false
OasisLMS
zh-CN,en,fr,de,ja,es
Catalog
35th AM (2025) - Poster Session
Substance Use and Diagnosis as Predictors of Long- ...
Substance Use and Diagnosis as Predictors of Long-Acting Injectable Antipsychotic Selection
Back to course
Pdf Summary
This study conducted a retrospective chart review of psychiatric inpatients at Mount Sinai between 2020 and 2022, focusing on individuals diagnosed with schizophrenia or bipolar disorder who received long-acting injectable (LAI) antipsychotics. Patients were categorized by the type of LAI antipsychotic received—first-generation antipsychotics (FGA) or second-generation antipsychotics (SGA). Key variables extracted included socioeconomic status, diagnosis, substance use, housing status, insurance coverage, and history of hospitalizations. Using logistic regression with backward elimination, the study aimed to identify predictors of SGA prescribing.<br /><br />Findings revealed that co-occurring substance use disorders and a diagnosis of bipolar disorder were associated with increased odds of receiving SGAs. Conversely, patients with schizophrenia or schizoaffective disorder were less likely to be prescribed SGAs. These patterns suggest that clinicians may preferentially select SGAs in dual-diagnosis patients (with substance use and bipolar disorder) possibly due to perceived efficacy or tolerability in this subgroup.<br /><br />The study situates its results within the broader literature, referencing works on substance use disorders in schizophrenia, the impact of different antipsychotic formulations on relapse prevention, and the pharmacological profile of aripiprazole, a dopamine partial agonist frequently used in these populations. Prior research underscores the prevalence and negative impact of substance use in schizophrenia and the comparative effectiveness of LAI versus oral antipsychotics.<br /><br />The authors conclude that larger, more comprehensive studies are needed to confirm these preliminary associations and to better guide clinical decision-making regarding LAI antipsychotic selection in patients with dual diagnoses. Improved understanding in this area could inform tailored treatment guidelines aimed at optimizing outcomes for complex psychiatric populations.
Keywords
schizophrenia
bipolar disorder
long-acting injectable antipsychotics
first-generation antipsychotics
second-generation antipsychotics
substance use disorders
psychiatric inpatients
logistic regression
dual diagnosis
aripiprazole
×