Module 6: Group Discussion: Clinical Case Study: Antipsychotic Agents

A 19-year-old male student is brought into the clinic by his mother, who has been concerned about her son erratic behavior and strange beliefs. He destroyed a TV because he felt the TV was sending harassing messages to him. In addition, he reports hearing voices telling him that family members are trying to poison his food. As a result, he is not eating. After a diagnosis is made, haloperidol is prescribed at a gradually increasing dose on an outpatient basis. The drug improves the patient positive symptoms but ultimately causes intolerable adverse effects including severe akathisia. Although costlier, lurasidone is then prescribed, which, over the course of several weeks of treatment, improves his symptoms and is tolerated by the patient.

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Questions:

What signs and symptoms would support an initial diagnosis of schizophrenia?

In the treatment of schizophrenia, what benefits do the second-generation antipsychotic drugs offer over the traditional agents such as haloperidol?

In addition to the management of schizophrenia, what other clinical indications warrant consideration of the use of drugs nominally classified as antipsychotics?

Module 6: Group Discussion: Clinical Case Study: Antipsychotic Agents