2015 issue 1


Volume 31, issue 1

Review article

Second-generation long-acting antipsychotics: when to use and how

Jerzy Samochowiec1, Adam Wichniak1, Dominika Dudek2, Paweł Mierzejewski3, Janusz Rybakowski4,5
1. Institute of Psychiatry and Neurology in Warsaw, Third Department of Psychiatry, Warsaw, Poland
2. Medical College of Jagiellonian University in Krakow, Chair of Psychiatry, Department of Affective Disorders
3. Pomeranian Medical University in Szczecin, Department of Psychiatry
4. Institute of Psychiatry and Neurology in Warsaw, Department of Pharmacology
5. Poznan University of Medical Sciences, Department of Adult Psychiatry
Farmakoterapia w Psychiatrii i Neurologii 2015, 31 (1), 57–66
DOI: http://dx.medra.org/10.17393/fpn.2015.06.003
Keywords: long-acting antipsychotics, guidelines for use


Long-acting antipsychotics constitute a valuable therapeutic option for people suffering from schizophrenia and other psychotic disorders. They are designated for the treatment of psychotic states, mainly in patients with schizophrenia, who require long-term antipsychotic treatment. The most important advantage of long-acting antipsychotics is the fact that they ensure a stable level of antipsychotic medication. Besides, the use of long-acting antipsychotics improves patient's compliance with treatment. Unsatisfactory treatment compliance increases the risk of worsening/relapse and it also increases the risk of patient's re-hospitalization. The improvement of treatment compliance also results in the reduction in family burden caused by the disease. Thus, the second-generation long-acting antipsychotics are of great help in the therapy of people with schizophrenia. The use of a second-generation long-acting antipsychotic agent combines the advantages of the treatment with a long-acting antipsychotic resulting from a more stable drug level with the advantages of the use of an atypical antipsychotic drug: better efficacy against negative and affective symptoms, and better influence on patient's cognitive functioning, but also with the decreased risk of bothersome side-effects, mainly extrapyramidal symptoms. The indications and contra-indications for the use of the second-generation long-acting antipsychotics are presented. The guidelines for the beginning of treatment as well as treatment continuation are also presented. The dosage and the potential drug-drug interactions are discussed with regard to four second-generation long-acting antipsychotics: aripiprazole, olanzapine, paliperidone, and risperidone. The availability of these drugs in Poland is also discussed.

Address for correspondence:
Marek Jarema
Instytut Psychiatrii i Neurologii
III Klinika Psychiatryczna
ul. Sobieskiego 9, 02-957
Warszawa, Poland
phone: +48 22 842 40 87
email: jarema@ipin.edu.pl