Psychiatry Unit, Department of Health Sciences, University Magna Graecia of Catanzaro, Catanzaro, Italy.
Psychiatry Unit, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy.
Expert Opin Drug Saf. 2021 Jul;20(7):771-790. doi: 10.1080/14740338.2021.1910674. Epub 2021 Apr 12.
: In this review, the authors discuss the role of long-acting injectable antipsychotics (LAIs) for schizophrenia, focusing on the effectiveness and new perspectives introduced by such treatment strategy. Despite their promising pharmacokinetic features and their potential advantages in medication adherence, clinical outcomes, and medical costs, LAIs are not habitually presented as an option for patients, especially in the early phase of schizophrenia.: This review explores the panorama of available LAIs for the treatment of schizophrenia, first-episode of psychosis, approved indications, medical costs, medication adherence, side effects, effectiveness and differences between first-generation (FGA)-LAIs and second-generation (SGA)-LAIs.: LAIs differ in terms of specific indications, approved injection sites, needle size, injection volume, injection interval as well as potential drug-drug interactions, and commonly reported adverse reactions. The approved indications have expanded beyond schizophrenia to include bipolar and schizoaffective disorder. SGA-LAIs are often preferred to FGA-LAIs. FGA-LAIs although are less chosen in new patients due to the induction of cognitive and extrapyramidal side effects, even if, on the other hand, many SGA-LAIs are burden by hyperprolactinemia and weight gain. After a review of the available evidence, insight is provided into the potential and current therapeutic opportunities offered by LAI antipsychotic formulations.
在这篇综述中，作者讨论了长效注射抗精神病药（LAIs）在精神分裂症中的作用，重点介绍了这种治疗策略的有效性和新视角。尽管它们具有有前景的药代动力学特征，并且在药物依从性、临床结果和医疗成本方面具有潜在优势，但 LAIs 并未作为患者的常规选择，尤其是在精神分裂症的早期阶段。
本篇综述探讨了目前可用于治疗精神分裂症、首发精神病的 LAIs 的全景，包括其适应证、医疗费用、药物依从性、副作用、疗效以及第一代（FGA）-LAIs 和第二代（SGA）-LAIs 之间的差异。
LAIs 在具体适应证、批准的注射部位、针的大小、注射量、注射间隔以及潜在的药物相互作用和常见的不良反应方面存在差异。批准的适应证已经超出了精神分裂症，包括双相情感障碍和精神分裂症谱系障碍。SGA-LAIs 通常比 FGA-LAIs 更受欢迎。尽管由于认知和锥体外系副作用的诱导，FGA-LAIs 在新患者中不太被选择，但另一方面，许多 SGA-LAIs 存在催乳素升高和体重增加的问题。在对现有证据进行回顾后，深入了解了 LAI 抗精神病药物制剂提供的潜在和当前治疗机会。
