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The combination of long-acting injectable antipsychotics, a new key in resistant schizophrenia

Published online by Cambridge University Press:  01 September 2022

M.F. Tascón Guerra ,
A. Osca Oliver ,
M.V. López Rodrigo ,
M. Palomo Monge  and
M. Pérez Fominaya
M.F. Tascón Guerra*
Affiliation:
Hospital Nuestra Señora del Prado, Psiquiatria, Talavera de la Reina, Spain
A. Osca Oliver
Affiliation:
Hospital Nuestra Señora del Prado, Psiquiatría, Talavera de la Reina, Spain
M.V. López Rodrigo
Affiliation:
Hospital Nuestra Señora del Prado, Psiquiatría, Talavera de la Reina, Spain
M. Palomo Monge
Affiliation:
Hospital Nuestra Señora del Prado, Psiquiatria, Talavera de la Reina, Spain
M. Pérez Fominaya
Affiliation:
Hospital Nuestra Señora del Prado, Psiquiatria, Talavera de la Reina, Spain
*
*Corresponding author.

Abstract

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Introduction

Schizophrenia is a chronic disease that requires lifelong medical care and supervision. There is a high rate of relapse, mostly caused by poor adherence to oral antipsychotics. Long-acting injectable (LAI) antipsychotics have proved effective in schizophrenia and other severe psychotic disorders due to the stable blood levels, leading to a reduction of the risk of relapse. LAIs are associated with better functioning, quality of life, and patient satisfaction. In Treatment-resistant schizophrenia the combination of antipsychotics is a common practice. Nevertheless, the combination of two different long-acting injectable antipsychotics is not frequent.

Objectives

A case of a 34-year-old man is presented, previously diagnosed of Schizophrenia, with highly disabling chronic positive symptoms. With no in-sight and no will in receiving treatment. Has been stable for a year while being in treatment with paliperidone 525mg LAI/ 10 weeks, and aripiprazole 400mg LAI/28 days.

Methods

The patient was closely observed and given oral paliperidone, after 5 days long-acting paliperidone was introduced. He was discharged with mild improvement of his psychiatric symptoms. While being in treatment with Paliperidone 525mg, he kept vivid delusions and hallucinations. The patient still refused to take any oral medications. Long-acting aripiprazole 300mg was added to the treatment.

Results

He showed clinical improvement after a month. He has been stabilized for one year.

Conclusions

Treating resistant schizophrenia is among the most challenging clinical endeavors. A very helpful approach to improve adherence in schizophrenia is the use of long-acting injectable (LAI) antipsychotics. A major effort on scientific research of combination of LAI is needed.

Disclosure

No significant relationships.

Keywords

paliperidoneAripiprazolLong-acting injectable antipsychoticsschizophrénia
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S726 - S727
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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