Combining Three Long-acting Injectable Antipsychotics: A Case Series

The decision to use multiple long-acting injectable antipsychotics (LAIAs) is difficult since there is no evidence base for their use in treatment guidelines. In this case series, we aimed to present our experiences with the use of triple LAIAs in four patients diagnosed with schizophrenia. The study included four treatment-resistant schizophrenia cases who were followed in the inpatient ward of a university hospital, who could not use clozapine due to non-compliance with treatment, who did not benefit from multiple electroconvulsive therapy procedures, who did not respond to dual antipsychotic treatments and who were using triple LAIAs. The clinical histories of the cases were analysed retrospectively by experienced psychiatrists. All patients responded to the treatment with a decrease in their psychotic symptoms and the number of hospitalizations without any significant side effects. Also, improvement in daily functioning and adherence to treatment was observed in all cases. Based on these results, the use of multiple LAIAs can be safely applied, especially in appropriate treatment-resistant schizophrenia patients and with close follow-up by a clinician.