AMERICAN ASSOCIATION OF COMMUNITY PSYCHIATRISTS
CLINICAL TIPS SERIES The Clinical Tips Series provides practical guides for common clinical challenges, specifically adapted to the needs and concerns of community psychiatrists.
LONG ACTING ANTIPSYCHOTIC MEDICATIONS AACP Recommendation: We recognize that long acting antipsychotic medications (LAAs) may have a significant contribution to improving outcomes for individuals with psychotic illnesses. Nevertheless, they are currently underutilized in community psychiatry settings. Therefore, AACP recommends that community psychiatrists and behavioral health organizations take steps to increase use of LAAs AACP endorses the following steps to increase access to LAAs. 1) Expanded Indications: The AACP recommends expanding the scope of indications for LAAs well beyond the single indication of antipsychotic nonadherence. LAAs may be extremely helpful to many individuals in facilitating a more convenient way to take medications and/or better addressing a variety of clinical and social challenges. The following factors may lead psychiatrists to consider offering LAAs: Personal preference of the person receiving care (or sometimes, of family or other key natural supports); Past history of positive response to LAAs; Past history of non-adherence to oral medications; Homelessness; Criminal Justice involvement (to demonstrate or promote adherence); Frequent utilization of ED and/or hospital; Co-occurring substance use disorder; Cognitive challenges; Anosognosia or limited insight; Facilitating a smooth transition to clozapine. 2) Recovery-Oriented, Trauma-informed, Shared Decision-Making: LAAs should be presented within the conceptual framework of “recovery-oriented care.” Individuals with mental health challenges should be empowered with the option to choose LAAs as a resource to help them work towards their own recovery goals. The personal benefits of using LAAs can be ethically balanced with the perceived challenges of receiving injections and the possible association of lack of personal control of their health needs.
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