The prevention of relapse and hospitalization in schizophrenia is a significant public health challenge. Antipsychotic medications reduce relapse risk, with long-acting injectable antipsychotics (LAIs) being superior to oral counterparts. However, adherence is a major issue, especially among patients with early-phase illness, with many discontinuing medication shortly after discharge. Enhancing adherence through interventions like LAIs can mitigate these risks, though LAIs are often reserved for patients with repeated hospitalizations and relapses.

The PRELAPSE study, a multicenter, cluster-randomized clinical trial, aimed to address this by comparing LAI aripiprazole monohydrate with treatment as usual in patients with early-phase schizophrenia. Results showed a significant 44% reduction in first hospitalization rates for the LAI group, highlighting the effectiveness of LAIs in this population. However, the study also noted that while LAIs improved adherence and reduced hospitalizations, there is a continued need for further research into the complex pathophysiology of schizophrenia to develop more effective treatments.

Reference: Kane JM, Schooler NR, Marcy P, et al. Effect of Long-Acting Injectable Antipsychotics vs Usual Care on Time to First Hospitalization in Early-Phase Schizophrenia: A Randomized Clinical Trial. JAMA Psychiatry. 2020;77(12):1217-1224. doi: 10.1001/jamapsychiatry.2020.2076. Erratum in: JAMA Psychiatry. 2020 Dec 1;77(12):1310. doi: 10.1001/jamapsychiatry.2020.3302.