Long-Acting Injectable Drugs for Schizophrenia (Nursing)

00:01 When we're thinking about long acting injectable anti-psychotics, we're thinking about the fact that this person will not have to think for 30 days about taking a pill.

00:14 I don't know about you, but if it's really hard to have, if you have a memory problem, if you have a thought processing problem, if you have an organization problem, because your prefrontal cortex is involved, the idea of having a medication that you take once a month and never have to think about it again, it seems like that seems pretty good idea.

00:36 It makes sure that the person doesn't forget to get take their medication, right.

00:40 So it reduces that problem of non adherence.

00:44 It also takes away the fact that the patient has to remember to take a pill every day.

00:52 It also brings the client into our dispensary, because they can't take the shot at home.

00:58 This way, once a month, at least we get to see this person and assess how they're doing.

01:05 It also reduces the frequency of any relapse.

01:09 So when we think about a person not taking their medication for psychosis, for schizophrenia, when we think about the relapse that occurs there, they usually either end up in the hospital, or they might end up in a prison, where they eventually get to the hospital so they can get medication.

01:31 If they're getting the depot long acting anti psychotic, we reduce the frequency of that relapse, and we reduce those re-hospitalizations or that recidivism into prison.

01:45 It also takes away the likelihood of overdose.

01:49 If you don't remember that you took a pill, you might take a second or third, or fourth.

01:56 If you have delusions, and you think someone's trying to poison you, you might mix up all the pills in different bottles, because that way, whoever's trying to poison you won't know what they're giving you.

02:08 So this takes away that idea of overdose.

02:13 It also has reduced side effects.

02:17 Normally, when I see my patients who get the shot the intramuscular, once a month, they're a little bit tired on that first day, but after that they're good to go.

02:28 And they can get back to work, they're able to get back to their activities of daily living.

02:35 Of course, we sometimes think to ourselves, well, why isn't everyone on long acting anti-psychotics? Well, one of the things is that there is less flexibility in dosage adjustment.

02:51 So once we give them the shot, if it's a little bit too much, they might be really tired for two days.

02:58 Also, it's important to know that they're painful.

03:03 A person may not want to get a shot every month, because it does hurt.

03:10 We need to have a little bit more time and to be able to activate a steady distribution in the bloodstream when we are starting out on the injectables.

03:26 And some of our patients think that it's more stigmatizing to have to come in to get a shot for their psychosis.

03:38 Now, what about travel, a lot of people like to travel.

03:43 And if they're going to be traveling and they can't get their shot, that's a real problem.

03:49 So their life starts to revolve around when they are going to be getting this shot.

03:55 And last but not least, it is far more expensive to get once a month shot than it is to be able to give somebody the pills.

04:05 And in this day and age and with insurance as it is.

04:10 Very frequently we have to think about can this patient afford to get this shot? Will it be covered by Medicaid? Will it be covered by their insurance? Do they want their insurance to know? So these are really real life, things that we have to think about as we're thinking about patients taking medications.