Section - Expert Consultations

01. Initiating LAIs: Engagement Strategies, Safety Considerations, and Clinical Transitions

Published on March 18, 2026 Certification expiration date: March 18, 2029

Guest

Brian Miller, M.D., Ph.D., M.P.H.

Interviewed by

Helen Tellegen

Key Points

When switching from an LAI to oral, start the oral agent 3–5 days before the next injection date to bridge the steady-state lag and avoid end-of-interval wearing-off.
“When raising LAIs, lead with convenience, not compliance. Use language like: ‘Some of my patients prefer one injection a month because it takes the daily decision off the table — is that something you’d want to explore?'”
Manage injection site pain with site rotation and pre-medication. Give acetaminophen or ibuprofen 30–60 minutes before the injection to blunt anticipated discomfort.

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Text Version

Engaging Patients in LAI Treatment Discussions

Helen Tellegen, P.M.H.N.P.: Patients who benefit most from long-acting injectables often include those with poor insight, frequent relapses, and challenges with adherence. In my experience, however, this subgroup can be the most difficult to engage in conversations about LAIs. How can we work collaboratively with these patients to help them understand and appreciate the potential benefits of long-acting injectable treatment?

Brian Miller, M.D., Ph.D., M.P.H.: The keyword here is collaborative. Collaborative decision making is essential, and conversations about long-acting injectable medications tend to be longitudinal and ongoing.

It’s not always at the first discussion that patients decide to pursue LAI treatment. The goal is to continue providing education and psychoeducation, discuss the relative risks and benefits, meet patients where they are, and apply motivational interviewing strategies to help move the needle for those who stand to benefit most.

Helen Tellegen, P.M.H.N.P.: One challenge I’ve

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02. Optimizing LAIs: Dosing Strategies, Formulation Choices, and Emerging Options

Learning Objectives:
After completing this activity, the learner will be able to:

Apply collaborative decision-making to engage patients with schizophrenia in conversations about long-acting injectable antipsychotics.
Select and individualize LAI antipsychotic treatment based on clinical factors .
Manage practical clinical challenges associated with LAIs.

Original Release Date: March 18, 2026
Expiration Date: March 18, 2029

Expert: Brian Miller, M.D., Ph.D., M.P.H.
Medical Editors: Helen Tellegen, P.M.H.N.P., Flavio Guzmán, M.D.

Relevant Financial Disclosures:
Brian Miller declares the following interest:
– Bristol-Myers Squibb: Consultant

All the relevant financial relationships listed above have been mitigated by Medical Academy and the Psychopharmacology Institute.

None of the other faculty, planners, and reviewers for this educational activity have relevant financial relationships to disclose during the last 24 months with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

Contact Information: For questions regarding the content or access to this activity, contact us at support@psychopharmacologyinstitute.com

Instructions for Participation and Credit:
Participants must complete the activity online within the valid credit period noted above.

Follow these steps to earn CME credit:

View the required educational content provided on this course page.
Complete the Post-Activity Evaluation to provide the necessary feedback for continuing accreditation purposes and for the development of future activities. NOTE: Completing the Post Activity Evaluation after the quiz is required to receive the earned credit.
Download your certificate.

Accreditation Statement
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education through the joint providership of Medical Academy LLC and the Psychopharmacology Institute. Medical Academy is accredited by the ACCME to provide continuing medical education for physicians.

Credit Designation Statement
Medical Academy designates this enduring activity for a maximum of 0.5 AMA PRA Category 1 credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Artificial Intelligence (AI) Use DisclosureArtificial intelligence (AI) tools may have been used in limited stages of developing this activity (e.g., drafting or language refinement). The specific tool, version, and date of use are documented internally.AI does not determine clinical recommendations. All content is reviewed, verified, and approved by the listed faculty and medical editors, and reflects independent human clinical judgment consistent with ACCME Standards for Integrity and Independence in Accredited Continuing Education.