• A comprehensive meta-analysis found that long-acting injectables (LAIs) for schizophrenia may be better than oral medications at preventing hospitalizations and relapses.
  • LAIs can be taken much less frequently than oral medications, which often require a daily dose.
  • Treatment for schizophrenia is customized to each person and may include psychosocial support in addition to medication.

For a long time, studies on the benefits and risks of long-acting injectables (LAIs) versus oral medications for schizophrenia have been inconsistent.

But a comprehensive systematic review and meta-analysis published in The Lancet Psychiatry in 2021 provides a fresh perspective.

After analyzing the results of randomized controlled trials and other studies, researchers found that injectable medications may have some clear advantages over oral medications used to treat schizophrenia in preventing hospitalization.

Here’s a closer look at what the research showed and what it may mean for the future of schizophrenia treatment.

For the report, a group of researchers analyzed the results from 137 other studies, all of which lasted at least 6 months and included a total of more than 397,000 adults with schizophrenia and related disorders.

Large sample sizes like the one used in this study help researchers make conclusions that are generalizable to a larger population.

The group’s analysis consistently showed that LAIs offered significant benefits over oral antipsychotic medications in preventing hospitalization or relapse among people with schizophrenia.

Furthermore, the study found that there were no significant differences in adverse events in either type of schizophrenia treatment.

It appears to be the first analysis of its kind to include evidence gathered from:

  • randomized controlled trials
  • cohort studies
  • pre-post studies

“This was a great review study, comprised of 137 prior studies,” Dr. Alex Dimitriu, founder of Menlo Park Psychiatry & Sleep Medicine in Menlo Park, California, told Healthline.

“The results consistently favored the benefit of long-acting injectable antipsychotics in reducing the rate of hospitalization or relapse,” added Dimitriu, who is double board certified in psychiatry and sleep medicine.

Dr. David A. Merrill, adult and geriatric psychiatrist, and director of the Pacific Neuroscience Institute’s Pacific Brain Health Center at Providence Saint John’s Health Center in Santa Monica, California, said the findings aligned with what he’s seen firsthand when treating people with schizophrenia.

“The advantages of LAIs are clear and more pronounced in this analysis,” said Merrill.

The results of the report echo the findings of previous research on LAIs for schizophrenia.

A 2020 review published in the Annals of General Psychiatry, which looked at data on more than 75,000 people with schizophrenia who had been hospitalized, found that LAIs reduced the readmission rate by 29 percent compared with oral medications.

That benefit was even greater among people with schizophrenia who had been hospitalized repeatedly in the past.

The recent findings on LAIs may influence treatment choices among healthcare professionals and people with schizophrenia.

The condition, which is estimated to affect around 1.5 million adults in the United States, is a chronic disorder that requires lifetime management. However, symptoms that affect a person’s ability to make decisions and think clearly can make it difficult to follow a treatment plan that includes daily medications.

In fact, the 2020 review noted that 74 percent of study participants who took oral antipsychotic medication for schizophrenia stopped treatment within 18 months.

“Adherence is always a challenge, even with motivated patients,” said Dimitriu.

Simply forgetting to take your daily medication could trigger schizophrenia symptoms, such as hallucinations and delusions. Paranoia, another common symptom of schizophrenia, can also lead some people to be fearful of taking their medications.

But LAIs may make it easier for people with schizophrenia to manage their symptoms and avoid hospitalization because they don’t need to be taken as frequently as oral medications.

Depending on the drug, one injectable dose can last from 2 to 12 weeks.

“With brain disorders in general, compliance is a problem. This can make injection regimens simpler to follow,” explained Merrill.

He added: “The steady-state of a LAI protects against relapse. LAIs might be particularly helpful for people who have trouble adhering to a treatment regimen or repeatedly end up in the hospital. It could lower the rates of relapses and hospitalizations.”

LAIs used to treat schizophrenia include:

  • aripiprazole (Abilify Maintena, Aristada, Aristada Initio)
  • fluphenazine decanoate
  • haloperidol decanoate (Haldol Decanoate)
  • olanzapine (Zyprexa, Zyprexa Relprevv)
  • paliperidone (Invega Sustenna, Invega Trinza)
  • risperidone (Risperdal Consta)

Schizophrenia can be a complex condition to manage. But with the right treatment, people with schizophrenia can lead fulfilling lives.

The right treatment may include antipsychotic oral medication or an LAI. Your psychiatrist or doctor can outline the risks and benefits of potential drugs as you work together to figure out a treatment plan. Keep in mind that it may take some trial and error before finding a treatment that works for you.

Psychosocial treatments can also be a helpful part of managing schizophrenia. They may include:

  • psychotherapy
  • family therapy
  • occupational rehabilitation
  • social skills training

Treatment for schizophrenia is customized to each person’s needs and lifestyle. While schizophrenia can be a challenging condition to manage at times, finding an effective treatment can reduce its impact on a person’s life.

Recent research has found that long-acting injectables (LAIs) may be better than oral medications at reducing the risk of hospitalization from schizophrenia.

They also can be taken less frequently than oral medications, which often need to be taken every day. That may make it easier for people to follow their treatment plan.

When you live with schizophrenia, sticking to a treatment plan is key to managing symptoms.

Regardless of which form your medication takes, the important thing is to find a treatment plan you can follow. Talk with your doctor, psychiatrist, or another healthcare professional to review all your options and choose the method that works best for you.