What are Long-Acting Injectable Antipsychotics? 

Long-acting injectable (LAI) antipsychotics have been shown to prevent psychosis relapse in patients with schizophrenia. To combat poor medication adherence, LAIs are a great option because they require dosing on monthly intervals instead of daily. Improved adherence can significantly improve quality of life, reduce hospitalizations, and outcomes among persons living with schizophrenia.

Share This Post

Almost 7 million people in the U.S. take antipsychotic medications for various conditions to help relieve psychosis symptoms.

During psychosis, you might see, hear, or believe things that aren’t real. 

Antipsychotics are especially useful in treating schizophrenia (characterized by distortions in thinking, emotions, language, and behavior).

Schizophrenia affects more than 21 million people worldwide. Although there is no “cure,” most individuals who are prescribed antipsychotics experience some relief from symptoms and often live satisfying and productive lives.  

Antipsychotics must be taken regularly to control and reduce symptoms.

Research has shown that after an individual’s first hospitalization for schizophrenia, approximately 35% of patients stop taking their antipsychotic medications within 30 days of discharge, and more than 50% of patients stop them after 60 days. 

Unfortunately, when medications are not taken as prescribed, persons living with schizophrenia are at greater risk for relapse of psychosis, continued symptoms (such as hearing and seeing things that aren’t there), and suicide attempts. 

Not taking medication as prescribed (non-adherence) is complex and multi-factorial among persons living with schizophrenia.

Individuals may simply forget to take their medications, or think they are “well enough” and, therefore, don’t need them anymore. In other circumstances, individuals may not have the resources to afford their medications, may be homeless or have other reasons affecting their ability to take their medications.

Regardless of the situation, long-acting medications may be able to help persons living with schizophrenia. To learn more, keep reading! 

Long-acting Injectable Antipsychotics 

Persons living with schizophrenia typically have to take oral antipsychotic medications to help control their symptoms.

These medications may be taken once daily or more frequently, depending on individual circumstances. 

Long-acting medications, commonly called long-acting injectables (LAIs), are an alternative to some oral medications and work to improve symptoms like oral medications.

Unlike oral medications, which must be taken daily, LAIs can last 2, 4, or even 12 weeks depending on the medication with a single dose since they slowly release medicine into the bloodstream. 

As a result, LAIs can help persons living with schizophrenia stay on track with their medication plan. As a result, individuals will have a better chance of controlling their symptoms and staying out of the hospital.

Also, because LAIs slowly release medication over time, they have a lower risk of side effects and can improve quality of life and satisfaction with medication. 

As with all medications, there are some advantages and disadvantages that should be considered. Let’s explore these in more detail. 

YouTube player

Advantages of LAIs 

  1. Convenience for persons living with schizophrenia 
  2. Medications are administered as a single dose monthly, or every 2 – 3 months depending on the drug selected 
  3. Drug levels in the body usually are more stable compared to oral medications 
  4. Reduced risk of accidental or intentional overdose 
  5. Easier for healthcare professionals to follow-up with individuals on their medication adherence 
  6. Lower relapse rates and frequency of hospitalizations 
  7. Improved patient satisfaction 

Disadvantages of LAIs 

  1. Slow dose titration – meaning that it can take some time to get to the best dose to control symptoms 
  2. Your healthcare provider may still prescribe an oral medication during this time 
  3. Newer medications have improved this time frame and may not be as much of a concern 
  4. Can be harder to adjust the dose of LAIs 
  5. Individuals may find traveling to their doctor’s office or clinic to receive their injection burdensomely 
  6. Many community pharmacies (where allowed by law) are now able to administer LAIs antipsychotics, further improving access 
  7. Potential for pain or irritation at the injection site 

Which LAIs are Currently Available on the Market?



Time between injections



Side Effects

Abilify Maintena


28-42 days

Into the muscle: deltoid or gluteal

Headache, trouble sleeping, muscle soreness

Haldol decanoate


28 days

Into the muscle: deltoid or gluteal

Trouble sleeping, agitation, uncontrolled muscle movement



30-90 days

Into the muscle: deltoid or gluteal

Trouble sleeping, headache, uncontrolled muscle movement

Fluphenazine decanoate

7-21 days

Into the muscle: deltoid or gluteal 

Under the skin

Into the veins

Uncontrolled muscle movement



28 days

Into the muscle: deltoid or gluteal

Tremor, headache, uncontrolled muscle movement, dizziness

Zyprexa Relprevv


14-28 days

Into the muscle: deltoid or gluteal

Drowsiness, uncontrolled muscle movement

How Effective are LAIs?

