Injectable antipsychotics reduce hospitalizations and mortality in severe mental illness
A Hong Kong study found that long-acting injectable antipsychotics cut relapse-related hospital admissions by 29% in older schizophrenia patients and 33% in bipolar disorder patients compared to oral medications. All-cause mortality was 77% lower in the schizophrenia group. The benefits were greatest when injectables were used earlier in the illness.
The study drew on territory-wide electronic health records from Hong Kong's Hospital Authority, tracking 4,696 older schizophrenia patients and 2,086 bipolar disorder patients. LAI antipsychotics, which are administered at intervals ranging from weeks to months, were compared against daily oral medications. The research team noted that first-generation LAI formulations may carry a higher risk of extrapyramidal symptoms, making careful monitoring essential.
The findings were published in two separate peer-reviewed journals: The Lancet Psychiatry and the American Journal of Psychiatry. The research also highlighted that second-generation LAI formulations showed particular promise, and that earlier initiation of injectable treatment produced the strongest benefits for long-term patient stability.
These findings could reshape clinical guidelines for treating severe mental illness in older populations, potentially reducing hospital burdens and mortality rates. Patients struggling with daily medication regimens may benefit most, as injectables remove adherence barriers. However, healthcare systems would need to weigh costs and monitoring requirements, particularly for movement-related side effects. The results may also encourage earlier intervention strategies, though individual patient circumstances and treatment tolerability will remain critical considerations.