Risperidone long-acting injectable was found to be effective in protecting from any mood/manic symptom compared to placebo , but not from depressive recurrences .
Add-on or monotherapy paliperidone palmitate in SAD patients  protected from psychotic , depressive , and manic symptoms .
In patients with BD-I with a manic episode at study enrolment , aripiprazole monohydrate significantly delayed time to recurrence of manic episodes without inducing depressive episodes .
LAIs  are effective and well-tolerated maintenance treatments for BD and SAD .
They showed better efficacy in preventing mania than depression .
LAIs may be first-line for BD-I and SAD patients with a manic predominant polarity and with non-adherence problems
Long-Acting Injectable Antipsychotics ( LAIs ) are used to overcome non-compliance in psychoses , mainly schizophrenia spectrum disorders .
We aim ed to summarize available evidence of studies comparing the efficacy of LAIs to placebo or oral medications for Bipolar Disorder ( BD ) and /or Schizoaffective Disorder ( SAD ) .
Paliperidone palmitate once-monthly reduces risk of relapse of psychotic, depressive, and manic symptoms and maintains functioning in a double-blind, randomized study of schizoaffective disorder.
OBJECTIVE Schizoaffective disorder is a complex illness for which optimal treatment is not well established . Results of the first controlled , relapse-prevention study of paliperidone palmitate once-monthly injectable ( paliperidone monthly ) in schizoaffective disorder are presented . METHOD The study was conducted between September 20 , 2010 , and October 22 , 2013 . Patients with schizoaffective disorder ( confirmed by the Structured Clinical Interview for DSM-IV Axis I Disorders ) experiencing acute exacerbation of psychotic and depressive/manic symptoms were stabilized with paliperidone monthly as monotherapy or as adjunctive therapy to mood stabilizers or antidepressants and r and omly assigned ( 1:1 ) to paliperidone monthly or placebo in a 15-month , double-blind , relapse-prevention phase . R and omization was stratified by administration as monotherapy or adjunctive therapy and by study center . The primary endpoint was time to relapse . RESULTS 334 patients were evaluated .  Paliperidone monthly significantly delayed time to relapse for psychotic , depressive , and manic symptoms compared with placebo ( P < .001 , log-rank test ) . Relapse risk was 2.49 times greater for placebo ( hazard ratio = 2.49 ; 95 % CI , 1.55 to 3.99 ; P < .001 , Cox proportional hazards model ) . Overall relapse rates were 33.5 % for placebo and 15.2 % for paliperidone monthly . For monotherapy , relapse risk was 3.38 times greater with placebo ( P = .002 ) , and for adjunctive treatment it was 2.03 times greater with placebo ( P = .021 ) . Paliperidone monthly was superior to placebo in maintaining functioning as measured by the Personal and Social Performance scale ( P = .014 , mixed-model repeated- measures analysis ) . The most common adverse events ( placebo , paliperidone monthly ) were increased weight ( 4.7 % , 8.5 % ) , insomnia ( 7.1 % , 4.9 % ) , schizoaffective disorder ( 5.9 % , 3.0 % ) , headache ( 3.5 % , 5.5 % ) , and nasopharyngitis ( 3.5 % , 5.5 % ) . Incidence of any extrapyramidal-related adverse event was 7.1 % for placebo and 8.5 % for paliperidone monthly . CONCLUSIONS Paliperidone monthly as monotherapy or adjunctive therapy significantly delayed psychotic , depressive , and /or manic relapses ; reduced their risk ; and better maintained functioning in patients with schizoaffective disorder . Results support the value of maintenance treatment with paliperidone monthly in schizoaffective disorder . TRIAL REGISTRATION Clinical Trials.gov identifier : NCT01193153
Risperidone long-acting injectable was found to be effective in protecting from any mood/manic symptom compared to placebo , but not from depressive recurrences .
Add-on or monotherapy paliperidone palmitate in SAD patients  protected from psychotic , depressive , and manic symptoms .
In patients with BD-I with a manic episode at study enrolment , aripiprazole monohydrate significantly delayed time to recurrence of manic episodes without inducing depressive episodes .
LAIs  are effective and well-tolerated maintenance treatments for BD and SAD .
They showed better efficacy in preventing mania than depression .
LAIs may be first-line for BD-I and SAD patients with a manic predominant polarity and with non-adherence problems
Long-Acting Injectable Antipsychotics ( LAIs ) are used to overcome non-compliance in psychoses , mainly schizophrenia spectrum disorders .
We aim ed to summarize available evidence of studies comparing the efficacy of LAIs to placebo or oral medications for Bipolar Disorder ( BD ) and /or Schizoaffective Disorder ( SAD ) .