The use of first-generation long-acting injectable antipsychotics in children and adolescents—A retrospective audit from India

Jacob, Preeti; Shere, Siddhesh Sanjeev; Kommu, John Vijay Sagar

doi:10.1016/j.ajp.2021.102663

Cited by 6 publications

(12 citation statements)

References 32 publications

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“…The included articles comprised one open-label trial [ 38 ], one observational prospective study [ 39 ], four retrospective chart review studies [ 28 , 40 – 42 ], four single case reports [ 43 – 46 ], and three case series (of 2, 3, and 6 patients with SSD) [ 47 – 49 ]. One study included a patient age range of 13–18 years, but the mean age was < 18 years (15.9 ± 3.3) [ 38 ].…”

Section: Resultsmentioning

confidence: 99%

“…None of the studies included LAIA use in patients < 12 years. All patients were on second-generation LAIAs, except for one study [ 40 ] (which was based on prescription of first-generation LAIAs), one case in a case series [ 49 ], and a case series [ 48 ] in which patients were on a combination of LAIAs (second-generation and first-generation). In total, 119 patients with SSD were on LAIAs in the included articles.…”

Section: Resultsmentioning

confidence: 99%

“…The most prevalent side effect was hyperprolactinemia. Jacob et al India National Institute of Mental Health and Neurosciences, Bangalore [ 40 ] 2021 Retrospective (chart review from 2010 to 2019) 20 SCZ 12 BD 4 PSI 2 SCZ-AFF (55.3% male) Inpatients Range for children and adolescents not specified, but the youngest was 10 years 14.7 ± 1.8 60.5% of patients were on fluphenazine decanoate (mean dose: 31 mg). 34.2% of patients were on flupentixol decanoate (mean dose: 25.3 mg).…”

Section: Resultsmentioning

confidence: 99%

“…Finally, one retrospective study was conducted in India with adolescent inpatients with severe mental disorders (including 26 patients with SSD) who received first-generation LAI [ 40 ] for different reasons: 65.8% for failed or only partial response to oral AP; 34.2% for severe, aggressive behavior which did not respond to other drugs, and 31.6% for non-adherence with oral AP. They justified the use of first-generation LAIAs due to the cost of the medication.…”

Section: Resultsmentioning

confidence: 99%

“…LAIAs were linked to an improvement of clinical symptoms in most of the studies included, both with first-generation [ 40 , 49 ] and second-generation drugs [ 28 , 39 – 46 ] or with a combination of both [ 48 ]. Better functional outcome, and a smaller number of hospitalizations than with adolescents on oral AP were also reported after 12-month follow-up [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

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What Role for Long-Acting Injectable Antipsychotics in Managing Schizophrenia Spectrum Disorders in Children and Adolescents? A Systematic Review

et al. 2023

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Background Long-acting injectable antipsychotics (LAIAs) are an efficacious and well-tolerated treatment in adults with schizophrenia spectrum disorders (SSD). However, there is less evidence for their use in children and adolescents. Objectives The aim of this systematic review was to summarize findings regarding the effectiveness and side effects of LAIA in children and adolescents with SSD. Methods Four databases (Web of Science, PubMed, MEDES, and Dialnet) were systematically searched for articles published between inception and 12 March, 2022, with the following inclusion criteria: (1) original articles or case reports; (2) providing data on efficacy/effectiveness or safety/tolerability of LAIA treatment in children and adolescents diagnosed with SSD (schizophrenia, schizoaffective disorder, schizophreniform disorder, non-affective psychotic disorder); (3) mean age of samples ≤ 18 years; and (4) written in English or Spanish. Exclusion criteria were review articles, clinical guides, expert consensus as well as posters or oral communication in conferences. The risk of bias was assessed using the ROBIS tool. Results From 847 articles found, 13 met the inclusion criteria. These included seven single case reports or case series, four retrospective chart reviews, a 24-week open-label trial, and one observational prospective study, covering a total of 119 adolescents (aged 12–17 years) with SSD. Almost all the articles described data on second-generation LAIA (53 patients on risperidone [once every other week], 33 on paliperidone palmitate [once monthly], 10 on aripiprazole [once monthly], and two on olanzapine pamoate [once monthly]). Twenty-one patients were reported to be only on first-generation LAIAs. Non-adherence was the main reason for starting an LAIA. In all of the studies, the use of LAIAs was associated with improvement in the patients’ symptoms. Conclusions There are few studies assessing the use of LAIAs in adolescents with SSD. Overall, these treatments have suggested good effectiveness and acceptable safety and tolerability. However, we found no studies examining their use in children aged < 12 years. The problems and benefits linked to this type of antipsychotic formulation in the child and adolescent population require further study, ideally with prospective, controlled designs. Supplementary Information The online version contains supplementary material available at 10.1007/s40272-023-00558-x.

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