Effect of long acting injectable antipsychotics on course and hospitalizations in bipolar disorder - a naturalistic mirror image study

Purpose To determining whether the addition of a long-acting injectable antipsychotic (LAI-AP) has a positive effect on prognosis in bipolar disorder. Materials and methods Medical records of patients with bipolar disorder who were using LAI-AP at least for one year in the community mental health center (CMHC) until March 2020 were investigated. Comparisons were made between the period of one year before and after the initiation of LAI-AP. Hospital admission was the primary outcome. Residual symptom severity and functionality were evaluated with Personal and Social Performance Scale (PSP), Young Mania Rating Scale (YMRS), and Beck Depression Inventory (BDI). Results There were 197 patients with bipolar disorder who were attending to the CMHC and 17 of them were under maintenance treatment with LAI-AP for at least one year. The LAI-APs used were aripiprazole (n = 8), paliperidone (n = 5) and risperidone (n = 4). Duration of illness was 13.5 +/- 8.02 years and duration of LAI-AP treatment was 24.8 +/- 22.74 months (median: 18). During the one-year period after the LAI-AP initiation, there were fewer days spent in hospital (2.5 +/- 5.68 vs. 15.5 +/- 20.59 days, p = .026) and the number of hospitalizations was lower than the year before the LAI-AP use (0.1 +/- 0.39 vs. 0.9 +/- 1.24 hospitalizations, p = .013). During the recovery period with LAI antipsychotics, there were mild residual symptoms presented with mean PSP (70.2), YMRS (1.7) and BDI (7.6) scores. Conclusion LAI-AP use may have positive effect on course for selected patients with a long history of bipolar disorder.

Automated summary

This study aimed to investigate the impact of long-acting injectable antipsychotics (LAI-AP) on the prognosis of bipolar disorder. The results showed that LAI-AP treatment may have a positive effect on selected patients with a long history of bipolar disorder, reducing hospitalization and residual symptoms. During the recovery period with LAI antipsychotics, patients exhibited mild residual symptoms.