The Prevention of Relapse in Schizophrenia (PRELAPSE) study was designed to evaluate various treatments for individuals with schizophrenia without affecting their overall care.

The study had 489 participants who had early stages of the illness and had fewer than five years of antipsychotic medication use. 

Half of the participants received an LAI antipsychotic medication, aripiprazole, and the other half received oral treatment as usual. The study evaluated these individuals for two years. 

The PRELAPSE study showed that individuals with early-stage schizophrenia receiving the LAI antipsychotic medication had a 44% reduction in re-hospitalization risk.  

Another study evaluated 2488 patients with early-stage schizophrenia and found that LAI antipsychotics had a 64% lower relapse rate than an equivalent oral antipsychotic medication. 

An additional review looked at ten studies to determine whether LAI antipsychotics should be used in early schizophrenia and concluded that the use of LAIs in first psychosis episodes might be more effective than oral medication in controlling symptoms and relapse. 

Bottom Line 

Long-acting injectable antipsychotics have an important place in therapy. 

It may take a little longer to get to the right dose and symptoms to resolve, but studies have shown that individuals using these agents have improved satisfaction and results. 

LAIs are often underutilized but may be the key to medication adherence and significantly improving the quality of life for people living with schizophrenia. 

References, Studies and Sources: 

1. Brissos S, Veguilla MR, Taylor D, Balanzá-Martinez V. The role of long-acting injectable antipsychotics in schizophrenia: a critical appraisal. Ther Adv Psychopharmacol. 2014;4(5):198-219. doi:10.1177/2045125314540297

2. Columbia University Medical Center. Benefits of Antipsychotics Outweigh Risks, Find Experts. https://www.eurekalert.org/pub_releases/2017-05/cumc-boa050217.php. Published 2017. Accessed 17 September 2020.

3. Kane JM, Schooler NR, Marcy P, et al. Effect of Long-Acting Injectable Antipsychotics vs Usual Care on Time to First Hospitalization in Early-Phase Schizophrenia: A Randomized Clinical Trial. JAMA Psychiatry. Published online July 15, 2020. doi:10.1001/jamapsychiatry.2020.2076

4. Klugh Kennedy W. When and how to use long-acting injectable antipsychotics. Current Psychiatry. 2012;11(8):40-43.

5. Opare-Addo MNA, Mensah J, Aboagye GO. A Case of Schizophrenia in a Young Male Adult with no History of Substance Abuse: Impact of Clinical Pharmacists’ Interventions on Patient Outcome. Case Reports in Psychiatry. 2020;2020:3419609.

We are committed to providing our readers with only trusted resources and science-based studies with regards to medication and health information. 

Disclaimer: This general information is not intended to diagnose any medical condition or to replace your healthcare professional. If you suspect medical problems or need medical help or advice, please talk with your healthcare professional.

Share This Post

Pharmacists.org Discount Club

Get Started for $1.

  • Cheapest cash pay option at your retail pharmacy
  • 1,000s of drugs below $10.00 that can beat your co-pay
  • Start for $1 for your first month. Cancel anytime. 
  • Tell us your meds, we tell you the cheapest options.

Popular Destinations

Recent Articles

trusted pharmacists giving patient information

Does Taking Effexor Cause Weight Gain?

Taking Effexor may cause weight gain in some patients. Weight gain is a common side effect of Effexor and other antidepressant medications, and more than half of patients on newer classes of antidepressants report experiencing weight gain.

Read More »

Cerebral Review: Online Depression & Anxiety Treatment

Today, we’re deep diving with a Cerebral review to give you some insider info to help you narrow down your choices.

We review and include products we think are useful for our community. If you buy through links on this page, we may earn a commission. For more info, please read our ad policy, content principles and vetting policy.

Read More »

Share On:

More To Explore

Does Taking Effexor Cause Weight Gain?

Taking Effexor may cause weight gain in some patients. Weight gain is a common side effect of Effexor and other antidepressant medications, and more

How Long Does Lexapro Take To Work?

If you are considering taking Lexapro for your depression or anxiety, you might be wondering how long it takes to work.

Zoloft and Weight Loss: Everything You Need To Know

When it comes to Zoloft and weight loss, here’s everything you need to know.

Cerebral Review: Online Depression & Anxiety Treatment

Today, we’re deep diving with a Cerebral review to give you some insider info to help you narrow down your choices.

We review and include

What are the signs of Depression?

