Three out of four PMHNPs who try to start a patient on a long-acting injectable antipsychotic do it wrong on the first attempt — under-load, over-overlap, wrong second-dose interval. Two hosts walk through the 2026 fix: when to actually offer the LAI (first-episode psychosis, schizophrenia maintenance, bipolar I with mixed features), the molecule-specific loading and oral-overlap rules for aripiprazole (Maintena, Asimtufii), paliperidone palmitate (Sustenna day 1 / day 8 / monthly), and risperidone (Consta vs. Uzedy), the missed-dose windows for each, and the 90-day monitoring schedule that decides whether the patient is still on the injection at year one. Full post and dose-conversion tables at https://psychnpfellowship.com/lai-antipsychotic-transition-protocol-pmhnp-2026/