Table 3.

Advantages and disadvantages of different routes of administration.

Administration route	Advantages32	Disadvantages32	Examples	Time to peak plasma concentration
Intramuscular	Rapid systemic entry; patient cooperation not necessary	Invasive; can damage patient–physician relationship	Haloperidol24	~20 minutes
			Olanzapine27	15–45 minutes
			Aripiprazole28	1–3 hours
			Ziprasidone26	60 minutes
Inhaled	Less invasive than intramuscular route and can improve patient experience. Enters alveoli for rapid entry into arterial circulation	Requires patient cooperation Bronchospasm/respiratory distress	Loxapine31	2 minutes
Oral
Standard tablets/capsules/solution	Less invasive than intramuscular route and can improve patient experience	Require patient cooperation; slow onset of action; enter systemic circulation via portal system resulting in potential for erratic absorption; can be diverted (“cheeking”)	Haloperidol24	2–6 hours
			Olanzapine27	5–8 hours
			Risperidone30	~1 hour
			Aripiprazole28	3–5 hours
			Ziprasidone26	6–8 hours
Orally disintegrating tablets	Less invasive than intramuscular route and can improve patient experience. Less potential for diversion (“cheeking”) vs standard tablets/capsules; suitable for patients with dysphagia	Slow onset of action; enter systemic circulation via portal system resulting in potential for erratic absorption	Olanzapine27	~6 hours
			Risperidone30,33,34	1–2 hours
			Aripiprazole28	3–5 hours
Buccal/sublingual	Less invasive than intramuscular route and can improve patient experience; rapid absorption; avoids first-pass metabolism	Requires patient cooperation; needs to be taken correctly so that it is not swallowed, mitigated in part by the friability of the tablet	Sublingual asenapine35	0.5–1.5 hours
Intranasal	Less invasive than intramuscular route and can improve patient experience; rapid absorption; avoids first-pass metabolism	Requires patient cooperation.	Intranasal midazolam32	10 minutes