A Case of Schizophrenia in a Young Male Adult with no History of Substance Abuse: Impact of Clinical Pharmacists’ Interventions on Patient Outcome

Abstract

Schizophrenia is a chronic and severe mental disorder characterized by distortions in thinking, perception, emotions, language, sense of self, and behaviour. This report presents the role of clinical pharmacists in the management of a patient diagnosed with schizophrenia with symptoms of paranoia. A gainfully employed young African male adult reported to be roaming around town moving from one bank to another was arrested. The patient was referred to the psychiatric unit of a hospital and diagnosed with schizophrenia. Key interventions offered included rapid tranquilization, electroconvulsive therapy, and psychotherapy. Medications administered to the patient while on admission included IV diazepam, IM haloperidol, IV Ketamine, IM flupentixol, olanzapine tablets, and trihexyphenidyl tablets. Issues raised by clinical pharmacists during the patient’s admission included need for alternative medication for rapid tranquilization, need for initial investigations and documentation of the patient’s vitals, initiation of antipsychotic therapy without initial monitoring and screening for substance abuse, inappropriate dose at initiation of antipsychotic medications, untreated indication, and incidence of missed doses. Interventions by the clinical pharmacists contributed to improvement in the patient’s symptoms prior to hospital discharge. The case proves that it is critical for clinical pharmacists to be involved in the multidisciplinary team during management of patients with psychosis.

A Clinical Case Report: Schizophrenia

“…Support the use of lorazepam in combination with haloperidol in the treatment of acute psychotic arousal.If the first dose of haloperidol 10 mg IM and diazepam 10 mg IM did not work, a second dose of the same drug combination was given. This did not comply with NICE guidelines for the prevention and treatment of psychosis and SCZ in adults, nor with the Indian Psychiatric Society's treatment guidelines for SCZ [19].…”

Self-Assembling Lecithin-Based Mixed Polymeric Micelles for Nose to Brain Delivery of Clozapine: In-vivo Assessment of Drug Efficacy via Radiobiological Evaluation

“…Clozapine (CLZ) is an antipsychotic drug, atypical class, which is FDA approved for the treatment of schizophrenia, a chronic mental disorder which is described by thinking, emotions and behavior distortions. 1 Based on recent guidelines recommendation, CLZ is the only drug which can manage treatment-resistant schizophrenia (TRS). 2,3 TRS, is the failure to respond to at least two sufficient trials of antipsychotic drugs, which has a probability of 30% to affect the schizophrenic patients.…”

A Case Study of Schizophrenia in a Young Female Following Unsuccessful Civil Service Exam: The Influence of Environmental Factors and Public Awareness on Patient’s Progress

“…Schizophrenia is a chronic and severe psychological disorder that affects cognition, perception, emotion, linguistics, behavior, and sense of self aberrations, thus affecting the patients' daily life [1] . The classic expressions of schizophrenia could include hallucination, delusion, disorganized speech, or behavior for positive symptoms while also experiencing some negative symptoms for behavioral deficits [2,3] .…”