Introduction & Background information:
Antipsychotics are primarily used to manage the symptoms of psychosis, particularly schizophrenia and bipolar disorder by blocking D2 receptors in the dopamine pathway of the brain. There are two main types of antipsychotics; typical antipsychotics, also known as the first generation antipsychotics (FGA) which were developed in 1950s, example of medicine in this category include Chloropromazine, Haloperidol, Flupenthixol, and Loxapine. Atypical antipsychotics, also referred as second generational antipsychotics (SGA) which acts as an antagonist for 5HT2A receptor aside from its blocking effect on D2 receptor, drugs in this class include Olanzapine, Quetiapine, Risperidone, Clozapine and Aripiprazole.
…show more content…
Psychosis such as schizophrenia and bipolar disorder if left untreated during pregnancy is found to be associated with unfavourable pregnancy outcomes such as low birth weight, neonatal hypoglycemia, congenital defects, and adverse neurodevelopmental result.1 Furthermore, women with schizophrenia and bipolar disorder might suffer from antepartum hemorrhage during delivery and there are many other complications associated with these serious mental illnesses.1 Hence, after the assessment between risk and benefits associated with this condition, many patients are prescribed with either FGA or SGA during pregnancy. Survey found that 76% of the women with psychosis were exposed to SGAs throughout pregnancy, 7 and of the SGAs that were prescribed, Quetiapine was the most frequently given one with Risperidone, Piprazole and Ziprasidone appearing in declining order.3 It is found that SGA prescription has increased from 0% in 1990 to 78% in 2005, also, there are approximately 3-4000 pregnancies exposed to antipsychotics every year in United Kingdom.6 Due to the inclining number of atypical antipsychotic prescription to pregnant women, the effect of SGA on pregnancy outcome has been closely monitored and studied by number of research groups. It is found that antipsychotic use during pregnancy might lead to unfavourable pregnancy outcomes, such as Caesarian delivery, low & high birth weights, prematurity, preterm birth, neonatal withdrwal and abnormal muscle movement and
Bipolar disorder is a serious mental illness that is characterized by changes in mood. It can lead to risky behavior, damage relationships and careers, and even suicidal outcomes if it’s not treated. Bipolar disorder is more common in older teenagers and young adults, it can affect children as young as 6. Women experience more periods of depression than men. More remains to be learned about this condition that affects millions of people.
The introduction of Clozapine, marked a turning point in the treatment of schizophrenia, as the first "atypical" antipsychotic drug lacking the propensity to produce ‘extra-pyramidal symptoms’ (associated with the older antipsychotic agents) (Kane et al. 1988). Even though, Clozapine has not conclusively demonstrated its significantly superior record or efficacy for psychosis (Gardner et al. 2005), it has proven exceptional effectiveness, compared to other more traditional antipsychotics (Claghorn et al. 1987). However, Kane et al. (1988) and others have concluded, 30–60% of all schizophrenic patients who fail to respond to typical antipsychotics may respond therapeutically/effectively to Clozapine (Breier et al. (1994) & Iqbal et al. (2003)). This is especially apparent for refractory schizophrenia (Kane et al. 1988), treatment-resistant schizoaffective disorders (Zarate et al. 1995) and aggression (Cohen & Underwood, 1994).
Antipsychotics are generally used to treat psychosis in mental disorders. These disorders include schizophrenia and bipolar disorder (Thyssen et al., 2010). Risperidone is known as an atypical second generation antipsychotic and used in the treatment of a multitude of disorders. This medication can often challenge behavioral problems that are associated with schizophrenia, autism spectrum disorder, bipolar disorder, or attention deficit hyperactivity disorder (Schatzberg & Nemeroff, 2013). It is important for the prescriber to be aware of the side effect and any possible adverse reactions that may occur. There can be many detrimental side effects that someone may not enjoy,
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
Within mental health and illness there is a vast amount of treatment options, medications and interventions to treat numerous psychotic disorders. A somewhat controversial treatment within the mental health field, known as long acting injectable antipsychotics (LAIAs), will be discussed in this argumentative paper. Evidence will be presented on how effective LAIA medication is, when compared to oral forms of antipsychotic medication, and the strengths and limitations of administering them. Perceptions of LAIAs from the view of nurses, health professionals and consumers, as well as the nurse’s role in administering and promoting recovery orientated care for people with a mental illness will also be covered. This essay will not provide a clear view, for or against LAIAs, but rather support both positives and negatives of the use of this medication within the mental health field.
