Long-Acting Injectable Center of Excellence

Education, resources, and tools to help you understand and optimize the use of LAIs

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Welcome to the Long-Acting Injectable (LAI) Center of Excellence (COE)

The LAI CoE helps clinicians and providers understand the safe and effective use of LAIs. It offers high-quality education, clinical consultations, interactive tools, vetted resources, and more.

Live and on-demand webinars
On-demand consultations
Intensive consultation to clinics, practices, and health systems
Clinical tips and resources

For individual and family resources on LAIs, visit Resources for Individuals & Families.

Some information presented within this Center of Excellence was created in collaboration with the California Department of State Hospitals (DSH). This includes that the content has been specifically aligned to the DSH’s medication guidelines (DSH Psychotropic Medication Operational Procedures, appended to DSH Policy Directive 3400). These medication guidelines are applicable only to the DSH settings and inclusion within this resource does not indicate that they must be followed in any non-DSH settings. The medication guidelines included in this Center are those of DSH and do not necessarily represent the views, policy(ies), and/or position(s) of the American Psychiatric Association (APA).

LAI Injection Videos

SMI CalAdviser is proud to present this five-part video series on the proper preparation and
administration of LAI medications.

Video: Intramuscular (IM) Injection of Long-acting Injectables into Deltoid Site

This video demonstrates how to administer (a long-acting injectable) medication…

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Video: Intramuscular (IM) Injection of Long-acting Injectables into Ventral Gluteal (or Ventrogluteal) Site

This video demonstrates how to administer (a long-acting injectable) medication…

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Video: Intramuscular (IM) Injection of Long-acting Injectables into Dorsal Gluteal (or Dorsogluteal) Site

This video demonstrates how to administer (a long-acting injectable) medication…

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Video: Subcutaneous (SC) Injection of Long-acting Injectables into Abdominal Site

This video demonstrates how to administer (a long-acting injectable) medication…

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Video: Subcutaneous (SC) Injection of Long-acting Injectables into Lateral Aspect of Upper Arm

This video demonstrates how to administer (a long-acting injectable) medication…

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Resources
Education
Consultation

Resources on Long-Acting Injectables

Browse resources and find answers from SMI CalAdviser Resources

LAI Dose Conversion Tool

Medication Specific Information

LAI Use and Guidelines

Switching and Titration

Side Effect Management

Administration and Practical Tips

For Individuals and Families

Patient Experience & Population Specific Considerations

Maximizing Treatment Success for Patients with SMI: Promoting Adherence and Treatment Engagement

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The American Psychiatric Association Guideline for Treatment of Patients with Schizophrenia

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Using Motivational Interviewing with Serious Mental illness to Address Medication Non-Adherence, Create Change and Enhance Stability

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Get Expert Guidance on Questions Around LAIs

Submit any questions you have on managing side effects, assessment and monitoring, medical comorbidities, and any other topic. Receive a response within one business day from one of our national experts.

How should long-acting injectables be initiated?

How much oral overlap is recommended with the first-generation antipsychotic decanoates?

What are the main differences between the aripiprazole long-acting injectables (LAIs)?

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Trending Topics

Use our Resources Page to find evidence-based answers and resources on LAIs.
Here are some new and popular topics — all vetted by our Clinical Expert Team.

APA’s Schizophrenia Treatment Guidelines – LAI Antipsychotics

On September 1, 2020, the American Psychiatric Association released a…

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Long-acting Injectable (LAI) Antipsychotics are Available in the U.S.

See clinical tips available (linked below) on individual LAIs for…

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Diminished Efficacy of an LAI Medication

There are several reasons why a LAI medication might have…

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LAI Injection Sites

There are many different options of LAIs available. See this…

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Shared Decision Making

Shared Decision Making (SDM) is a collaborative process between a…

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View More LAI Resources

LAI Explorer
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LAI Explorer

LAI Dose Conversion Tool
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LAI Conversion Tool

