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Maximizing the Benefits of Antipsychotic Medications

December 07, 2020

In this video, Psych Congress Steering Committee member Rakesh Jain, MD, MPH, discusses whether it is appropriate to increase the frequency of a long-acting injectable medication if a patient is still psychotic while taking the maximum dosage. Dr. Jain is Clinical Professor, Department of Psychiatry, Texas Tech Health Sciences Center School of Medicine, Midland.

Read the transcript:

Hello there. I would like to address a question I often get asked about long‑acting injectable medications. The question is, "With patients who are still psychotic on max doses of an LAI, is it acceptable to increase the frequency of the injections?"

My response to it is “no.” No, because doing so changes the pharmacokinetics so significantly. We simply don't know the safety nor the efficacy of doing so. Therefore, I would advise against that.

It is true. Very often, we do run into a roadblock with use of maximum doses of a particular LAI. Yet the patient is symptomatic. In that situation, it may be better to switch to another LAI, or—if you need to and if it's appropriate—perhaps the addition of another antipsychotic.

Not that it is on‑label, but we certainly often do that off‑label to assist our patients in order to get the maximum benefits for our patient. I would not advise increasing the frequency of the maximum dose of LAI you have available, just for the sake of increasing efficacy, because there are other means to achieving that.

All right. Thank you very much for asking that question. I will be talking to you soon.

More with Dr. Jain: Using LAIs in Patients With Dementia and Delusions 

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