Clinical Effectiveness of Second-Generation Injectable Antipsychotics

Key Messages

• The evidence in this report is limited because statistical information was not adequately reported in included studies.
• When comparing second-generation paliperidone palmitate injections and first-generation haloperidol decanoate injections, there is little-to-no difference in treatment success or adverse events.
• When comparing second-generation risperidone injections and first-generation haloperidol decanoate and fluphenazine decanoate injections given together, there is little-to-no difference in whether patients discontinue treatment.
• Hospitalization appears higher for patients who receive haloperidol decanoate injections compared to those who receive second-generation risperidone or aripiprazole injections, but there is little-to-no difference when comparing injections of risperidone to those of haloperidol decanoate and fluphenazine decanoate given together.
• There is little-to-no difference between patients who stop treatment when comparing risperidone injections to any oral second-generation antipsychotics, second-generation olanzapine injections compared to oral olanzapine, or aripiprazole injections compared to oral aripiprazole. There is little-to-no difference in adverse events between patients given aripiprazole injections compared to those given oral aripiprazole.
• Some studies showed a difference in relapse between second-generation injections compared to oral second-generation medication, while other studies showed little-to-no differences.
• Patients may experience fewer hospital days when given olanzapine injections compared to those receiving oral olanzapine.