such treatments could play a central role in suicide prevention in patients (2,3) for whom suicide is the most likely cause of premature death, in addition to repercussions for caregivers and clinicians. Both Kraepelin (4) and Bleuler (5) highlighted the issue of suicide risk among patients suffering from schizophrenia.…”

Hospitalization Rates and Therapy Costs of German Schizophrenia Patients Who are Initiated on Long-Acting Injectable Medication: A Mirror-Image Study

“…Multiple European studies have associated LAI usage with lower relapses, symptomatic improvement, increased personal recovery, and lower suicidal ideation and suicide attempts [20,43,44]. Interestingly, Corigliano et al [44] reported that patients in the early stages of schizophrenia (≤ 5 years of schizophrenia) seemed to benefit more from LAI initiation than chronic patients (> 5 years of schizophrenia). Similar effects were noted by Brown et al [45] on administering PLAI once a month and once every 3 months to patients with various durations of schizophrenia.…”