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Clinical Pearls
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Clinician Biases: LAIs are often viewed by clinicians as a last resort, reserved for patients with severe symptoms, adherence issues, or frequent relapses. There is also concern that discussing LAIs may seem coercive or stigmatizing or may strain the therapeutic relationship (2,26–28).
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Patient and Caregiver Preferences: Many patients, including those with adequate adherence to oral medications, favor LAI therapies, finding them more effective and supportive of personal goals, such as maintaining employment, reducing the risk of hospitalization, and simplifying medication management (6,24,29,30).
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Non-adherence, a major predictor of relapse, is often underestimated by clinicians and patients (6,31–33). Long-acting treatments offer a reliable solution to support consistent medication use (20).
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Patient-centered Care: Providing patients and caregivers with comprehensive information about all treatment options fosters shared decision-making, which leads to increased engagement in mental health services and improved medication adherence (24,34).
Novel LAI Therapies
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Some newer LAI formulations eliminate or reduce the need for oral supplementation and loading regimens to reach therapeutic plasma levels during the initial weeks of treatment (21).
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Novel options also allow for longer dosing intervals for increased convenience (21).
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Practical Tips
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Introduce LAIs Early: Present LAIs as a treatment option early in discussions to empower patients with a full understanding of their choices (2,3,7,14).
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Foster Shared Decision-Making: Proactively explain LAI benefits to patients and caregivers to enable personalized, informed decisions that align with their goals (34).
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Address Adherence: Acknowledge that non-adherence is common and explore how LAIs can simplify treatment, even for patients who report adequate adherence (10,11,31,32).
