Long-Acting Injectable Antipsychotics for First-Episode Schizophrenia: The Pros and Cons

Table 2

The pros and the cons of using long-acting injectable (LAI) antipsychotics for the treatment of first-episode schizophrenia.

Pros	Cons
High relapse caused by poor compliance could be prevented	Because of uncertainty of diagnosis for those in first-episode psychosis, prescribing LAI drugs may be stigmatizing and may hamper therapeutic relationships
Some high-functioning individuals may prefer depot formulations	Discourage patient’s motive to recover because of the general perception that an injectable treatment means a more severe condition with respect to the illness
Favorable side effect profile due to low variation in the peak and trough levels would have positive effects on drug compliance	For those with first-episode schizophrenia showing a positive outcome, the goal of treatment is to gradually reduce the dosage of antipsychotics, which does not fit the traditional goals of LAI drugs
Best time to prescribe LAI drugs may be just before discharge	It is difficult to adjust the dosage of LAI drugs quickly in response to side effects; therefore, LAI treatment may negatively affect subsequent treatment compliance during the critical period