Dual Atypical Antipsychotics in Treatment-Resistant Schizophrenia: A Correctional Case Report and Review of Literature.
J Correct Health Care
; 30(3): 167-171, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38563618
ABSTRACT
Treatment-resistant schizophrenia (TRS) is a challenging condition to treat for the correctional psychiatrist. Guidelines from the American Psychiatric Association indicate that the first-line pharmacotherapy for TRS is the use of the atypical antipsychotic clozapine. The use of clozapine is unique in that it requires patient adherence with weekly blood draws as a prophylactic measure against agranulocytosis and leukopenia. In the correctional setting, patients with severe and persistent schizophrenia are frequently nonadherent due to lack of insight and anemic access to health care resources, specifically as these pertain to clozapine. Therefore, an alternative treatment option would be a welcome solution for this demographic. Our literature review demonstrates a limited number of studies documenting the successful use of clozapine alternatives or combination antipsychotic therapy for treatment of TRS. In this article, we present a putative case where we believe that a combination regimen of paliperidone palmitate, oral aripiprazole, and escitalopram led to a notable mitigation of both positive and negative symptoms of psychosis in the case of an incarcerated patient with TRS, as well as an improvement in functional stability, which was conducive to housing in a less restrictive setting. A brief review of the published literature follows the report.
Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Antipsicóticos
/
Aripiprazol
/
Esquizofrenia Resistente ao Tratamento
Limite:
Adult
/
Humans
/
Male
Idioma:
En
Revista:
J Correct Health Care
Assunto da revista:
SAUDE PUBLICA
/
SERVICOS DE SAUDE
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos