Citation

McInnis P, Kasinathan J. Australas. Psychiatry 2019; 27(2): 160-164.

Affiliation

Consultant Forensic, Child and Adolescent Psychiatrist, Adolescent Unit, The Forensic Hospital, Matraville, NSW, and; Conjoint Senior Lecturer, School of Psychiatry, University of New South Wales, Sydney, NSW, Child and Adolescent Mental Health Service, ACT Health, Sydney, NSW, and; Visiting Fellow, Centre for Mental Health Research, Australian National University, Canberra, ACT, and; The Level 8 Practice, Sydney, NSW, Australia.

Copyright

(Copyright © 2019, Royal Australian and New Zealand College of Psychiatrists, Publisher SAGE Publishing)

DOI

10.1177/1039856218815744

PMID

30474388

Abstract

OBJECTIVES:: We examine the use of combination long-acting injectable (LAI) antipsychotic medication for adolescents with severe psychosis and aggression. We discuss benefits and risks with this approach, for a highly challenging small group of young people.

METHODS:: A clinical summary is given of three adolescents admitted to a secure adolescent forensic inpatient unit, and the literature is reviewed.

RESULTS:: In these adolescents with severe psychosis, aggression and violent offending, combination LAI antipsychotics effectively treated psychosis and enabled transfer to less restrictive settings. Brief Psychiatric Rating Scale (BPRS) scores decreased significantly with treatment, without any severe adverse effects.

CONCLUSIONS:: Combination LAI antipsychotics may be an effective treatment for adolescents with severe psychosis and aggression where clozapine is not a realistic therapeutic option. Close monitoring for side-effects, clear documentation of clinical reasoning and appropriate safeguards are important.

Language: en

Keywords

adolescents; antipsychotic; combination depot; long-acting injectable; psychosis