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Catalog
35th AM (2025) - Poster Session
Long-Acting Injectable Antipsychotics in Serious M ...
Long-Acting Injectable Antipsychotics in Serious Mental Illness and SUDs
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Pdf Summary
This IRB-approved retrospective chart review examined psychiatric readmission rates among patients with schizophrenia or bipolar spectrum disorders who also had recent or active substance use and were treated with long-acting injectable (LAI) antipsychotics at Mount Sinai from January 2020 to October 2022. Patients were grouped by the type of LAI medication received: partial dopamine agonist (aripiprazole lauroxil) or full dopamine antagonists (paliperidone palmitate, haloperidol decanoate, fluphenazine decanoate). The study's primary outcome was psychiatric readmission within one year, with secondary analyses using Kaplan–Meier methods to assess time to readmission.<br /><br />Results indicated a nonsignificant trend where partial agonist LAIs were associated with a longer time to psychiatric readmission compared to full antagonists. This suggests that partial agonist medications, such as aripiprazole, might offer clinical benefits in patients with dual diagnoses of psychotic disorders and substance use. However, these findings did not reach statistical significance, emphasizing the need for larger, prospective studies to validate the potential advantages and better guide individualized treatment approaches.<br /><br />The study integrates existing literature on substance use disorders in schizophrenia, the comparative effectiveness of LAI antipsychotics for relapse prevention, and the pharmacological properties of partial dopamine agonists like aripiprazole. Prior research reflects the high prevalence and adverse impact of substance use in schizophrenia, and suggests partial agonists might reduce craving and substance use, which could improve overall outcomes.<br /><br />In conclusion, while preliminary evidence points toward a possible benefit of partial dopamine agonist LAIs in reducing readmission risk among dual diagnosis patients, more robust research is needed to establish definitive treatment guidelines and optimize outcomes in this complex population.
Keywords
psychiatric readmission
schizophrenia
bipolar spectrum disorders
substance use
long-acting injectable antipsychotics
partial dopamine agonist
full dopamine antagonist
aripiprazole lauroxil
paliperidone palmitate
Kaplan–Meier analysis
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