Risperidone long-acting injection as monotherapy and adjunctive therapy in the maintenance treatment of bipolar I disorder.

It is very rare for patients with bipolar disorder to have a single episode of mania or depression over a lifetime and the vast majority of these individuals need long-term prophylactic/maintenance treatment. However, treatment nonadherence is a major issue for close to half of subjects with bipolar disorder who are prescribed medications. Risperidone long-acting injection (LAI) has proven efficacious for the maintenance phase of bipolar disorder and may mitigate the problem of nonadherence in the substantial group of patients for whom this is a significant concern. This paper comprises a review and commentary regarding the use of risperidone LAI in bipolar disorder. The reader will gain an understanding regarding the risks and benefits of risperidone LAI in bipolar disorder. We review the available evidence and discuss the strengths and weaknesses of published studies, providing an opinion about the clinical usefulness of risperidone LAI as well as suggestions for future research. The use of risperidone LAI, through improved adherence, has the potential to ameliorate the course of bipolar disorder.