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Know Your Options Part Two


Hi! My name is David Montgomery. I’m an independent artist and show organizer. I currently live with a mental illness, and I enjoy making art, spending time with my partner, and meeting new people.

I’m here today to talk to you about long-acting injectables for the treatment of diagnosed Bipolar-I disorder and Schizophrenia.

Welcome to part 2 of Know Your Options, a video series on long-acting injectables as a treatment option. This is the second part of a two-part video series. The first video covered long-acting injectables, or LAIs, as a potential treatment option for people living with Bipolar-I disorder or Schizophrenia. It discussed how to think about your treatment goals in order to have better conversations with your doctor and care team about your treatment plan.

In this second video, we will explore some of the potential benefits and potential risks of long-acting injectables. We will also discuss some important questions that you should keep in mind as you think about your treatment options, including potential LAIs. These videos can also be helpful if you are providing care to someone with Bipolar-I disorder or Schizophrenia. You can help them think about and discuss different treatment options.

Some people may prefer an LAI, because an LAI could make it possible to take one less daily oral medication after initial dosing. An LAI could provide a person with a gradual release of medication in their body. Some people may prefer the option of an LAI.

To understand if an LAI may be right for you, you should discuss it with your doctor. If you do take an LAI, you will receive the injection from a professional healthcare provider every few weeks or months, depending on the medication.

In the next section of this video, we are going to explore some of the potential benefits and drawbacks of LAIs. But before we do, there is one important consideration to keep in mind.

LAIs are not for everyone. The goal of this video is to help you have a conversation with your healthcare provider to understand if an LAI may be an option for you or someone you care about.

For now, let’s look at what some advocates say about potential benefits of LAIs for people living with Bipolar-I disorder and Schizophrenia.

SMI Adviser – a clinical support system funded by the Substance Abuse and Mental Health Services Administration (SAMHSA) and administered by the American Psychiatric Association (APA) – has suggested that LAIs may foster regular contact between the person living with mental illness and their treatment team.

CPNP (College of Psychiatric and Neurologic Pharmacists) and SMI Adviser are organizations designed to help people living with mental illness and their care teams. Their views should not be considered as medical guidance, and the most important thing you can do is discuss these ideas with your care team and healthcare provider.  Now that we have reviewed some of the potential benefits that some people may experience with LAIs, let’s turn to some of the potential drawbacks.

Again, LAIs are not for everyone. Here are some reasons why. One doctor, who serves as an advisor to SMI Adviser, shares a few of her observations about LAIs. She suggests that LAIs may take more time for the medication to start working. This means that you may, for a period of time, need to take both an LAI and an oral medication. Unlike a daily oral medication, you cannot give LAIs to yourself. You will need to see a healthcare provider to receive an LAI.

You may also experience some pain on the part of your body where the LAI is administered. For some people, the potential pain with an injection or the fear of a needle makes LAIs undesirable. It’s an important discussion to have with your healthcare provider and your care team.

Additionally, it may take longer for potential side effects with an LAI to lessen or go away, given that the medications are in your body for an extended period of time.

Also, depending on where you live, it may be difficult to get to a location where you can receive an LAI. Not all healthcare providers either administer or are set up to give LAI injections. And some health insurance plans may not cover LAIs.

As you consider treatment options, you may want to start the conversation with your care team and healthcare provider. And you may want to share these benefits and drawbacks to see if an LAI may be right for you. Psychiatrists do not always offer LAIs as an option— LAIs are an underutilized treatment option in clinical practice. It is up to you and your care team to start the conversation.

To understand LAIs as a potential treatment option, it is important to know which LAIs are prescribed for which conditions, how they are administered, how often, and by whom. You should talk to your healthcare provider to learn more. Some LAIs treat Bipolar-I disorder, some LAIs treat Schizophrenia, and other LAIs can treat both or other conditions. Some LAIs may be injected in the shoulder muscle (also known as the deltoid).

Others may be administered in the buttocks (also known as the gluteal muscle). It’s an important consideration to take into account. Some long-acting injectables are given every two to three weeks, while others may be given every month. Some LAIs may be administered every two to six months.

In many cases, you may need to take an oral medication for a set time as determined by your doctor after you begin taking an LAI. This is to make sure that there are sufficient levels of medication in the blood. When advised by your doctor, you may be able to stop taking the oral medication.

To summarize what we have covered in this video:

  • LAIs are long-acting medicines that may be able to replace one daily oral medication
  • Some experts believe LAIs may provide advantages for certain individuals while other patients may experience disadvantages.
  • When considering if an LAI is right for you, you should consult your care team and healthcare provider
  • LAIs are not for everyone – but you should feel empowered to see if they’re right for you

Thank you for watching this video. We hope this helps you understand your options – and the potential role LAIs may play in your treatment and care.

This video was made possible by Otsuka America Pharmaceutical Inc., and Lundbeck in collaboration with the National Alliance on Mental Illness and the National Council for Mental Wellbeing.

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