You and your doctor have decided on an extended-release injectable (LAI) antipsychotic to help manage your bipolar I. These long-acting injectable medications help keep you on course with your treatment for longer because they don’t rely on discipline and memory to take a pill once a day.
Instead, depending on which medication you take, you’ll go anywhere from two to eight weeks between doses. The medication continues to work until you get your next shot.
Here’s what you can expect as you start and continue your injectable treatments.
How You Take Them
Getting your injection requires an appointment with your doctor in their office or at a hospital. The specific medication you take will dictate how often you go.
- Aripiprazole (Abilify Asimtufii): Every eight weeks
- Aripiprazole monohydrate (Abilify Maintena): Every four weeks
- Risperidone microspheres (Risperdal Consta): Every two weeks
A doctor or technician will give you the shot in a muscle, either in your arm or your bottom.
When you start an LAI for the first time, your doctor will have you take the same medication by mouth for the first two to three weeks into your dosing schedule to help the medication get into your system.
Advantages You Can Expect from LAIs
Fear of needles keeps some people from even considering LAIs. But if you can bear the temporary needle anxiety, this type of treatment does have many benefits. Here’s what you can expect:
A better track record. Studies show that only about 41% of people with bipolar I who take antipsychotic medications in pill form take them every day, the way they should. People who take LAIs are nearly 10% more likely to take every dose on time. They’re also almost 20% less likely to stop their treatment altogether.
Fewer hospital stays. Doctors used to wait to prescribe LAIs to people who have already been hospitalized many times because they weren’t sticking to their medications. But now doctors are recommending injectables earlier in treatment for bipolar I because they’ve seen that the shots can keep people out of the hospital to begin with. Early use of LAIs leads to steady management of symptoms and helps avoid the kinds of episodes that could lead you to the hospital. This can help you steer clear of high/low relapses and keep you in a more even-keeled mood for longer.
Avoiding conflict with loved ones. A mood episode in bipolar I can decrease motivation or make you feel like you don’t need treatment at all. This can lead to tensions with family and friends who care about your well-being and want to be sure you’re taking care of yourself. When treatment is ongoing without pause, you can avoid these conflicts.
Side Effects You Should Prepare For
There is a chance you’ll have some side effects from the medication in your LAI. Side effects are different for everyone and depend on your particular dosage and the type of medication you’re taking. But the potential side effects are the same whether you’re taking your medication by mouth or through a shot.
Some of the common side effects include:
A reaction at the injection site. The place where your doctor gives you the shot may get red, swell, or be painful after your dose. This reaction may go away quickly or last for a couple of days.
Weight gain. One of the most common side effects people report from taking Abilify Maintena in particular is increased weight. This usually happens in the first 6 months and slows down after that.
Restlessness. You may feel like you can’t be still and need to move your body, a condition called akathisia.
Sleepiness. There’s a chance you feel drowsy after your injection, so plan to get it on a day when you don’t have to drive or operate machinery afterward.
Involuntary movements. This potential side effect, when your muscles move on their own, is called tardive dyskinesia. It’s more serious than other side effects and can be permanent if you get it, even if you stop the medication.
What if I Miss a Dose?
Even though it’s easier to stay the course with medication you don’t have to take every day, it’s definitely possible to forget an appointment or not be able to go for one reason or another. If you miss your injection date, you should reschedule it for as soon as possible and reset your dosing schedule from that date forward.
If it’s been longer than six weeks since you missed your dose, your doctor will want to have you take oral medication along with your next shot.
Show Sources
Photo Credit: Westend61/Getty Images
SOURCES:
North Carolina Department of Health and Human Services: “Aripiprazole Extended-release Injectable Suspension, for Intramuscular Use (Abilify Asimtufii) HCPCS Code J3490 – Unclassified Drugs: Billing Guidelines.”
National Alliance on Mental Illness: “Long-Acting Injectables (LAIs),” “Getting Real about Long-Acting Injectables.”
SMI Adviser: “What long-acting injectable (LAI) antipsychotic medications are available in the U.S.?”
Journal of Clinical Psychopharmacology: “Adherence to Antipsychotic Medication in Bipolar Disorder and Schizophrenic Patients.”
Journal of Medical Economics: “Medication adherence and discontinuation of long-acting injectable versus oral antipsychotics in patients with schizophrenia or bipolar disorder.”
MedlinePlus: “Aripiprazole Injection.”
FDA: “Abilify Maintena.”
British Association for Psychopharmacology: “Antipsychotic medication and weight gain.”
Centre for Addiction and Mental Health: “Antipsychotic Medications.”
