Non-adherence to oral antipsychotic medication is common among people with schizophrenia and is associated with the return of symptoms. Long-acting injectable antipsychotics offer the potential of improved adherence and clinical outcomes but are rarely used in patients with first-episode psychosis.
Now, a randomised clinical trial involving 86 patients with a first schizophrenia episode has shown that treatment with the long-acting injectable risperidone is associated with a significantly lower rate of psychotic exacerbations or relapses than oral risperidone (5% versus 33%; P<0.001). The injectable formulation is also associated with better adherence and greater control of psychotic symptoms such as hallucinations.
These “notable advantages” presumably reflect the more consistent administration of the long-acting drug, say the researchers in JAMA Psychiatry (online, 24 June 2015)
. The team conclude that such formulations should be offered earlier in the course of illness.
 Subotnik KL, Casaus LR, Ventura J et al . Long-acting injectable risperidone for relapse prevention and control of breakthrough symptoms after a recent first episode of schizophrenia: a randomized clinical trial. JAMA Psychiatry 2015. doi:10.1001/jamapsychiatry.2015.0270.