Clinical Use of Aripiprazole Monohydrate Long-Acting Injectable in Adolescents: A Case Series and Review of the Literature

Objective Long-acting injectable (LAI) antipsychotics may improve treatment adherence by maintaining stable plasma drug concentrations and reducing relapse risk associated with inconsistent oral medication use. Although LAIs are widely used in adults with severe psychiatric disorders, their use in pediatric populations remains off-label, and evidence is limited. Aripiprazole, a partial dopamine D 2 receptor agonist, has a favorable tolerability profile in adolescents, particularly regarding metabolic adverse effects and prolactin elevation. Methods This retrospective case series describes the clinical use of aripiprazole monohydrate LAI (AM LAI) in six adolescents aged 13-17 years with severe psychiatric conditions and poor adherence to oral treatment. Results Treatment with AM LAI was associated with improved adherence and clinical stabilization in all cases. Reductions in symptom severity and improvements in functional outcomes were observed during follow-up. No serious adverse effects were reported. Conclusion AM LAI appears to be a safe and effective off-label treatment option in high-risk adolescents with poor adherence to oral antipsychotics. This case series contributes clinically relevant real-world data to the limited literature on LAI use in pediatric psychiatry.