Problems with the Administration of Antipsychotic Drugs in Depot Formulations in the Treatment of Schizophrenia

Summary The aim of this study was to investigate problems with the administration of antipsychotic long-acting injections (LAIs) in patients with schizophrenia. Besides many benefits, long-acting injections have been associated with a number of complications at the site of the injection. The qualitative study included four medical workers and five patients who had been treated with fluphenazine, haloperidol, risperidone given in the form of a long-acting depot injection. The data were collected by direct observation, analysis of the history of the disease and used semi-structured interview. Interviews completed by patients, psychiatrists and nurses were analyzed and condensed into nine key categories: Competence and training of the medical workers, Sites and technique, Registration of complications, Care of patients and privacy, Availability and evidence, Duration and frequency of treatment, Burden for the patients, The choice of formulation therapy, and Sense of stigma. Monitoring of side-effects of LAIs was not extensive and doctors did not write adverse effects. The nurses who administered the injections were competent. Not enough attention is paid to the choice of the needle diameter and the patient was not given a choice to decide on the sites of the administraton of injection. Three out of five patients did not feel any changes at the injection site, but another patient had severe pain, redness, and induration. The exchange of information, a possibility of choosing the site of administration, and monitoring of the effects of treatment are all positive strategies that doctors and nurses can use to help patients in the compliance to the treatment with antipsychotic long-acting injections.