For many people living with schizophrenia, remembering to take a daily tablet can be one of the hardest parts of managing their illness. A study from China, published in Frontiers in Psychiatry, suggests that once patients actually try a long-acting injectable form of treatment, they become far more willing to keep using it, offering fresh insight into how doctors might improve long-term care for one of psychiatry’s most challenging conditions.
The research, carried out at a psychiatric hospital in Fujian province, surveyed 227 outpatients with schizophrenia about their attitudes towards second-generation antipsychotic long-acting injectables, often referred to as SGA-LAIs. These injections are designed to be administered every few weeks or months, reducing the need for daily oral medication and helping to prevent the relapses that so often follow missed doses.
Overall, more than two thirds of participants said they were willing to use these injections. The strongest predictor of a positive attitude was whether someone had already tried the treatment. Patients with prior experience of SGA-LAIs were around eleven times more likely to say they would use them again compared with those who had never tried them.
Length of illness also played a significant role. People who had lived with schizophrenia for more than five years were noticeably more accepting of long-acting injections than those diagnosed more recently. Researchers suggest that as the condition becomes more chronic, patients grow more aware of how disruptive relapses and the burden of daily pill taking can be, making a simplified treatment schedule more appealing.
Among those open to the injections, the biggest attractions were not having to remember daily medication and a belief that the treatment would work better than tablets. Fear of needles was, unsurprisingly, the main worry, though this concern rarely stopped people who had already experienced the injections from continuing treatment. For those who remained unwilling, an aversion to needles and reluctance to change an established routine were the most common reasons given.
The findings echo a wider pattern seen internationally, where long-acting injectable antipsychotics have been linked to lower rates of hospital readmission and better overall stability for people with schizophrenia. Yet uptake in mainland China has historically lagged far behind countries in Europe, the US and other parts of Asia, partly because patients and even some clinicians remain unfamiliar with the treatment or hesitant to recommend it.
The authors argue that giving patients a genuine opportunity to try long-acting injections, alongside clear communication from healthcare professionals about their benefits, could help shift attitudes and improve adherence over time. They also call for greater investment in patient education, particularly for those earlier in their treatment journey who may not yet appreciate the long-term advantages.
While the study was limited to one hospital and cannot prove cause and effect, it adds to growing evidence that first-hand experience, rather than assumptions about needles or routine, is what ultimately shapes how people with schizophrenia feel about long-acting treatment options.
