Real-World Data Link LAI Risperidone to Fewer Emergency Visits in Schizophrenia, Improved Bipolar Treatment

Eric Hughes, MD, PhD, shared insights on a matched cohort analysis of adults with schizophrenia, where once-monthly Uzedy was associated with a 40% lower all-cause emergency department visit rate and more than $1000 in lower monthly direct healthcare costs per patient.^1,2 Compared with risperidone microspheres every 2 weeks, Uzedy was associated with 3.6x higher odds of adherence and an 80% lower likelihood of discontinuation, which Hughes attributed to a reduced burden of care for patients and clinicians. In bipolar I disorder, a retrospective chart review found that switching from an oral antipsychotic to Uzedy reduced treatment failure compared with switching to another oral antipsychotic. Hughes advised that these data support considering LAIs earlier in the treatment continuum for bipolar I disorder rather than reserving them for use after multiple oral failures, and that framing LAIs as a way to simplify treatment may help address patient hesitancy.

Psychiatric Times: What points from this recent analysis are most pertinent for practicing clinicians?

Eric Huges, MD, PhD: The key takeaway is that not all long-acting injectables—or delivery systems—are created equal. This real-world evidence demonstrates that Uzedy significantly improves continuity of care in schizophrenia, leading to fewer emergency department visits compared to other LAIs and more than $1,000 savings in monthly direct healthcare costs per patient versus once-monthly paliperidone palmitate. In BD-I, transitioning patients from an oral antipsychotic to Uzedy also significantly reduced treatment failure (47% vs. 63%) compared to switching to another oral option.

PT: What might explain the lower rate of emergency visits with Uzedy compared with PP1m?

Hughes: In our matched cohort analysis, patients on once-monthly Uzedy achieved a 40% lower all-cause emergency department visit rate compared to those on PP1m. Clinically, we attribute this to greater treatment continuity driven by Uzedy’s subcutaneous administration, simple initiation with no oral loading doses or complex loading regimens required and our SteadyTeq™ technology, which provides controlled, continuous release of risperidone to maintain therapeutic levels and help prevent acute crises leading to emergency care.

PT: Why were the largest differences seen against risperidone microspheres every 2 weeks?

Hughes: It comes down to reducing the burden of care for both patients and clinicians. First-generation risperidone LAIs require biweekly intramuscular injections and mandatory oral supplementation for three weeks during initiation. Uzedy eliminates those friction points with 1- or 2-month subcutaneous dosing and zero oral loading requirements. In our real-world comparison, that streamlined experience translated into 3.6x higher odds of adherence and an 80% lower likelihood of treatment discontinuation.

PT: What factors do you see likely driving the higher adherence and lower discontinuation rates with Uzedy?

Hughes: Adherence breaks down when treatment feels complex or burdensome. Uzedy addresses several of the traditional barriers associated with LAIs. It is administered subcutaneously with a small needle, comes in a ready-to-use prefilled syringe requiring no reconstitution and requires no daily oral supplementation at initiation. When LAI treatment options are more straightforward to start and maintain, they may help reduce practical barriers and support patients in staying on track with treatment.

PT: What do these findings mean for clinicians choosing among risperidone-based LAIs?

Hughes: These data give clinicians a compelling reason to re-evaluate standard LAI selection. Clinicians have long trusted the efficacy profile of risperidone, but traditional formulations can carry logistical challenges. By utilizing a modern subcutaneous delivery system like Uzedy, clinicians can deliver a trusted molecule while achieving meaningful improvements in real-world treatment adherence, lower discontinuation, and reduced reliance on emergency care.

PT: In bipolar I disorder, which patients might benefit more from Uzedy instead of another oral antipsychotic?

Hughes: Any patient with BD-I who struggles with the daily burden of oral medications, treatment non-adherence or frequent relapse is a strong candidate. Our real-world chart review showed that 63% of patients who were switched from one oral antipsychotic to another oral antipsychotic experienced treatment failure within six months. Transitioning to Uzedy reduced that risk significantly, keeping more patients stable and on therapy without stopping because of inadequate effectiveness.

PT: What does the lower treatment failure rate (47% vs 63%) suggest about using an LAI earlier in bipolar I disorder?

Hughes: The findings reinforce the importance of considering LAIs much earlier in the treatment continuum for BD-I, rather than reserving them as a last resort after multiple oral failures. Proactively initiating Uzedy helps break the cycle of sub-therapeutic coverage and treatment interruption, giving patients a steady foundation for long-term mood stability and functional recovery.

PT: How can clinicians address patient hesitancy about LAIs, especially in bipolar I disorder?

Hughes: Addressing hesitancy starts with changing how we talk about LAIs. Instead of viewing an injectable as a sign that a patient’s condition is more severe, clinicians can help patients see it as a way to simplify their treatment – removing the daily burden of remembering pills and the constant reminder of their diagnosis. Sharing real-world data showing that switching to an LAI like Uzedy helps patients remain on treatment longer and avoid treatment failure can support a more informed discussion with patients about treatment options that fit seamlessly into their daily lives.

Helping clinicians navigate these nuanced conversations is a priority for us at Teva. Effective communication matters across severe mental illnesses, not only in BD-I. That is why we recently launched www.LongActingImpact.com, a dedicated educational website for providers with information to support informed treatment discussions and decision-making about the role of LAIs in schizophrenia care.

Dr Hughes is executive vice president, global R&D and chief medical officer at Teva Pharmaceuticals.

References

1. Kane JM, Harary E, Eshet R, et al. Efficacy and safety of TV-46000, a long-acting, subcutaneous, injectable formulation of risperidone, for schizophrenia: a randomised clinical trial in the USA and Bulgaria. Lancet Psychiatry. 2023;10(12):934-943.
2. Teva highlights new real-world data showing Uzedy (risperidone) outperforms other long-acting injectables in keeping schizophrenia patients on treatment, while reducing emergency care and healthcare costs. Press release. September 18, 2026. Accessed October 1, 2026. https://www.globenewswire.com/news-release/2026/09/18/3364952/0/en/teva-highlights-new-real-world-data-showing-uzedy-risperidone-outperforms-other-long-acting-injectables-in-keeping-schizophrenia-patients-on-treatment-while-reducing-emergency-care.html