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Dual Atypical Antipsychotics in Treatment-Resistant Schizophrenia: A Correctional Case Report and Review of Literature.
- Source :
-
Journal of correctional health care : the official journal of the National Commission on Correctional Health Care [J Correct Health Care] 2024 Jun; Vol. 30 (3), pp. 167-171. Date of Electronic Publication: 2024 Apr 01. - Publication Year :
- 2024
-
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.
- Subjects :
- Humans
Male
Adult
Drug Therapy, Combination
Citalopram therapeutic use
Citalopram administration & dosage
Paliperidone Palmitate administration & dosage
Paliperidone Palmitate therapeutic use
Schizophrenia drug therapy
Correctional Facilities
Clozapine therapeutic use
Clozapine administration & dosage
Antipsychotic Agents therapeutic use
Antipsychotic Agents administration & dosage
Aripiprazole therapeutic use
Aripiprazole administration & dosage
Schizophrenia, Treatment-Resistant drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1940-5200
- Volume :
- 30
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of correctional health care : the official journal of the National Commission on Correctional Health Care
- Publication Type :
- Academic Journal
- Accession number :
- 38563618
- Full Text :
- https://doi.org/10.1089/jchc.23.09.0079