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Long-acting aripiprazole injectable may be effective during first episode schizophrenia

Key clinical point: Long-acting injectable aripiprazole once-monthly (AOM) may improve psychotic symptoms, quality of life (QoL), and social functioning in young people with schizophrenia at their first psychotic episode (FEP).

Major finding: After 12 months, AOM was associated with a progressive improvement in the Positive and Negative Syndrome Scale positive and negative scores, general psychopathology scale scores, and global severity (P less than .001 for all). Similarly, progressive improvement in QoL and social and personal functioning was observed with AOM. Mean treatment adherence was 78%.

Study details: The data come from a study of 50 patients with schizophrenia (aged 18-26 years) with or without a substance use disorder comorbidity.

Disclosures: No study sponsor was identified.


"The onset of a first psychotic episode often occurs during late adolescence or in early adulthood, when young people are in the process of working on major life goals in the educational, occupational and personal life domains. Symptoms and functional impairment in these domains has negative downstream effects, especially among individuals who have limited engagement in care due to poor medication adherence. Unfortunately, the ability of clinicians to estimate adherence is often limited and adherence can change over time. The findings of this small study, which need to be interpreted cautiously given methodological limitations, suggest that use of long-acting injectable antipsychotic medication might help improve the trajectory of outcomes among young people with psychotic disorder, and should be considered beyond a more traditional orientation where clinicians might consider long-acting treatments for those who have already had relapse and poor outcomes due to poor adherence with prescribed antipsychotic drug."

Martha Sajatovic, MD
Professor of Psychiatry and of Neurology
Willard Brown Chair in Neurological Outcomes Research
Director, Neurological and Behavioral Outcomes Center, University Hospitals
Cleveland Medical Center
Case Western Reserve University School of Medicine

Dr. Sajatovic has no relevant financial conflicts of interest.


Giordano G et al. Front Psychiatry. 2020;10:935. doi: 10.3389/fpsyt.2019.00935.