Description
This presentation will focus on common errors and best practices when using long-acting injectable antipsychotics (LAIs). Key topics covered include: LAI Kinetics: The importance of understanding the kinetics of different LAI agents and which ones require loading injections or oral coverage. Combination Treatment: Detailed guidance on which oral or injectable agents can be combined. The presentation emphasizes that partial agonists like LAI aripiprazole have high D2 receptor affinity and should not be used in combination with other D2 antagonist LAIs. Specific Recommendations: For LAI aripiprazole, the presentation suggests adding oral xanomeline-trospium (XT) or clozapine. For other agents like LAI risperidone or paliperidone, it advises against combination LAIs and instead suggests either a dose increase of the oral agent or adding XT or clozapine. First-Generation Antipsychotics (FGAs): The presentation highlights that FGAs, such as haloperidol decanoate, still have a role in treatment and provides a simple conversion formula from oral to injectable doses.
Learning Objectives
At the completion of the activity, participants will:
Know your LAI kinetics and which agents can be started without loading injections or the need for extended oral coverage
There is still a role for 1st generation antipsychotic LAIs with haloperidol decanoate having an established and easy to use formula for converting from an oral dose
Remember that partial agonists have high D2 receptor affinity and don't play well with D2 antagonists
Outline
- Partial Agonists Don’t Play Well with D2 Agonists
- Examples of Problems: Interactions with Partial Agonists
Format
Live webinar
Target Audience
Psychiatrist, Resident or Fellow, Medical Student, Physician (Non-Psychiatric), Nurse Practitioner, Pharmacist
Instructional Level
Intermediate, Advanced
Estimated Time to Complete
Estimated Duration: 1 hour
Program Release Date: October 16, 2025
Program End Date: October 16, 2025
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 1.00 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 1.00 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 1.00 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 UAN JA0000145-0000-25-016-L05-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:
- Jonathan Meyer, MD, is a Voluntary Clinical Professor of Psychiatry at University of California, San Diego, and a Distinguished Life Fellow of the American Psychiatric Association. Dr. Meyer is a graduate of Stanford University and Harvard Medical School, and finished psychiatry residency and fellowships at LA General Medical Center. Dr. Meyer has teaching duties at UC San Diego, is a Senior Academic Advisor to the California Department of State Hospitals, and is a psychopharmacology consultant to the first episode psychosis program at the Balboa Naval Medical Center. Along with Dr. Stephen Stahl he is co-author of the Clozapine Handbook published in 2019, The Clinical Use of Antipsychotic Plasma Levels released in 2021, and The Lithium Handbook published in 2023. Dr. Meyer has no financial relationships with commercial interests.
Program Planners:
- John Torous, MD, Beth Israel Deaconess Medical Center. Dr. Torous has no relevant financial relationships to disclose.
- Kathryn Hanley, APRN, Austin State Hospital. Ms. Hanley has no relevant financial relationships to disclose.
- Megan Ehret, PharmD, BCPP, University of Maryland, Baltimore. Dr. Ehret 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 JavaScript and session cookies to 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, or 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
For assistance: Contact educme@psych.org for questions about this activity
Contact support@smicaladviser.org for technical assistance