Two Long-Acting Antipsychotics in a Patient with Treatment-Resistant Schizophrenia: A Case Report

Area of Science:

• Psychiatry
• Pharmacology
• Clinical Neuroscience

Background:

• Treatment-resistant schizophrenia (TRS) presents ongoing challenges in patient management, often linked to poor medication adherence and frequent relapses.
• Long-acting injectable (LAI) antipsychotics are a valuable tool for improving adherence and managing schizophrenia, but evidence for combining two LAI formulations is scarce.

Observation:

• A 62-year-old female patient with a history of severe TRS, marked by recurrent hospitalizations and insufficient response to various oral and monotherapy treatments, was studied.
• The patient received alternating intramuscular injections of haloperidol decanoate (100 mg/28 days) and aripiprazole (400 mg/28 days) during her most recent hospitalization.

Findings:

• The implementation of a dual LAI strategy led to significant improvements in the patient's psychotic symptoms.
• Substantial gains in functional recovery and enhanced treatment adherence were observed.
• No adverse side effects were reported during the dual LAI treatment period.

Implications:

• This case suggests that dual LAI therapy could be a beneficial strategy for managing complex cases of TRS, especially in patients with adherence issues or those unresponsive to standard treatments.
• Further research is warranted to explore the long-term efficacy and safety profile of combining two different LAI antipsychotic formulations in a broader TRS population.
• This innovative approach may offer new therapeutic avenues for individuals with refractory schizophrenia who have not benefited from conventional treatment regimens.