‘Safety First: Five-Year Report of the National Confidential Inquiry into Suicide and Homicide by People with Mental Illness’ recommends that patients at risk of suicide, including all patients with a recent history of self-harm, who are treated with psychotropic drugs should receive modern, less toxic drugs and/or supplies lasting no more than 2 weeks.
1. Depots are given by deep i/m injection and are by definition long-acting and very slow to reach steady-state blood levels.
2. Risperidone long-acting injection is expensive and is most appropriately used for patients who have responded to oral risperidone but are not concordant with oral, or who cannot tolerate the movement disorder side-effects of other depot injections. It should be given every 14 days, using the whole vial. Once taken from the fridge it is stable for only 7 days and provided it is kept < 25 °C. Note that this preparation is not suitable for the acute treatment of psychosis, as release of risperidone from the injection is much delayed.