Dual long-acting injectable antipsychotic use in treatment-resistant schizophrenia with extensive hospitalization history: A case report

Treatment-resistant schizophrenia (TRS) is a challenging condition to manage and can result in the need for dual antipsychotic prescribing especially after oral clozapine failure. Poor medication adherence is prevalent among patients with TRS, and long-acting injectable antipsychotics are frequently used to overcome this barrier. Whereas there is limited data on the risks and benefits of dual long-acting injectable antipsychotic treatment, this is a treatment modality that is being used for patients with TRS who have poor adherence. We contribute a case of successful dual long-acting injectable therapy with intramuscular paliperidone palmitate and haloperidol decanoate in a patient with TRS and an extensive history of hospitalizations who failed treatment with oral clozapine.