Treatment effectiveness and preference in patients with schizophrenia switched from oral standard of care atypical antipsychotics to aripiprazole once-monthly: a brief report over a six-month period

Background Schizophrenia is a chronic and disabling psychiatric disorder characterized by poor treatment adherence, often leading to relapse and functional decline. Long-acting injectable antipsychotics (LAIs), such as aripiprazole once-monthly (AOM), offer a potential solution by improving adherence and reducing relapse rates. This study evaluates the clinical effectiveness, safety, tolerability, and patient satisfaction in individuals with schizophrenia who transitioned from oral standard-of-care (SOC) atypical antipsychotics to AOM over a six-month period. Methods An open-label, single-arm, mirror-image study design was employed. Forty adult patients diagnosed with schizophrenia and previously stabilized on oral antipsychotics for at least two months were enrolled. Following a retrospective assessment of a six-month oral treatment period, patients were prospectively followed for six months after switching to AOM. Clinical assessments included the Investigator’s Assessment Questionnaire (IAQ), Clinical Global Impression-Severity (CGI-S) scale, and the Treatment Satisfaction Questionnaire for Medication (TSQM 1.4). Adverse effects were monitored via self-report and clinician-rated tools. Results Twenty- five patients completed at least the first follow-up visit. A statistically significant improvement in IAQ scores was observed over time, indicating enhanced global clinical effectiveness (p=0.010 at six months). CGI-S scores also significantly decreased, reflecting reduced illness severity (p<0.001 at six months). Patient satisfaction, measured by TSQM, increased significantly at three and six months (p<0.001). AOM was well-tolerated, with only minor, non-significant changes in weight gain, extrapyramidal symptoms, and prolactin levels. Notably, negative symptom scores showed a modest but statistically significant improvement (p=0.032). Only five patients (18%) reported adverse events, mostly with moderate impact, and no treatment discontinuation was recorded. Conclusions Transitioning to AOM from oral antipsychotics in schizophrenia patients was associated with significant improvements in clinical outcomes, symptom severity, and treatment satisfaction, with a favorable safety and tolerability profile. These findings support the use of AOM in early-stage schizophrenia and highlight its potential to enhance long-term adherence and functional recovery. Further long-term studies are warranted to assess the durability of these benefits and their impact on relapse prevention and quality of life.