{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T11:00:17Z","timestamp":1777806017242,"version":"3.51.4"},"reference-count":25,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2024,6,1]],"date-time":"2024-06-01T00:00:00Z","timestamp":1717200000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Correct Health Care"],"published-print":{"date-parts":[[2024,6,1]]},"abstract":"<jats:p>Treatment-resistant schizophrenia (TRS) is a challenging condition to treat for the correctional psychiatrist. Guidelines from the American Psychiatric Association indicate that the first-line pharmacotherapy for TRS is the use of the atypical antipsychotic clozapine. The use of clozapine is unique in that it requires patient adherence with weekly blood draws as a prophylactic measure against agranulocytosis and leukopenia. In the correctional setting, patients with severe and persistent schizophrenia are frequently nonadherent due to lack of insight and anemic access to health care resources, specifically as these pertain to clozapine. Therefore, an alternative treatment option would be a welcome solution for this demographic. Our literature review demonstrates a limited number of studies documenting the successful use of clozapine alternatives or combination antipsychotic therapy for treatment of TRS. In this article, we present a putative case where we believe that a combination regimen of paliperidone palmitate, oral aripiprazole, and escitalopram led to a notable mitigation of both positive and negative symptoms of psychosis in the case of an incarcerated patient with TRS, as well as an improvement in functional stability, which was conducive to housing in a less restrictive setting. A brief review of the published literature follows the report.<\/jats:p>","DOI":"10.1089\/jchc.23.09.0079","type":"journal-article","created":{"date-parts":[[2024,4,2]],"date-time":"2024-04-02T09:49:31Z","timestamp":1712051371000},"page":"167-171","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Dual Atypical Antipsychotics in Treatment-Resistant Schizophrenia: A Correctional Case Report and Review of Literature"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9986-1035","authenticated-orcid":false,"given":"Justina A.","family":"Warnick","sequence":"first","affiliation":[{"name":"Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel I.","family":"Gifeisman","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Khevna P.","family":"Joshi","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie A.","family":"Roe","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rick A.","family":"Hiciano","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher P.","family":"Conroy","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sohrab","family":"Zahedi","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA."},{"name":"Centurion Health, State Correctional Institution, Waymart, Pennsylvania, USA."},{"name":"University of Connecticut School of Medicine, Farmington, Connecticut, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"e_1_3_5_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.52.10.1343"},{"key":"e_1_3_5_3_1","first-page":"188","article-title":"Psychiatric disorders and suicide in the nation's largest state prison system","volume":"37","author":"Baillargeon J.","year":"2009","unstructured":"Baillargeon J., , Penn J. V., , Thomas C. R., , Temple J. R., , Baillargeon G., , & Murray O. J. (2009). Psychiatric disorders and suicide in the nation's largest state prison system. Journal of the American Academy of Psychiatry and the Law, 37(2), 188\u2013193.","journal-title":"Journal of the American Academy of Psychiatry and the Law"},{"key":"e_1_3_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/JCP.0000000000000766"},{"key":"e_1_3_5_5_1","doi-asserted-by":"publisher","DOI":"10.18176\/resp.00052"},{"key":"e_1_3_5_6_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2014.302043"},{"key":"e_1_3_5_7_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200464150-00010"},{"key":"e_1_3_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0000000000000457"},{"issue":"2","key":"e_1_3_5_9_1","first-page":"149","article-title":"Treatment of psychosis in prisons and violent recidivism","volume":"1","author":"Igoumenou A.","year":"2015","unstructured":"Igoumenou A., , Kallis C., , & Coid J. (2015). Treatment of psychosis in prisons and violent recidivism. British Journal of Psychiatry, 1(2), 149\u2013157. https:\/\/doi.org\/10.1192\/bjpo.bp.115.000257","journal-title":"British Journal of Psychiatry"},{"issue":"2","key":"e_1_3_5_10_1","article-title":"Clinical guidance on the identification and management of treatment-resistant schizophrenia","volume":"80","author":"Kane J. M.","year":"2019","unstructured":"Kane J. M., , Agid O., , Baldwin M. L., , Howes O., , Lindenmayer J. P., , Marder S., , Olfson M., , Potkin S. G., , & Correll C. U. (2019). Clinical guidance on the identification and management of treatment-resistant schizophrenia. Journal of Clinical Psychiatry, 80(2). https:\/\/doi:10.4088\/JCP.18com12123","journal-title":"Journal of Clinical Psychiatry"},{"issue":"4","key":"e_1_3_5_11_1","article-title":"Neurobiology of schizophrenia: A comprehensive review","volume":"14","author":"Luvsannyam E.","year":"2022","unstructured":"Luvsannyam E., , Jain M. S., , Pormento M. 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