Addressing Misconceptions About LAI Antipsychotics

What holds mental health professionals back from using long-acting injectable (LAI) antipsychotics earlier in treatment? In this discussion, Brooke Kempf, PMHNP-BC, MSN, hospitalist at the Hamilton Center, sheds light on the most common misconceptions surrounding LAIs and why they shouldn't be reserved as a last resort. Discover evidence-based strategies for initiating these treatments in first-episode psychosis and learn how to better engage patients and their care partners in shared decision-making. Kempf emphasizes the power of patient education, addressing myths, and involving families to ease the daily medication burden. 

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Read the Transcript: 

Psych Congress Network: What are the most common misconceptions among clinicians regarding the use of LAI antipsychotics, and how can they be addressed?

Brooke Kempf, PMHNP-BC: I think one of the biggest misconceptions that we have when it comes to long-acting injectable antipsychotics is that these medications need to be saved and used later in treatment. I believe we are waiting way too long. There's no reason why these cannot be initiated in first-episode psychosis. I believe that we save these for people that have failed multiple other medications, and we almost use them as a last resort, which is the opposite of what we should be doing. If you look at evidence-based practice, we want to utilize these medications earlier in treatment to avoid the negative outcomes of this illness.

Psych Congress Network: What strategies can be employed to better engage patients and their care partners in the decision-making process? 

Kempf: I think it's very important to dispel any misconceptions that your patient may have about long-acting injectables. Part of informed consent is being sure that a patient is informed on all of the treatment options. I often run across patients that are on medications that they never even knew came in an injectable form and never knew they had the option to take this in another manner. So first and foremost, we have to inform patients that these options are available, and it's important to involve family and other caregivers because often there's conflict when a patient is taking daily medication. We're providing education about the illness and we're providing education about medications. When it becomes a burden, when the patient is being monitored constantly or they feel they're constantly being questioned about taking medication every day, this is a great opportunity to open up to the family and the patient to talk about the benefit of LAIs. 

Brooke Kempf, MSN, PMHNP-BC, has worked as a psychiatric nurse at Hamilton Center in Terre Haute, Indiana, since she graduated from Indiana State University with an associate degree in 1994. Her passion for mental health was sparked as she worked as a charge nurse on the Inpatient Unit and continued to grow as she served in their outpatient setting while obtaining her bachelor’s degree from ISU in 1996. She was awarded the 2008 Hamilton Award for Outstanding Staff Member. Kempf was then able to obtain her master’s degree from the State University at Stony Brook of New York and is board-certified by the ANCC as a psychiatric mental health nurse practitioner. She currently practices as the Hospitalist for the Inpatient Psychiatric Unit of Hamilton Center Community Mental Health Center in Terre Haute, Indiana and is an adjunct lecturer for IUPUI’s PMHNP program, teaching and was awarded the 2022 Daisy Award for Extraordinary Nursing Faculty.