Improving quality of life (QoL) is a primary objective in the treatment of schizophrenia. The current analysis aimed to evaluate the impact of antipsychotic administration routes on QoL in early-phase schizophrenia (SZ) patients randomized to treatment with either long-acting injectable (LAI) or oral aripiprazole or paliperidone as part of the “European Long-acting Antipsychotics in Schizophrenia Trial” (EULAST).

A total of 492 patients were followed for up to 19 months. QoL was assessed using the EQ-5D-5L. In the primary analysis, the relationships between oral versus LAI treatment and between treatment with paliperidone versus aripiprazole were investigated by fitting generalized estimating equation models. In secondary analyses, we examined the individual dimensions of the EQ-5D-5L, including mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. In subgroup analyses, we estimated the treatment effect on the EQ-5D-5L across clinically relevant subgroups, including sex, age, symptomatology, and side effects.

Overall, EQ-5D-5L scores improved over the course of the study, with no significant differences between patients treated with LAI versus oral antipsychotics (p = 0.662) or between those treated with aripiprazole versus paliperidone (p = 0.266). Subgroup analyses based on sex, age, medication side effects, and psychopathology also did not reveal any significant differences in EQ-5D-5L outcomes between LAI and oral antipsychotic treatment.

These findings indicate comparable QoL in SZ patients starting LAI or oral antipsychotic treatment with aripiprazole or paliperidone. Further research with extended follow-up periods is required to gain deeper insights into potential subgroup-specific benefits and the long-term effects of different antipsychotic administration routes on QoL.