Treating Schizophrenia With 2 Long-Acting Injectable Antipsychotic Drugs

Wartelsteiner, Fabienne; Hofer, Alex

doi:10.1097/jcp.0000000000000358

Cited by 6 publications

(24 citation statements)

References 8 publications

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“…The patient generally does not mistake them for reality. 2 Although this last point is important to distinguish between hallucinosis and psychiatric visual hallucinations, our case highlights that persistence of hallucinations may progressively impact on patient's ability to criticize them.…”

Section: Discussionmentioning

confidence: 75%

“…The simultaneous use of multiple injectable antipsychotics has not been studied in randomized controlled trials, and we know of only 2 case reports to date. 2,3 In this case report, we present the successful use of dual injectable antipsychotics in a patient with refractory schizophrenia and psychotically driven violent behavior with long-term refusal of oral medication.…”

mentioning

confidence: 99%

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Multiple Long-Acting Injectable Antipsychotics for Treatment-Resistant Schizophrenia

Caton

Newman

2016

Journal of Clinical Psychopharmacology

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Section: Discussionmentioning

confidence: 75%

mentioning

confidence: 99%

Multiple Long-Acting Injectable Antipsychotics for Treatment-Resistant Schizophrenia

Caton

Newman

2016

Journal of Clinical Psychopharmacology

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“…When combining certain LAI with existing LAI with or without existing oral AP, clinicians should be more careful since there are a dearth of data regarding the mixed use of two or more LAIs. However some case series reports proposed the clinical utility of diverse combination of two different LAIs without further AEs including PP [ 86 - 88 ], RLAI [ 88 , 89 ], OP [ 86 , 88 , 90 ], and HD [ 90 ] in clinical practice. Even in one case report, it was used for adolescent patients with severe psychosis and aggression where clozapine was not a viable therapeutic option and the results endorsed the effectiveness of two LAIs combination without showing any tolerability issues [ 88 ].…”

Section: Discussionmentioning

confidence: 99%

Consideration of Long-Acting Injectable Antipsychotics for Polypharmacy Regimen in the Treatment of Schizophrenia: Put It on the Table or Not?

Pae

Han

Bahk

et al. 2021

Clin Psychopharmacol Neurosci

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Antipsychotic monotherapy (APM) is considered best-acceptable treatment option regardless of antipsychotic class and formulation types for treating schizophrenia. However, antipsychotic polypharmacy (APP) has been also widely utilized in routine clinical practice. Despite APP has some clinical benefits it has also numerous pitfalls in relation with increased total number and doses of APs leading to adverse events as well as decrease of treatment adherence and persistence resulting in poor clinical outcomes. Recent introduction of long-acting injectable antipsychotics (LAIs) to the market has offered a chance for better medication adherence/persistence and also provided a simplification of treatment regime leading to more stabilized treatment for schizophrenia patients. When we cannot stay away from APP in the treatment of schizophrenia, clinicians need to find more proper APP regimens and thereby utilization of APP in efficient way should be a practical strategy to benefit schizophrenia patient in a real world treatment setting. With this regard, LAIs can be one of available APP regimen for treatment of schizophrenia in routine practice since their clinical utility and pharmacokinetic stability over oral APs have been well-elaborated today. However, when we have to commence LAIs as a part of APP with oral APs or other LAIs, every effort should be made before doing so whether or not validated and available treatment options or other clinical factors were not done or evaluated yet. Any treatment guidelines do not support APP regardless of the formulation of APP regimen or address two or more LAIs for treatment of schizophrenia till today.

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“…Several themes arose across the cases reported in the literature. First, dual LAI therapy is only utilized in challenging cases 9 - 14 in which the use of oral antipsychotic medications has not been successful. Second, a majority of the authors 9 , 10 , 12 , 13 recommend close monitoring given the rarity of this treatment plan.…”

Section: Discussionmentioning

confidence: 99%

“…There was a total of 9 dual LAI case reports [9][10][11][12][13][14] as shown in the Table . Although there were no cases with the combination of aripiprazole and risperidone/paliperidone, there were 2 cases 13,14 of concurrent atypical LAI antipsychotics. Both cases described clinical improvement after the second atypical antipsychotic was added orally.…”

Section: Discussionmentioning

confidence: 99%

The use of concurrent long-acting injectable antipsychotic therapy with paliperidone palmitate and aripiprazole monohydrate in a patient with schizophrenia

Evernden¹,

Giang

Anderson

2021

Mental Health Clinician

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International schizophrenia guidelines endorse seeking the patient's preference for guiding antipsychotic therapy. There exists a small niche of patients who prefer, or are required to use, long-acting injectable antipsychotic medications due to the adherence benefit. However, they may not be able to achieve adequate symptom reduction prior to experiencing treatment-limiting adverse effects from a single agent. Here, we present a patient case prescribed concurrent long-acting injectable antipsychotic therapy with paliperidone palmitate and aripiprazole monohydrate due to patient preference in the setting of a history of nonadherence to oral medications, treatment-limiting adverse effects to long-acting injectable paliperidone, and failure to achieve adequate symptom reduction with long-acting injectable aripiprazole monotherapy.

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Treating Schizophrenia With 2 Long-Acting Injectable Antipsychotic Drugs

Cited by 6 publications

References 8 publications

Multiple Long-Acting Injectable Antipsychotics for Treatment-Resistant Schizophrenia

Multiple Long-Acting Injectable Antipsychotics for Treatment-Resistant Schizophrenia

Consideration of Long-Acting Injectable Antipsychotics for Polypharmacy Regimen in the Treatment of Schizophrenia: Put It on the Table or Not?

The use of concurrent long-acting injectable antipsychotic therapy with paliperidone palmitate and aripiprazole monohydrate in a patient with schizophrenia

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