Using Long-Acting Injectable Antipsychotics to Enhance the Potential for Recovery in Schizophrenia
In this journal CME activity, find experts’ recommendations for reducing schizophrenia relapse, such as adopting a patient-centered approach, selecting medications based on current evidence, and implementing psychosocial interventions.
The goals of schizophrenia treatment are to control symptoms, prevent relapse, and improve functioning and quality of life. For many patients, these goals are not being met. This report highlights information provided by experts on the reasons for, impact of, and means to reduce relapse in patients with schizophrenia; on patient-centered and patient-reported assessment; on the benefits and risks of medication options, including long-acting injectable (LAI) antipsychotics; and on psychosocial interventions that may improve adherence and help prevent relapse in individuals living with schizophrenia. Modifiable risk factors for poor outcomes in patients with schizophrenia include longer duration of untreated illness, comorbid substance abuse, early nonresponse to an antipsychotic, and the number of relapses that are related to nonadherence. Recommendations include 1) adopting a patient-centered approach that incorporates the use of patient-reported outcome measures; 2) selecting medications based on a balanced risk-benefit assessment, including a focus on addressing symptoms for which the agents were superior to placebo and/or active controls; 3) considering LAIs as an alternative to oral medications, as they offer benefits such as reliable drug delivery, uncovering nonadherence and pseudo-resistance, and reduced relapse risk and mortality; and 4) implementing psychosocial interventions that have been proven to be effective in improving adherence and overall outcomes.
From the Series: The Schizophrenia Remission Roller Coaster: Using Long-Acting Injectable Antipsychotics to Improve Adherence and Enhance Potential for Functional Recovery
To cite: Correll CU, Lauriello J. Using long-acting injectable antipsychotics to enhance potential for recovery from schizophrenia. J Clin Psychiatry. 2020;81(4):MS19053AH5C.
To share: https://doi.org/10.4088/JCP.MS19053AH5C
© Copyright 2020 Physicians Postgraduate Press, Inc.
- Psychiatrists, nurse practitioners/physician assistants
- Neurologists, nurse practitioners/physician assistants
After studying this article, you should be able to:
- Select evidence-based treatment for patients with schizophrenia who often relapse
Articles are selected for credit designation based on an assessment of the educational needs of CME participants, with the purpose of providing readers with a curriculum of CME articles on a variety of topics throughout each volume. Activities are planned using a process that links identified needs with desired results.
This Academic Highlights section of The Journal of Clinical Psychiatry presents the highlights of the teleconference series “The Schizophrenia Remission Roller Coaster: Using Long-Acting Injectable Antipsychotics to Improve Adherence and Enhance Potential for Functional Recovery,” which was held in September and October 2019. This report was prepared and independently developed by the CME Institute of Physicians Postgraduate Press, Inc., and was supported by educational grants from Alkermes, Inc.; Otsuka America Pharmaceutical, Inc. and Lundbeck.
The teleconference was chaired by Christoph U. Correll, MD, Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, and Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA; and Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany. The faculty was John Lauriello, MD, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.
Release, Expiration, and Review Dates
This educational activity was published in June 2020 and is eligible for AMA PRA Category 1 Credit™ through August 31, 2022. The latest review of this material was April 2020.
Disclosure of off-label usage
Dr Correll has determined that, to the best of his knowledge, no investigational information about pharmaceutical agents or device therapies that is outside US Food and Drug Administration–approved labeling has been presented in this activity.
The faculty member(s) agreed to provide a balanced and evidence-based presentation and discussed the topic(s) and CME objective(s) during the planning sessions. The faculty’s submitted content was validated by CME Institute staff, and the activity was evaluated for accuracy, use of evidence, and fair balance by the Chair and a peer reviewer who is without conflict of interest.
The opinions expressed herein are those of the faculty and do not necessarily reflect the opinions of the CME provider and publisher or the commercial supporter.
Christoph U. Correll, MD
Department of Psychiatry, The Zucker Hillside Hospital, Glen Oaks, New York; Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
John Lauriello, MD
Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania
All individuals in a position to influence the content of this activity were asked to complete a statement regarding all relevant personal financial relationships between themselves or their spouse/partner and any commercial interest. The CME Institute has resolved any conflicts of interest that were identified. In the past year, Marlene P. Freeman, MD, Editor in Chief, has received research funding from JayMac and Sage; has been a member of the advisory boards for Otsuka, Alkermes, and Sunovion; has been a member of the Independent Data Safety and Monitoring Committee for Janssen; has been a member of the Steering Committee for Educational Activities for Medscape; and, as a Massachusetts General Hospital (MGH) employee, works with the MGH National Pregnancy Registry, which is sponsored by Teva, Alkermes, Otsuka, Actavis, and Sunovion, and works with the MGH Clinical Trials Network and Institute, which receives research funding from multiple pharmaceutical companies and the National Institute of Mental Health. No member of the CME Institute staff reported any relevant personal financial relationships.
Dr Correll is a consultant for and has received honoraria from Acadia, Alkermes, Allergan, Angelini, Axsome, Boehringer-Ingeheim, Gedeon Richter, Gerson Lehrman Group, Indivior, IntraCellular Therapies, Janssen, LB Pharma, Lundbeck, MedAvante-ProPhase, Medscape, Merck, Neurocrine, Noven, Otsuka, Pfizer, Recordati, ROVI, Servier, Sumitomo Dainippon, Sunovion, Supernus, Takeda, and Teva; has received grant/research support from Janssen and Takeda; is a member of the speakers/advisory boards for Alkermes, Allergan, Angelini, Gedeon Richter, IntraCellular Therapies, Janssen, LB Pharma, Lundbeck, Neurocrine, Noven, Otsuka, Pfizer, Recordati, Sumitomo Dainippon, Sunovion, Supernus, Takeda, and Teva; is a stock option holder of LB Pharma; and has received other financial or material support for expert testimony from Bristol-Myers Squibb, Janssen, and Otsuka and royalties from UpToDate. Dr Lauriello is a consultant for Indivior and Alkermes, has received royalties from UptoDate, and has lectured on clinical trial training for Roche.
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The CME Institute of Physicians Postgraduate Press, Inc., designates this enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Note: The American Nurses Credentialing Center (ANCC) and the American Academy of Physician Assistants (AAPA) accept certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the ACCME.
MOC Approval Statement
Through the American Board of Medical Specialties (“ABMS”) ongoing commitment to increase access to practice relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, Using Long-Acting Injectable Antipsychotics to Enhance the Potential for Recovery in Schizophrenia has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:
MOC Part II CME Activity
Psychiatry and Neurology
- 1.00 AMA PRA Category 1 Credit™
- 1.00 Participation