PHARMACOLOGICAL TREATMENT INTERVENTIONS

Pharmacological Treatment Interventions for Mental Health, Attention and Memory Disorders

Abstract

This paper is based on the case study of a person having insomnia, restless sleep bad dreams, and agitation; he hears voices and has false perception that the people riding in buses that pass his apartment watch him. The scenario describes the typical case of schizophrenia. This paper describes the pharmachological treatment and management of schizophrenia. Pharmacological Treatment Interventions for Mental Health, Attention and Memory Disorders

Introduction

Schizophrenia is a major psychiatric disorder or cluster of disorders that alters a person's thoughts, perception, and behavior. Person who develops schizophrenia have multiple symptoms, the pattern of symptoms depend on person's particular circumstances. The symptoms of schizophrenia are associated by a 'prodromal' period, which is associated with deterioration in functioning. Other issues include concentration and memory problems, social withdrawal, bizarre ideas, and reduced interest in day-to-day activities. These symptoms affect his ability to study, or relate to his family and friends. This period is followed by an acute phase associated with positive symptoms, which includes delusions, hallucinations, agitation, distress, and behavioral disturbances. After resolution of the acute phase, positive symptoms disappear for many people, leaving negative symptoms, which may last for many years (Miller & Mason, 2011).

Positive symptoms

Delusions - strange beliefs, which cannot be changed by reasoning. For example, a belief that somebody is watching or listening.

Hallucinations -false perception, the person hears, smells, sees, tastes or feels things that are not real. The most common form is hearing of voices.

Disordered thinking and fragmenting of thought.

Catatonic movements, the person adopts odd postures, becomes restless and agitated (Miller & Mason, 2011).

Negative symptoms

Emotional numbness.

Lack of motivation.

Inability to do everyday tasks (Miller & Mason, 2011).

Discussion

Pharmacological Treatment Approach of DiseaseThe disease responds well with antipsychotics drugs, the selection of drug depends on the following factors:

Severity of symptoms and response.

Past experience about the side effects.

Patient's preferences about route of administration.

Available formulations of a drug.

Second-generation antipsychotics should be given as a first-line medications, because of the low risk for tardive dyskinesia and extrapyramidal side effects and have superior efficacy in treating cognitive, negative symptoms (Miller & Mason, 2011).

Atypical antipsychotics or second-generation agents are considered as first-line treatment for patients having the first episode. If one drug produces side effects, another can be tried. After the first episode, the dose may be gradually decreased with careful monitoring of patient's symptoms. For patients who have experience multiple episodes, long-term treatment is essential. The main mechanism of antipsychotic drugs is the blockage of postsynaptic dopamine D2 receptors, as well as other receptors. These drugs block D2 receptors in the mesolimbic projections; this blockage is effective to control positive symptoms. Those antipsychotic drugs that act on D2 receptors of hypothalamus and basal ganglia cause neurohormonal changes and extrapyramidal side effects. These side effects mostly associated with typical antipsychotics drugs (Stroup & Lieberman, 2010).

Most of patients having positive symptoms are partially responsive to these drugs. Negative symptoms respond poorly to these drugs. Typical antipsychotics can cause many side effects, including weight gain, ...