Department of Psychiatry and Behavioral Sciences, University of New Mexico, Albuquerque, New Mexico
Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York City, New York
J Clin Psychiatry. 2020 Jun 16;81(4):OT19046AH1. doi: 10.4088/JCP.OT19046AH1.
People with bipolar I disorder experience an illness course marked by potentially disastrous manic episodes, disabling depressive episodes, and functional impairment. A frequent obstacle to wellness in these individuals is nonadherence to treatment. Long-acting injectable (LAI) antipsychotics have the potential to address nonadherence and thereby increase patients' chances at sustained recovery and normal psychosocial functioning. LAI formulations of 2 second-generation antipsychotics-aripiprazole monohydrate and risperidone-have received approval from the US Food and Drug Administration as monotherapy or adjunctive therapy to lithium or valproate for the maintenance treatment of bipolar I disorder in adult patients. In a recent roundtable meeting, a panel of 4 experts discussed the use of these medications in bipolar I disorder. This Academic Highlights summarizes their discussion, which included the impact of functional impairment, the potential benefits of employing an LAI antipsychotic at earlier stages of bipolar illness, and the characteristics of patients who may be good candidates for treatment with an LAI antipsychotic.
双相 I 障碍患者的疾病过程以潜在灾难性的躁狂发作、使人丧失能力的抑郁发作和功能障碍为特征。这些患者实现健康的一个常见障碍是不遵医嘱治疗。长效注射（LAI）抗精神病药有可能解决不遵医嘱的问题，从而增加患者持续康复和正常社会心理功能的机会。美国食品和药物管理局已批准 2 种第二代抗精神病药——阿立哌唑一水合物和利培酮的 LAI 制剂，作为单药治疗或锂盐或丙戊酸盐的辅助治疗，用于治疗成人双相 I 障碍的维持治疗。在最近的一次圆桌会议上，一个由 4 名专家组成的小组讨论了这些药物在双相 I 障碍中的应用。本学术要点总结了他们的讨论，其中包括功能障碍的影响、在双相疾病早期使用 LAI 抗精神病药的潜在益处，以及可能是 LAI 抗精神病药治疗良好候选者的患者特征。
