Adverse effects and antipsychotic long-acting injections*

Peter Haddad and W. Wolfgang Fleischhacker

in Antipsychotic long-acting injections

Published on behalf of Oxford University Press

Published in print October 2010 | ISBN: 9780199586042
Published online February 2013 | e-ISBN: 9780191754708 | DOI:
Adverse effects and antipsychotic long-acting injections*

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Antipsychotic drugs can cause a wide range of adverse effects (Table 3.1) irrespective of whether they are administered as oral medication or as a long-acting injection (LAI; Haddad & Sharma 2007). Clinicians need to be familiar with these effects to minimize their occurrence and recognize and manage them when they arise. The adverse effects listed in Table 3.1 are not considered in detail in this chapter as they are reviewed in other chapters of this book in relation to specific LAIs, namely Chapter 4 on first-generation antipsychotic LAIs (FGA-LAIs), Chapter 5 on risperidone long acting-injection (RLAI), and Chapter 6 on olanzapine long-acting injection (OLAI) and paliperidone long-acting injection (PLAI). This chapter concentrates on aspects of tolerability and safety that have special relevance to LAIs compared to oral medication.

We start by considering whether non–injection-related adverse effects are more frequent with LAIs than with oral medication. This is a common clinical question with a good pharmacological rationale; the pharmacokinetic profiles of oral medication and LAIs are very different. We then review injection-related adverse effects including pain, injection-site problems, and the olanzapine post-injection syndrome. Next we consider how the pharmacokinetics of LAIs can lead to the delayed appearance and resolution of adverse effects compared with those seen with oral medication following initiation and termination of treatment and dose adjustment. The clinical implications for the assessment and management of adverse effects and use of LAIs are reviewed. The chapter concludes with a short summary.

Chapter.  10317 words.  Illustrated.

Subjects: Psychiatry

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