Map Case Study

The adverse effects of drug-drug interactions in patients with schizophrenia and bipolar disorder can be severe and depends mainly on the pharmacokinetic properties of the drug. Both the distances between drug targets and the comparison of target neighbors are important when when administering olanzapine in combination with other drugs due to its effects on the CNS. To avoid severe adverse effects such as sedation, orthostatic hypotension, tachycardia or transaminase the prescribing drugs in combination such as olanzapine with fluvoxamine or diazepam should be therapeutically monitored while drugs such as sertraline will not cause adverse effects. (Spina, E., de Leon, J., (2007)).

Antipsychotics are medications that physicians use to treat psychotic disorders such as Schizophrenia, Delusional disorder, Paraphrenia, and Substance-induced psychotic disorders. These disorders are characterised by the patient’s inability to make good judgments, think with a clear head, communicate effectively, relate to society, and understand reality. Antipsychotic drugs are also useful in the treatment of bipolar conditions that involve extreme cases of manic behaviour. Examples of these drugs include Thorazine and Trilafon. These drugs belong to a drug class called phenothiazines. They work by changing the actions of chemicals in the brain. The drugs can be beneficial, however, Steen et al. (2014) argue that the medicines have several harmful effects such as changes

As we have seen, treatment of schizophrenia with antipsychotic drugs can have impressive results in terms of decreasing active symptoms, although it does nothing to alleviate negative symptoms or to improve cognitive functioning. Unfortunately, this kind of treatment has the drawback of extremely serious and even fatal side-effects. Newer generation atypical antipsychotics offer more hope, as they can treat both active and negative symptoms, and also improve cognitive functioning. Moreover, they have fewer side-effects. However, treatment is complicated by the fact that results are unpredictable; and in addition the side-effects that they do have can be very serious, such as diabetes, which in itself is life-threatening. However, as the potential side-effects are known, the physician has leeway to choose a drug which is a good match for the patient’s clinical profile. Then, once the patient’s symptoms have been much alleviated with an appropriate newer generation atypical antipsychotic, the patient should be able to also benefit from a range of psychotherapeutic interventions. It is argued that this is the best treatment regime to choose, as it is likely to result in the greatest improvement in quality of life, coupled with the lowest risk of potentially devastating side-effects, or of death. This is likely to be better than utilizing cognitive behavioral therapy, the results of which are not reliably known – although research has certainly shown that it is less efficacious

A comparison between schizophrenia and bipolar spectrum disorder focusing on history, etiology, treatment, and symptoms of each disease will introduce the concept of the Continuum Disease Model (CDM) as a basis for further debate and discussion on the controversial designation of schizoaffective disorder (bipolar type/depressive type). The concept of a possible connection between distinct disorders is strongly disputed between many experts due to presence of manic or hypomanic episodes as a clear distinction requiring the designation of bipolar spectrum disorder as opposed to negative and positive schizophrenic symptoms; however, similarities in the disorders including etiology, presence of psychosis, and effectiveness of new atypical antipsychotic treatments may present similar neurological psychopathology. Schizoaffective disorder may present only unipolar depressive symptoms along with negative or positive schizophrenic symptoms but bipolar type will be the focus of discussion. An argument disputing the legitimacy of the CDM will be presented though the stress-diathesis model supports the designation of schizoaffective disorder in the newest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). A deeper look at the mechanisms in the psychopharmacological drug treatments specifically focused on the atypical antipsychotics quetiapine (trade name Seroquel) and lurasidone (trade name Latuda), providing theories of their effects on brain

Treatments vary depending on the type and severity of symptoms, and whether the disorder is depressive-type or bipolar-type ".While in PPBHC facility J.M.B was given Depakote ER 100 mg twice daily which is an anticonvulsant and first line treatment for acute mania. Seroquel XR 300 mg P.O at bedtime which was increased to Seroquel 400 mg P.O. at bedtime and Seroquel 200 mg P.O one per day in am to be discontinued in one month. Thorazine 100 mg P.O. / IM every 6 hours for psychosis. J.M.B. was also getting Ativan 4 mg P.O every 8 hours, Lorazepam 4 mg P.O. / IM every 6 hours as needed for agitation and Benadryl 100 mg P.O. / IM every 6 hours which is an anticholinergic agent used to treat extrapyramidal side effects. Along with medical management to treat schizoaffective disorder there is also group therapy, psychotherapy and electroconvulsive therapy (ECT) which is used to subdue severe manic behavior (Varcarolis & Halter (2010). More importantly, group therapy was ordered as part of J.M.B plan of

The process of creating a district map in Texas sounds easier than it is done. The whole point of congressional district maps is to divide voters into their own election districts. The boundary that divides these two is set by the state legislature which in this case would be Texas legislature. Sounds simple enough but there is also the part where the law requires that there be the same number of population under each state district in order to keep the balance of voting to an equal and the way that is determined is by the census that goes around counting up people in different neighborhoods in that state and extra information is also gathered along such as age, number of people in the house hold, ethnicity, etc. This format could and does

Schizophrenia is a life-long disorder that affects about one percent of the population (Mueser & McGurk, 2004). The cause of this mental illness is still unclear. Studies have suggested that Schizophrenia does not arise from one factor but from a combination of genetic, environmental, and social factors (Liddle, 1987). People diagnosed with Schizophrenia struggle to deal with a multitude of symptoms that make it difficult to function (Mueser & McGurk, 2004). Antipsychotic medications are a popular treatment of the symptoms of Schizophrenia (Mueser & McGurk, 2004). Research is constantly being done to develop these medications to enhance the quality of life of those diagnosed with Schizophrenia.

