Psychiatry 2008 - September 2008 - (Page 40)

[CASE REPORT] RISPERIDONE LONG-ACTING INJECTIONS: Successful Alternative Deltoid Muscle Injections for Refractory Schizophrenia by ARJUN SAXENA, MD; JEFFERY GRACE, MD; JOSIE L. OLYMPIA, MD; EILEEN TRIGOBOFF, RN, DNS; THOMAS WATSON, RN, MSN; SHARON CUSHMAN, LCSW-R; and DAVID NEWCOMER, BA Drs. Saxena, Grace, Olympia, and Trigoboff and Mr. Watson are from Buffalo Psychiatric Center in Buffalo, New York; Drs. Grace, Olympia, and Trigoboff are also with State University of New York at Buffalo; and Ms. Cushman and Mr. Newcomer are from Northwest Community Mental Health Center, Buffalo, New York. Psychiatry (Edgemont) 2008;5(9):40–42 ABSTRACT Treatment-resistant paranoid schizophrenia is often addressed with long-term intramuscular preparations of conventional antipsychotics (haloperidol and fluphenazine), which can be associated with the development of painful, lumpy nodules at the injection site. In this article, we present a case example of a 58-year-old male patient with paranoid schizophrenia who was treated with risperidone long-acting injection given into the deltoid muscle instead of the US Food and Drug Administration (FDA)-approved gluteal muscle injection site. Use of this agent in the deltoid muscle facilitated healing of the numerous painful lumpy nodules associated with prior trials of conventional long-acting injections. In addition, the patient’s psychiatric outcome was improved relative to what had been observed with the previous agents. INTRODUCTION Addressing long-term, treatmentresistant, paranoid schizophrenia with long-acting antipsychotic medication can be difficult due to side effects associated with the oil-based medium in which the medication is suspended. Specifically, this can lead to the development of painful, lumpy nodules at the injection site over time.1 Given that problems with medication adherence are the most 40 Psychiatry 2008 [ S E P T E M B E R ] ADDRESS CORRESPONDENCE TO: Eileen Trigoboff, RN, DNS, Buffalo Psychiatric Center, 400 Forest Ave., Buffalo, New York 14213-1298; Phone: (716) 816-2129; Fax: (716) 816-2450; E-mail address: buisert@omh.state.ny.us KEY WORDS: schizophrenia, long-acting, injections, treatment, deltoid

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Psychiatry 2008 - September 2008 Editor’s Message Editorial Advisory Board Contents Psych Rx Letters to the Editor Use of Benzodiazepines in the Treatment of Anxiety Functional Neurosurgery in the Treatment of Severe Obsessive Compulsive Disorder and Major Depression: Overview of Disease Circuits and Therapeutic Targeting for the Clinician Treatment of Comorbid Adolescent Cannabis Use and Major Depressive Disorder Risperidone Long-acting Injections: Successful Alternative Deltoid Muscle Injections for Refractory Schizophrenia Alcohol/Substance Misuse and Treatment Nonadherence: Fatal Attraction Transforming the Psychiatric Inpatient Unit from Short-term Pseudo-asylum Care to State-of-the-art Treatment Setting Journal Watch Classified Advertising Information for Authors

Psychiatry 2008 - September 2008

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