These authors read with interest the recent psychopharmacology pearls published in the journal. In the update on long-acting injectable antipsychotics (LAIA), Case 4 is about a fictional patient, B.B., who is diagnosed with schizophrenia and stabilized on paliperidone 3-month injectable 546 mg for 3 years.1 B.B. misses a dose of their paliperidone injection because of relocating to a different state and having subsequent delays in establishing psychiatric care. A discussion then follows about the management of missed doses of LAIAs.
Although the case is fictional, it describes a real situation that clinicians may very well encounter in their practice. We would like to point out that Alkermes, Otsuka, and Janssen offer online resources that enable patients or their practitioners to find providers who can administer LAIAs thereby preventing disruptions in therapy like the one in the case described.2-4 To our knowledge, the olanzapine LAIA and risperidone subcutaneous LAIA do not offer this level of support. Readers may find the Substance Abuse and Mental Health Services Administration's Behavioral Health Treatment Services Locator helpful when coordinating care for patients treated with these products.5 For all other LAIAs, Table 1 lists the drug name and the corresponding websites that can help find providers who can administer them. These online search tools help locate care centers that have staff who are experienced with the safe administration of LAIAs. In states where pharmacists are legally allowed to administer LAIAs, care centers include retail pharmacies, and in states where this is not legally permitted, outpatient clinics, doctors' offices, and urgent care facilities may serve as care centers. These resources can be used well in advance of the patient's planned trip or relocation and can assist in maintaining continuity of care even before the patient is able to establish long-term psychiatric care. In some cases, reimbursement may be available from the pharmaceutical company for coordinating the patient's care.
Since 2018, our office has served as a local care center for patients treated with aripiprazole monohydrate LAIA. Since that time, we've provided injections for patients diagnosed with schizophrenia or bipolar 1 disorder who are traveling to our region, relocating, or having trouble establishing mental health care.
We hope to boost awareness of these valuable industry-enabled resources that can and should be used to help avoid disruptions in therapy that can be costly and all too often precede decompensation like in the case described. We should applaud our industry partners for offering these tools that assist with coordinating patient care and help individuals with mental illness lead more normal lives.