Clinical Utility of Long-Acting Injectable Antipsychotics in Schizophrenia Based on Real-World Evidence
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Long-acting injectable antipsychotics (LAIs) have emerged as a key strategy in the treatment of schizophrenia by improving medication adherence and reducing relapse and hospitalization rates. While randomized controlled trials have traditionally evaluated antipsychotic efficacy, real-world evidence complements these findings by reflecting broader clinical populations. Recent studies suggest that LAIs are particularly beneficial in early-phase schizophrenia, with growing support for early initiation and continuous treatment. Comparative effectiveness varies among LAI formulations depending on agent, dosing interval, and patient adherence. Although dopamine supersensitivity has been suggested as a mechanism for relapse during LAI treatment, longitudinal data do not consistently support this. Evidence increasingly highlights the clinical utility of LAIs beyond chronic cases. Further research using real-world data is needed to optimize patient selection, sustain long-term treatment, and guide individualized care. LAIs are expected to play a critical role in improving functional outcomes and quality of life for patients with schizophrenia.
Abstract
Long-acting injectable antipsychotics (LAIs) have emerged as a key strategy in the treatment of schizophrenia by improving medication adherence and reducing relapse and hospitalization rates. While randomized controlled trials have traditionally evaluated antipsychotic efficacy, real-world evidence complements these findings by reflecting broader clinical populations. Recent studies suggest that LAIs are particularly beneficial in early-phase schizophrenia, with growing support for early initiation and continuous treatment. Comparative effectiveness varies among LAI formulations depending on agent, dosing interval, and patient adherence. Although dopamine supersensitivity has been suggested as a mechanism for relapse during LAI treatment, longitudinal data do not consistently support this. Evidence increasingly highlights the clinical utility of LAIs beyond chronic cases. Further research using real-world data is needed to optimize patient selection, sustain long-term treatment, and guide individualized care. LAIs are expected to play a critical role in improving functional outcomes and quality of life for patients with schizophrenia.