Pharmacotherapy of schizo

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Project Integration Management

Ved Jason Mock

Elements of the language curriculum design process

Ved Alexandra Fernández

Schizophrenia

Ved John Keane

Process of Managing

Ved Emily Straw

Pharmacotherapy of schizo

Hyperprolactinemia

Sxs/Management

Tardive Dyskinesia - chronic/possibly irreversible

Treatment

EPS: Acute Presentations

Pseudoparkinsonism Manifestations

Schizo treatment

-meds +/- psychotherapy -antipsychotics --> GREAT for + -less role in - -psychotherapy does NOT have much of a role by itself/used adj

Second Gen

Clozapine: 1st atypical

ADEs -REMS Program for Agranulocytosis/Neutropenia -Weight gain, hyperlipidemia, hyperglycemia -seizures -anticholinergic effects

-low D2/high 5HT2 blockade -LAST LINE, beneficial in pts w/ EPS, suicidality/treatment resistant schizo.

-atypical -D2 + serotonin (5HT2A) RA -less specific to dopamine -effective for (+) sxs

First Gen

Monitoring: -movement (AIMS or other scale) -prolactin lvls -cognition (MMSE) -QTc -Vitals (BP, HR, weight) -EEG/Seizure

ADEs

Drugs

Effects

-typical -D2 RA -block H1/M1/a1 -more specific to dopamine -effective for (+) sxs

Psychosis

Disorders associ. w/ psychosis

-Schizoaffective -Mood disorders -dementia -personality disorders -medical conditions

Schizophrenia

Clinical presentation:

Negative: -lack of interest/withdrawal from the world -emotionless/flat affect The A's: -Avolition, Alogia, Anhedonia, Asociality

Positive: -hallucinations -auditory/visual/tactile -delusions

Psychosis vs. Schizo

schizo: -mental illness that impacts thought process/emotion/behavior -diagnosis: must experience at least 2 of the following sxs for 6 months, incl one of the first 3 Sxs: -Delusions -hallucinations -disorganized speech -catatonic behavior -negative symptoms (lessened emotional expression)

Psychosis: -episode where one is detached from reality -symptom of sleep deprivation, substance use, mental illness, etc. -signs: hallucinations, delusions, agitation, disorganized thought/behavior

DSM5: two or more of these present for at least 1 mo

1. hallucinations 2. delusions 3. disorganized speech 4. grossly disorganized or catatonic behavior 5. negative sxs + cont. disturbance for 6mo, social/occupational dysfun for sig time.

-loss of reality, inability to distinguish what is real/not -described in terms relating to thoughts/sensations that occur when they shouldn't

-dopaminergic response -symptoms incl. hallucinations, delusions, paranoia