Medication Specific Information
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What should clinicians know about Abilify Maintena (aripiprazole monohydrate LAI)?
What should clinicians know about Aristada (aripiprazole lauroxil LAI)?
Aristada Initio (aripiprazole lauroxil LAI)
What should clinicians know about fluphenazine decanoate (“Prolixin Dec”)?
What should clinicians know about haloperidol decanoate (“Haldol Dec”)?
What should clinicians know about Invega Hafyera (paliperidone palmitate 6-month LAI)?
What should clinicians know about Invega Sustenna (paliperidone palmitate LAI)?
What should clinicians know about Invega Trinza (paliperidone palmitate 12-week LAI)?
Risperdal Consta/Risperidone for Extended-Release Injectable Suspension
What should clinicians know about Uzedy (risperidone subcutaneous LAI)?
Brixadi (Subutex)
Sublocade (Suboxone)
Vivitrol (Naltrexone)
Antipsychotic Receptor Binding Properties
Long-Acting Injectables: Pharmacological Information – LAI Table of Considerations
Pharmacological similarities and differences between paliperidone (Invega) and risperidone (Risperdal)

LAI Use and Guidelines
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First-Generation (typical) Antipsychotics – Medication Fact Sheets
First-Generation (typical) Antipsychotics – Medication Fact Sheets (Spanish Version)
Long-acting Injectable (LAI) Antipsychotics are Available in the U.S.
Guidance for Missed Maintenance Doses for Long-acting Injectable Antipsychotics
Atypical Injectable Antipsychotics for Schizophrenia or Bipolar Disorder: A Review of Clinical Effectiveness and Cost-Effectiveness
Guide to Long-acting Medications for Providers and Organizations – Treatment-Resistant Cases
APA’s Schizophrenia Treatment Guidelines – LAI Antipsychotics
Guidelines for the use and management of long-acting injectable antipsychotics in serious mental illness
Changing or switching a patient from a different long-acting injectable (LAI) antipsychotic medication to Aristada
Changing or switching a patient from a different long acting injectable medication (LAI) to Abilify Maintena
Changing or switching a patient from a different long-acting injectable medication (LAI) to Invega Sustenna (paliperidone palmitate)
Changing or switching a patient treated with LAI to Risperdal Consta (risperidone microspheres)
Offering a long-acting injectable (LAI) for first-episode patients

Switching and Titration
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Dose Conversions
Establishing Tolerability
Changing or switching a patient from a different long-acting injectable medication (LAI) to Invega Sustenna (paliperidone palmitate)
Changing or switching a patient treated with LAI to Risperdal Consta (risperidone microspheres)
Changing or switching a patient from a different long-acting injectable (LAI) antipsychotic medication to Aristada
Changing or switching a patient from a different long acting injectable medication (LAI) to Abilify Maintena
Transitioning a patient from risperidone oral to paliperidone palmitate (Invega Sustenna)

Side Effect Management
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Tardive Dyskinesia (TD)
Antipsychotics and Heat-related Illnesses
VMAT2 Inhibitors and Tardive Dyskinesia (TD)
Deltoid Injection Side Effect Relief
Akathisia

Administration and Practical Tips
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Aspiration in Injections
LAI Injection Frequency
LAI Injection Sites
Guidance for Missed Maintenance Doses for Long-acting Injectable Antipsychotics
Video: Intramuscular (IM) Injection of Long-acting Injectables into Deltoid Site
Video: Intramuscular (IM) Injection of Long-acting Injectables into Dorsal Gluteal (or Dorsogluteal) Site
Video: Intramuscular (IM) Injection of Long-acting Injectables into Ventral Gluteal (or Ventrogluteal) Site
Video: Subcutaneous (SC) Injection of Long-acting Injectables into Abdominal Site
Video: Subcutaneous (SC) Injection of Long-acting Injectables into Lateral Aspect of Upper Arm
Diminished Efficacy of an LAI Medication

For Individuals and Families
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LAI Injection Sites
LAI Injection Frequency
Shared Decision Making
Acute Dystonia
Drug-Induced Parkinsonism

Patient Experience & Population Specific Considerations
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Shared Decision Making
Long-acting Injectable (LAI) Antipsychotics Use for Older Adults
Long-acting Injectable (LAI) Antipsychotic Use During Pregnancy

Funding for SMI CalAdviser was made possible by the State of California Department of State Hospitals (DSH) (the Department), but does not necessarily represent the views of the Department or any of its employees except to the extent, if any, that it has formally been approved by the Department.

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