ArticleBMC psychiatry2022
Off-label long acting injectable antipsychotics in real-world clinical practice: a cross-sectional analysis of prescriptive patterns from the STAR Network DEPOT study.
Article in BMC psychiatry, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 14 citations in OpenAlex.
- A Multicentre, 4-Year Mirror-Image Study Comparing the Effectiveness of Long-Acting Injectable Antipsychotics in the Treatment of Bipolar Disorder: Results From the LAICO Study.Bipolar disorders · 2026Article
- Comparison of Typical and Atypical Long-Acting Antipsychotics in a Real-World Sample in terms of Treatment Adherence and Factors Influencing Treatment Choice: A One-Year Follow-Up Study.Noro psikiyatri arsivi · 2026Article
- Impact of treatment with long‑acting injectable antipsychotics on hospitalization and relapse rates in schizophrenia spectrum disorders: a 3‑year follow-up mirror‑image study.Therapeutic advances in psychopharmacology · 2026Article
- Antipsychotic off-label use in the 21st century: An enduring public health concern.Dialogues in clinical neuroscience · 2025Review
- Early use of long-acting injectable antipsychotics in bipolar disorder type I: An expert consensus.Bipolar disorders · 2025Review
- Clinical Utility of Long-Acting Injectable Risperidone in Schizophrenia and Bipolar I Disorder: A Review of Clinical Studies.Psychology research and behavior management · 2025Review
- Combination of Two Long-Acting Antipsychotics in Schizophrenia Spectrum Disorders: A Systematic Review.Brain sciences · 2024Review
- Effect of long-acting injectable antipsychotics on 1-year hospitalization in bipolar disorder: a mirror-image study.European archives of psychiatry and clinical neuroscience · 2023Article
- Clinical trajectories of individuals with severe mental illness continuing and discontinuing long-acting antipsychotics: a one-year mirror-image analysis from the STAR Network Depot study.Schizophrenia (Heidelberg, Germany) · 2023Article
- Long-acting injectable antipsychotics for the treatment of bipolar disorder: evidence from mirror-image studies.Therapeutic advances in psychopharmacology · 2023Review
- Effect of long-acting injectable antipsychotics on hospitalizations and global functioning in schizophrenia: a naturalistic mirror-image study.Therapeutic advances in psychopharmacology · 2022Article
Corrections and comments
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Authors and funding
12 authors at 20 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionInformation on the off-label use of Long-Acting Injectable (LAI) antipsychotics in the real world is lacking. In this study, we aimed to identify the sociodemographic and clinical features of patients treated with on- vs off-label LAIs and predictors of off-label First- or Second-Generation Antipsychotic (FGA vs. SGA) LAI choice in everyday clinical practice.
methodIn a naturalistic national cohort of 449 patients who initiated LAI treatment in the STAR Network Depot Study, two groups were identified based on off- or on-label prescriptions. A multivariate logistic regression analysis was used to test several clinically relevant variables and identify those associated with the choice of FGA vs SGA prescription in the off-label group.
resultsSGA LAIs were more commonly prescribed in everyday practice, without significant differences in their on- and off-label use. Approximately 1 in 4 patients received an off-label prescription. In the off-label group, the most frequent diagnoses were bipolar disorder (67.5%) or any personality disorder (23.7%). FGA vs SGA LAI choice was significantly associated with BPRS thought disorder (OR = 1.22, CI95% 1.04 to 1.43, p = 0.015) and hostility/suspiciousness (OR = 0.83, CI95% 0.71 to 0.97, p = 0.017) dimensions. The likelihood of receiving an SGA LAI grew steadily with the increase of the BPRS thought disturbance score. Conversely, a preference towards prescribing an FGA was observed with higher scores at the BPRS hostility/suspiciousness subscale.
conclusionOur study is the first to identify predictors of FGA vs SGA choice in patients treated with off-label LAI antipsychotics. Demographic characteristics, i.e. age, sex, and substance/alcohol use co-morbidities did not appear to influence the choice towards FGAs or SGAs. Despite a lack of evidence, clinicians tend to favour FGA over SGA LAIs in bipolar or personality disorder patients with relevant hostility. Further research is needed to evaluate treatment adherence and clinical effectiveness of these prescriptive patterns.
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