In this article, we will discuss the signs and symptoms of depression as well as some treatment options for this condition.

Can You Use Gabapentin For Anxiety?

While Neurontin is the most common brand name for gabapentin, other forms (such as Horizant and Gralise) may be prescribed depending on the specific

What is Zoloft?

If you have been recently diagnosed with depression and are given Zoloft, you may want to know how the medication works, what common side

What is Venlafaxine HCL ER?

The prescription drug belongs to a class of drugs called selective serotonin norepinephrine reuptake inhibitor antidepressants (SNRIs), which are commonly used to treat mental

Using Prozac With Alcohol: What Are the Risks?

Prozac can be used to treat many different mental health conditions, is associated with a relatively low risk of side effects, and causes the

How Long Does Clonazepam Stay in Your System?

This fast-acting medication is known for being effective at panic attacks, but how long does clonazepam stay in your system?

What is Sertraline and What are the Side Effects?

Sertraline is the generic form of Zoloft, a medication that belongs to a class of drugs called selective serotonin reuptake inhibitors (SSRIs). SSRIs like

Turn On, Tune In, and…. Heal Your Brain? Psychedelics Return as Potential Therapy for Mental Health Disorders

Before they fell out of favor over half a century ago, psychedelic drugs, like psilocybin and LSD, were studied for various psychiatric diseases such

How Long Does Alprazolam Stay in Your System?

Alprazolam is a fast-acting medication, but exactly how long alprazolam stays in your body varies tremendously based on the form of the medication taken,

Paxil vs Zoloft: Differences, Similarities and Which is Better

When it comes to Paxil vs. Zoloft, which is better?

A Supplement for Stress? The Science Behind Adaptogens

Stress is part of all our lives. Adaptogens are a group of herbal supplements studied throughout history as a way to improve the body’s

Does Buspirone Cause Weight Gain?

Many antidepressants can cause weight gain as a side effect. Buspirone may cause an altered appetite as a side effect, which can lead to

Duloxetine Withdrawal: Symptoms, Timeline, and Treatment

Duloxetine withdrawal is very common and well documented, affecting nearly half of all patients. Common withdrawal symptoms include dizziness, headaches, and nausea, and symptoms

Cymbalta vs. Prozac: Comparison Guide

Cymbalta and Prozac are commonly prescribed medications to treat mental health conditions such as major depressive disorder. The medications are similarly effective, although one

How Long Does Ativan Stay in Your System?

If you use Ativan to manage your health but are curious about how long Ativan lasts in your system, we have all the information

Why is Mental Health Important?

As the saying goes, “There is no health without mental health,” but why is mental health so important? The reality is that although we

What is BuSpar? Uses, Costs, Benefits, and Doses

If you’re one of 40 million American adults suffering from an anxiety disorder or experiencing symptoms of anxiety, you might think that your battle

Cymbalta vs Effexor: Differences and Side Effects

Effexor and Cymbalta are antidepressants used for the treatment of major depressive disorder and generalized anxiety disorder. Although both medications are FDA-approved, Effexor and

Celexa vs Lexapro: Which is Better For Depression?

Both are regarded as equally effective drugs for treating depression. Find out the core difference between Celexa vs. Lexpro now!

What is Ativan? Uses, Costs, Benefits, Doses

More than 40 million adults in the United States are diagnosed with an anxiety disorder, making it the most common mental illness in the

Lexapro Overdose: Signs, Symptoms, and Precautions

We’ve put together a list of the signs and symptoms to look out for when it comes to Lexapro overdose and some of the

Panic Attacks: The Story of an Overpowering Fear

Panic attacks are when you experience a sudden feeling of intense fear with no apparent threat or danger.  This triggers a "fight or flight"

Using Lorazepam with Alcohol: What Are the Risks?

Using lorazepam with alcohol is incredibly dangerous but can be a common occurrence, and is associated with potentially life-threatening side effects, which are outlined

Using Citalopram with Alcohol: What Are the Risks?

Mixing antidepressants with alcohol is always potentially dangerous, but using citalopram with alcohol is particularly unsafe due to the high potential for life-threatening side

Brightside Health Review: Is This Depression & Anxiety Care Useful?

Brightside is an online mental healthcare company that provides treatment services for a range of issues related to anxiety and depression. These conditions include

SonderMind Reviews: Pros & Cons of Their Therapy Services

SonderMind is a virtual mental health service that makes therapy and psychiatry more accessible. Find out if the pros outweigh the cons.

We review and