Suicide Rates Lower Among People Using Long-Acting Injectable Antipsychotics Than Those Taking Oral Antipsychotics

Suicide rates are lower among those using long-acting injectable antipsychotics (LAI) than those taking oral antipsychotics of the same compounds. Specifically, there was a 47% lower suicide death rate in those who switched to the corresponding LAIs within the first two years of starting an oral antipsychotic, than those who did not switch from the oral medication. Overall, those who switched to LAIs had a 66% lower risk of all-cause mortality, compared to those who received the corresponding oral antipsychotic. Those who switched to LAIs also had a 63% lower natural-cause mortality, and 72% fewer suicide attempts, than those who received oral antipsychotics.

These findings were reported in “Comparison of Long-Acting Injectable Antipsychotics With Oral Antipsychotics and Suicide and All-Cause Mortality in Patients With Newly Diagnosed Schizophrenia” by Cheng-Yi Huang, M.D.; Su-Chen Fang, Ph.D.; and Yu-Hsuan Joni Shao, Ph.D. The researchers analyzed data from the Taiwan National Health Insurance Research Database: a population-based sample of those with schizophrenia who received oral antipsychotics (OAPs) from January 1, 2002, to December 31, 2017. Those taking LAIs included those who switched to LAIs, and were prescribed LAIs at least four times within one year. A total of 2,614 individuals who switched to LAI’s were compared to 2,614 individuals who received OAPs. The goal was to investigate associations of LAI) with all-cause, natural-cause, and suicide mortality risks as well as the impacts of early use of LAIs in those with newly diagnosed schizophrenia.

The researchers concluded that LAI use in those with newly diagnosed schizophrenia is associated with decreased all-cause mortality and suicide risk. Early treatment with LAIs within the first two years of starting an oral antipsychotic is also associated with a decrease in suicide mortality risk. They recommend that LAI use in the early stage of treatment should be actively considered for those with newly diagnosed schizophrenia.

The full text of “Comparison of Long-Acting Injectable Antipsychotics With Oral Antipsychotics and Suicide and All-Cause Mortality in Patients With Newly Diagnosed Schizophrenia” was published May 11, 2021, by JAMA Network Open. An abstract is available online at https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2779762.

If you or someone you know is in crisis, please contact the Suicide Prevention Hotline / Lifeline at 1-800-273-TALK (8255), or text the Crisis Text Line at 741-741.

For more information, contact:

• Cheng-Yi Huang, M.D., Attending physician & Director, Department of Community Psychiatry & Addiction Psychiatry in Bali Psychiatric Center, Ministry of Health and Welfare, Huafushan, Noumber 33, Bali District, New Taipei County Taiwan; 249; +886 2-26101660, ext. 2003; Email: cyhpsychiatrist@gmail.com; Website: https://pubmed.ncbi.nlm.nih.gov/33974056/