Dopamine Antagonist LAIs: The Tried and True
Content Ownership
Information presented herein may have been created in collaboration with the California Department of State Hospitals (DSH) and may not necessarily represent the views, policy(ies), and/or position(s) of the American Psychiatric Association (APA) or the California Department of State Hospitals (DSH). No course or information provided herein may be recorded, reproduced, or distributed, nor may it be accessed or used outside of the SMI CalAdviser platform.
Overview

Description 

This activity focuses on the use of long-acting injectable (LAI) dopamine antagonist antipsychotics as a superior treatment strategy for schizophrenia spectrum disorders. The presenters argue that these "tried and true" formulations significantly improve treatment adherence, reduce relapse and violence rates, and are more cost-effective than newer, more expensive atypical LAIs. A key component of the session is providing detailed, practical guidance on how to properly load specific LAIs (haloperidol decanoate, fluphenazine decanoate, and paliperidone palmitate) to ensure rapid and effective dosing. The activity concludes by comparing the pros and cons of various depot antipsychotics, advocating for the use of potent D2 antagonists to achieve optimal control of positive psychotic symptoms. 

Format 

Recorded webinar, non-interactive, self-paced distance learning activity with post-test.  

This presentation was recorded on April 19, 2023. 

Learning Objectives  

Summarize challenging conditions including psychogenic polydipsia, suicidality, aggression and violence, treatment resistant illness, etc. 

Review the data from studies supporting the utility of clozapine in various illnesses. 

Discuss how clozapine may be an option in several disorders which are difficult to treat.  

Outline 

  • Introduction & Learning Objectives 
  • Antipsychotic Mechanisms & Pathways 
  • Advantages of LAIs Over Oral Antipsychotics 
  • Kinetics & Loading Strategies for Key LAIs 
  • Therapeutic Drug Monitoring Concepts 
  • Cost Comparison of LAIs 
  • Clinical Comparison: FGA vs. SGA LAIs 
  • Switching Strategies 
  • Take-Home Points  
  • Conclusion & Contact 

Target Audience 

Psychiatrist, Physician (Non-Psychiatric), Nurse, Nurse Practitioner, Pharmacist 

Instruction Level 

Intermediate 

Estimated Time to Complete  

Estimated Duration: 45 minutes 
Program Start Date: October 2, 2025
Program End Date: OCtober 2, 2028

Ongoing Interdisciplinary Discussion Board  

After completing the course, engage with colleagues in the mental health field through the Webinar Roundtable Topics discussion board. This is an easy way to network and share ideas with other clinicians who participate in this webinar. Access through the discussion tab.  

How to Earn Credit 

After completing the evaluation, participants will have the opportunity to claim their hours of participation and download the appropriate certificate. Physicians may obtain an official CME certificate, other healthcare professionals may receive a CE certificate (as applicable), and all other attendees may generate a certificate of participation. Each certificate will reflect the event date and total hours earned. 

Continuing Education Credit 

In support of improving patient care, American Psychiatric Association (APA) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.  

Physicians   

The APA designates this live event for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.   

Nurses/Nurse Practitioners   

The American Psychiatric Association (APA) designates this activity for 0.75 Nursing contact hours. Nurses should only claim credit commensurate with the extent of their participation in the activity.   

Pharmacists  

This curriculum has been approved for 0.75 contact hours by the American Psychiatric Association.  The American Psychiatric Association is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. The Universal Activity Number for this program is JA0000145-0000-25-020-H05-P. This learning activity is knowledge-based. Your CE credits will be electronically submitted to NABP upon successful completion of the activity. Pharmacists with questions can contact NABP customer service (custserv@nabp.net).   

Faculty and Planner Disclosures 

The American Psychiatric Association adheres to the ACCME's Standards for Integrity and Independence in Accredited Medical Education. Any individuals in a position to control the content of a CME activity - including faculty, planners, reviewers, or others - are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.  

Faculty  

  • George Proctor, MD, Consultant - Psychopharmacology Resource Network (PRN), California Department of State Hospitals-Patton. Dr. Proctor has no relevant financial relationships to disclose. 
  • Ai-Li Arias, MD, Consultant, Psychopharmacology Resource Network / Senior Psychiatrist Specialist, California Department of State Hospitals. Dr. Arias has no relevant financial relationships to disclose.  

Program Planners 

  • John Torous, MD, Beth Israel Deaconess Medical Center. Dr. Torous has no relevant financial relationships to disclose.  
  • Megan Ehret, PharmD, BCPP, University of Maryland, Baltimore. Dr. Ehret has no relevant financial relationships to disclose.  
  • Kathryn B. Hanley, LPA, RN, PMHNP-BC, Austin State Hospital. Ms. Hanley has no relevant financial relationships to disclose.  

Accessibility for Participants with Disabilities 

The American Psychiatric Association is committed to ensuring accessibility of its website to people with disabilities. If you have trouble accessing any of APA’s online resources, please contact us at 202-559-3900 for assistance. 

Technical Requirements 

This internet-based CME activity is best experienced using any of the following: 

The latest and 2nd latest public versions of Google Chrome, Mozilla Firefox, or Safari 

Internet Explorer 11+ 

This Web site requires that JavaScript and session cookies be enabled. Certain activities may require additional software to view multimedia, presentation, or printable versions of the content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Acrobat Reader, Microsoft PowerPoint, and Windows Media Player. 

Optimal System Configuration: 

Browser: Google Chrome (latest and 2nd latest version), Safari (latest and 2nd latest version), Internet Explorer 11.0+, Firefox (latest and 2nd latest version), or Microsoft Edge (latest and 2nd latest version) 

Operating System: Windows versions 8.1+, Mac OS X 10.5 (Leopard) +, Android (latest and 2nd latest version), or iOS/iPad OS (latest and 2nd latest version) 

Internet Connection: 1 Mbps or higher 

Minimum Requirements: 

Windows PC: Windows 8.1 or higher; 1 GB (for 32-bit)/2 GB (for 64-bit) or higher RAM; Microsoft DirectX 9 graphics device with WDDM driver; audio playback with speakers for programs with video content 

Macintosh: Mac OS X 10.5 or higher with latest updates installed; Intel, PowerPC G5, or PowerPC G4 (867MHz or faster) processor; 512 MB or higher RAM; audio playback with speakers for programs with video content 

For assistance: Contact educme@psych.org for questions about this activity |  

Contact support@smicaladviser.org for technical assistance 

Summary
Availability:
On-Demand
Expires on Oct 02, 2028
Credit Offered:
0.75 CME Credit
0.75 NCPD Credit
0.75 Pharmacy CE Credit
0.75 COP Credit
Powered By