OBJECTIVES: Treatment continuation of four long acting, injectable, antipsychotic drugs: paliperidone palmitate, risperidone microspheres, olanzapine pamoate and haloperidol decanoate, was evaluated in the Dutch outpatient setting using panel data from public pharmacies. Restart rates, maintenance dose distribution, age distribution and frequency of co-prescriptions were also investigated.  METHODS: The IMS Lifelink^TM Treatment Dynamics database was used, applying appropriate selection criteria. Four patient cohorts that started paliperidone palmitate, risperidone microspheres, olanzapine pamoate or haloperidol decanoate treatment, between 1 April 2011 and 31 March 2012, and 1 October 2012 and 31 September 2013 were analyzed. All cohorts included at least 13 months of follow up. Treatment continuation was investigated. RESULTS: After 180 days, in both study periods, a significantly higher percentage of patients continued treatment with paliperidone palmitate. After six months, respectively 59% and 55% of patients continued paliperidone palmitate. For risperidone microspheres this was 42% and 40%, for olanzapine pamoate 25% and 43%, and for haloperidol decanoate 42% and 47%. In both study periods, significantly higher percentages of patients restarted index treatment within 3 months when using paliperidone palmitate (42% and 40%) or olanzapine pamoate (44% and 42%) compared to risperidone microspheres (35% and 33%) or haloperidol decanoate (26% and 28%). For all therapies, dosing was comparable between treatment initiation and discontinuation. Medication used to treat extrapyramidal symptoms was on average more frequently used with haloperidol decanoate (24% and 18%) than with paliperidone palmitate (4% and 5%) risperidone microspheres (11% and 3%), or olanzapine pamoate (0 and 6%). CONCLUSIONS: Results of the database research indicate that a higher percentage of patients treated with paliperidone palmitate continued therapy and restarted therapy than patients receiving the other three long-acting antipsychotics. Co-medication against extrapyramidal symptoms was more frequently used with haloperidol decanoate. FINANCIAL SUPPORT: This work was funded by Janssen.