Positive symptoms and medication adherence in response to oral versus long-acting injectable risperidone in black, latino, and white first-episode psychosis patients.

Black and Latino Americans are more likely to be diagnosed with psychotic disorders compared to White Americans. Furthermore, there are well documented ethnoracial disparities in access to second-generation antipsychotics including long-acting injectables (LAIs). LAI medications have the potential to help attenuate disparities by improving adherence and thus reducing relapse. Given this knowledge, a more concerted effort is needed to examine the clinical response and adherence to these medications in the early stages of psychosis. The present study examined positive symptoms and medication adherence in response to oral versus LAI risperidone in a sample of Black (N = 24), Latino (N = 34), and White (N = 17) first-episode psychosis patients. Participants were recruited from local psychiatric hospitals and enrolled in a randomized controlled trial. Participants were randomly assigned to receive oral or LAI risperidone. Findings suggest that Latino patients were less likely to benefit from LAI risperidone and also had higher rates of nonadherence across medication conditions. Both Black and White patients benefited from LAI in terms of positive symptoms and medication adherence. Future studies should examine sociocultural factors that could be influencing the acceptability of LAIs for Latino first-episode patients as well as develop culturally responsive interventions to improve medication adherence and clinical outcomes. In addition, greater advocacy and equitable policies are likely needed to ensure access to LAIs for minoritized populations.