A new study confirms the earlier that someone who is starting to show symptoms of schizophrenia gets treatment, the better the outcome for that person. Studies on this subject over the past few years say, that the greater the interval between the onset of psychosis and its treatment, the greater the severity of negative symptoms. Thus, ameliorating the symptoms of the initial psychosis may not only ease the pain and suffering experienced by patients and their families but will also improve long-term prognosis by slowing down the progression of the illness, assisting their ability to respond better to antipsychotic medication. Unfortunately, side effects become apparent while taking these drugs and can consist of a patient's mental alertness being affected as well as dizziness, dry mouth, weight gain, ear pain, back pain, headache, etc. It is also worth mentioning, that if a patient is considered a threat to themselves or others, hospitalization would be utilized in such severe

Antipsychotic agents are the most commonly used treatments for schizophrenia. However, more than two-thirds of patients suspended antipsychotic treatment in 18 months. [8] Although the drug is unlikely to be due to various factors in patients with schizophrenia, not all of these factors are a problem, such as negative attitude towards drugs. There was a questionnaire consisted of six questions about adverse events. The first question is whether the patient was suffering from any adverse events. The last question aimed to check whether the patient's reaction and other adverse events tolerated a specific or let them have changed their medicine. Multiple answers were about he patients’ toleration of the cause of specific symptoms. The

If all these preventive strategies failed, prompt interventions to correct the condition and treat delirium should be initiated. In such cases, pharmacological treatments are often necessary. Haloperidol,a typical antipsychotic, is the most commonly used empiric agent in this regard, but the staff need to be very vigilant upon potential, significant side-effects of this medication, including extrapyramidal symptoms, torsades de points, prolongation of the Q-T interval, and neuroleptic malignant syndrome(12). Although the exact mechanism of action of this medication in treating delirium is unknown, it is thought that haloperidol acts through antagonizing brain dopamine-2 receptor and reducing dopaminergic activity at the cerebral synapses and basal ganglia(97, 109, 110). Initially, 2mg of the medication is administered intravenously. It could be repeated every 15-20 min, doubling the dose each time until agitation is resolved. After stabilizing the patient, the leasteffective dose should be used every 4-6h as the maintenance (11). Olanzapine (2.5-5 mg orally per day) and other atypical antipsychotics such asziprasidone (40 mg orally every 6-12h) and quetiapine (50 mg orally every 12h)have also been used in treating ICU delirium(11, 111-113). However, there is still controversy in this regard, because these drugs may increase death risk(111,

For treatment of psychosis, antipsychotic medication is offered in conjunction with psychological interventions, which entails family intervention with individual cognitive behavioral therapy. For a patient to have the most effective results in treatment it is advised that both interventions are done together, that is taking an oral antipsychotic medication and psychological interventions with therapy. The parents will more than likely be deciding on the antipsychotic medication offered by the mental health service specialist. The parents and patient should be aware of the benefits and side effects of the drug such as metabolic changes, extrapyramidal effects, cardiovascular, hormonal and other changes that may occur. Baseline overall health should be recorded prior and during oral anti-psychotic therapy. Therapy sessions are in place to further support the adolescent in treatment. Hospital care may be referred if a case becomes unavoidable.

In order for the drug treatment approach to continue, psychotic conditions must be approached using a biomedical perspective.

Chlorpromazine and haloperidol are considered benchmark antipsychotic drugs, and are the most popular treatment methods of all antipsychotic meds. When patients take medications there is a potential for withdraws, side effect, physical or mental changes. Medications may not always work, and are usually short term. So, it’s important for patients to find treatments that work and medications that give patients fewer side affects. Testing on the treatment drugs consisted of finding patients who were already diagnosed with schizophrenia or schizophrenia-like psychoses. Data gathered from registries, trials, and pharmaceutical companies and authors of relevant trials to find effective results. The results yielded for the two medications and found

Ethical approval: All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Helsinki Declaration is a set of guidelines on clinical research for physician as their responsibility toward protection of their research subjects (Williams, 2008). World Medical Association (WMA) also encourage it is used as reference by other parties in conduction of clinical research (Bădărău, 2013). Compared with the Nuremberg Code, which mainly focuses on safeguard of the subjects, its