Schizophrenia is a mental disorder characterized with severe, chronic, and potentially disabling thought disorder (American Psychiatric Association, 2013). Antipsychotic drugs are the primary use of treatment for schizophrenic disorders (Kane, 1987). Some of the common used psychotropic medications used to treat schizophrenia are: haloperidol, risperidone, aripiprazole, olanzapine, trifluoperazine, perphenazine, quetiapine, thioridazine, chlorpromazine, and clozapine. Antipsychotics like FGAs and SGAs are can be administered orally, in the form of a pill or liquid, or intravenously, by injections. Like with oral forms of antipsychotics, injections offer side effects too. These side effects vary but are very much alike to those of the matching drugs in oral form, though added mild or infrequent injection-related side effects can occur such as: pain, skin thickening, and nodules (Haddad & Fleischhacker, 2011). Antipsychotics administered by injection is one approach to managing nonadherence, although this approach does not work for all patients. Additionally, a proportion of patients who start on injections, later, do not continue with treatment. One study found more than half of patients who began risperidone (Risperdal) injections, stopped after 6 months of treatment (Taylor et al., 2004). With injections, patient nonadherence can be due to the personal characteristics, dosage range, initial startup, administration of the drug, and monitoring. The dosage range for each
Medication is the foundation on which treatment of schizophrenia is based. Oftentimes, medication is combined with one or several types of psychotherapy to help the patient deal with their illness the best that they can. Antipsychotics are the most common and most effective type of medication used to treat schizophrenic patients. They are “effective in suppressing specific positive symptoms of psychosis such as hallucinations, delusions, and thought disturbance” which is why they are the most popular type of medication for schizophrenic patients (Shean, p.140). The main goal of antipsychotics is to effectively control symptoms at the lowest dosage possible. This type of medication
Schizophrenia treatment has developed to have two specific classes of drugs, typical antipsychotics and atypical antipsychotics. Typical antipsychotics were the first type of drugs to be used on schizophrenia patients. They are also known as the ‘first-generation’ drugs. Atypical antipsychotics, or ‘second-generation’ drugs are newer drugs that are now often used in replacement of the ‘first-generation’ drugs. However this progression of drug treatment for schizophrenia patients has shown little change in effectiveness as studies were unable to find distinct difference. The only real difference between the two can be seen in their prices and side effects. Although, the typical antipsychotics have now tapped into the fast-growing generic drug
The cases of diagnosed Schizophrenia and Bipolar Disorder have been on the rise for the past several years. Since these diseases are hereditarily linked, the rise of childhood onset Schizophrenia and Bipolar disorder has also had increased diagnosed cases. Through new medical research and availability of new treatments and medication, scientists and doctors are now uncovering new reasons as to why these mental diseases are on the come up. Human studies administered by various research facilities also conducted examinations on the brain activity and chemical balances to understand the impact of cranial functionality.
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
In the United States, in 2012, approximately 1% or 2.4 million people were diagnosed with schizophrenia. Schizophrenia is a chronic, severe, and disabling brain disorder in which symptoms usually develop in men in their late teens or early twenties, and women in their early twenties and thirties (Anderson, 2014). It is a psychotic disorder characterized by loss of contact with the environment, by a noticeable deterioration in the level of functioning in everyday life, and by a disintegration of personality expressed as disorder of feeling, thought, perception, and behavior (p. 580). Clinicians classify schizophrenia as positive, negative, or cognitive. Positive symptoms include hallucinations, which may include auditory, visual, olfactory, gustatory, or tactile hallucinations. Delusions or false beliefs are also positive symptoms, as is disorganized thinking and movement disorders. Negative symptoms include flat affect, ahedonia, or apathy. Cognitive symptoms include a decreased ability to understand information, and using that information to make decisions (Herzog & Varcarolis, 2011). Men with schizophrenia do not outwardly express their emotions, when compared to women with schizophrenia. This can result in a decrease of self-value, social interaction, and life satisfaction. Understanding ones emotions can create a healthier lifestyle, with a more functional outcome (Mote, Stuart, & Kring, 2014).
Schizophrenia is a psychotic disorder that disrupts the essential ability to perceive what is real and not real (Varcarolis, 2010). This type of disease may be considered as a multitude of conditions but with mutual features and interrelating etiologies. It has been found through research that a person with schizophrenia has a different brain chemistry, neurotransmitter activity, and structure than a healthy human being. There is no single proven cause of schizophrenia, however there are several factors that contribute to the incidence of this disorder. It affects millions of people in the United States and is considered one of the most debilitating and disabling brain disorders.
Schizophrenia is a very complex disorder, and it is said that it involves irregulation of multiple pathways. It is believed that schizophrenics have an abnormal level of dopamine in their brains. Serotonin, GABA (gamma-aminobutyric acid) and glutamate may also play a role. Deficits in acetylcholine muscarinic receptors have been identified in individuals with schizophrenia. “Evidence from genetic, post-mortem and animal studies over the past decade has identified a number of susceptibility factors for schizophrenia, including neuregulin 1 (Nrg1) and its receptor ErbB4, disrupted-in-schizophrenia-1 (DISK1), dysbindin-1, catechol-O-methyl tranferase (COMT), BDNF, and Akt” (Deng & Dean, 2016, para. 1). These factors interact with dopaminergic, glutamatergic and GABAergic neurotransmitter systems.
Bipolar disorder is a chronic mental illness, and is characterized by alternating between elevated moods such as mania or the milder condition hypomania and periods of depression. Bipolar disorder often shows during late teens or early adult years. At least half of all cases start before the age of 25. Some people experience symptoms during childhood, while others might develop symptoms late in life ("Bipolar Disorder in Adults"). The purpose of the study was to investigate if quetiapine monotheraphy is an effective medication in managing relapse or recurrence of critical elevations in mood and the tolerance level of quetiapine amongst
The atypical antipsychotics or second generation antipsychotics (SGA) are a group of antipsychotics that were introduced in the clinical practice during the early 1990. All over world these agents are most commonly prescribed for Schizophrenia and other illnesses with psychotic symptoms. This article will focus on brief overview of the atypical antipsychotics as a class and brief description of selected atypical antipsychotics.