Describe about the Current Research and Development of New Treatments?
Schizophrenia is a complex, severe psychological disorder that approximately affects 1% of the overall world population. The disease is characterized by abnormal social behavior, which leads to failure in recognition (Haywood et al. 2011). Symptoms associated with the disease primarily include confused and inappropriate thinking, false beliefs, delusions and hallucinations with reduced social engagement and lack of expression. The primary method of treatment associated with the disease includes both psychosocial and pharmacotherapeutical interventions (Wheeler et al. 2012). Thus, the present essay will help in developing knowledge regarding various aspects of Schizophrenia, which primarily includes an understanding of the causes, developmental factors, symptoms, complications and interventions associated with the disease. Today, it has been observed that Schizophrenia is most common among all social groups around the world, affecting men and women equally (Richardson et al. 2014). The present essay will help in understanding the extended role of the pharmacist in providing proper recommendations in order to implement schizophrenia care in the community.
Pharmaceutical care dealing with Schizophrenic patients, primarily includes elaboration of information regarding the use of drugs associated with the disease, the difficulties arising because of pharmacotherapeutical difficulties, monitoring of the adverse effects associated with the disease and regular screening of the medication process. The pharmacist plays a vital role in providing information regarding the patient’s condition through prescriptions to the primary health care provider, which includes the psychiatrist and the general practitioner. Thereby, the pharmacist helps to discover about the various complications associated with the disease, which includes an understanding of the present mental state of the patient, care, and treatment that needs to be provided to the patient (O’Reilly et al. 2013). The pharmacists also encourage the primary health care systems to initiate and encourage relevant patient information and indications regarding the relapse of the disease. The pharmacists are considered as the last primary health care professionals who need to be consulted before implementing the long term medication process. Therefore, a well-educated and highly motivated pharmacist promotes the advantages of the therapeutic compliance in association with Schizophrenia.
Approximately 1 % of the overall world population are affected by Schizophrenia that generally affects individual between the age group of 16 and 30 and thus produces a long-term effect associated with various kinds of chronic disorders. A report suggests that in the United States, about 1.2 million patients remain hospitalized because of Schizophrenia ((Richardson et al. 2012). Although a majority of the people generally is discharged within the first year of treatment, the average length of the disease is 13 years. Considering the various opinions on the nature, etiology and interventions of the disease, there are various conditions, which reflects the adaptation and integration of the more divergent findings. A psychiatrist defines schizophrenia as a structural defect of the brain that is influenced either by the hereditary factors or by other toxic factors leading to improper functioning of the cerebral. Studies suggest that a majority of the people considers schizophrenia as a series of familial incidence affected by a large number of environmental factors leading to accumulation of the metabolic dysfunctioning.
Schizophrenia is considered as a life threatening condition that is associated with high mortality rates, which is three to four times greater than that has been observed or expected in the general population. The disease is also associated with high suicidal rate, which is found mostly among young adults. Thus, a delay in the treatment leads to a larger number of suicides and as a result, there is an overall increase in the suicide rate in relation to Schizophrenia However, reports suggests that approximately two-fourth of the excess mortality has been primarily caused by the natural deaths (Phokeo et al. 2014).
The first line therapy for the particular mental disorder includes use of antipsychotic drugs associated with reducing the positive symptoms of the disease. However, it has been observed that the drugs are not being able to eradicate the negative and the cognitive symptoms. Continuous use of the drugs also enhances the risk of relapse. Moreover, the type or choice of antipsychotic drugs also plays a vital role, which is significantly based on the risks, costs and benefits of using such drugs (O’Reilly et al. 2010). Thus, important strategies need to be implemented for reducing the dependency on these kinds of drugs, which is not only costly but also associated with other greater side effects. The side effects include weight gain, development of diabetes and increased risk of the associated metabolic syndrome.
The pharmacists association in understanding of the various aspects of Schizophrenia will help in interpreting about the background, symptoms, medication and diagnosis of the disease. Pharmacist’s helps in providing effective communication among the patient regarding the long-term complications associated with the disease. A clear idea regarding the genetic and environmental factors playing a key role in the development of the disease will also help in implementation of effective strategies to place implications regarding the development and maintenance of schizophrenia. The initial prevention of the disease may be provided by the use of antipsychotic drugs in combination with social and psychological support. The community also produces support for providing checkup in all available in all health care system. Clozapine, amisulpride and other available drugs etc. are associated in producing side effects.
Thus, a pharmacist also helps in providing replacement over the normal drugs by introducing a number of psychosocial interventions, which includes introduction of family therapy, cognitive recommendation, supported employment of staffs and proper medical therapies. Family therapy helps in providing education, which helps in addressing the entire system of the family that reduces relapses and hospitalizations. Cognitive behavioral theory also assists in reducing the symptoms associated and helps in promoting effective research methods (Agid et al. 2010).
Thus, pharmacists help in preparing care plan and includes counseling, education, advice and monitoring of parameters that influences the lifestyle, social and consideration of ethical issues. Pharmacists shall also need to introduce strategies to abstain people from smoking and drinking because study estimates that 70%-90% people of regular smokers suffers from schizophrenia as compared to the overall solution (O’Reilly et al. 2010). Thus, the pharmacists play important role in the effective implementation of medical and care plans in order to promote growing concern about Schizophrenia.
Schizophrenia is considered as mental disorder and characterized by failure to recognition of “Real” things and abnormal social behavior. The common symptoms of schizophrenia include confused thinking, reduced social engagement, false beliefs, lack of motivation, auditory hallucinations and emotional expression. It is observed that the occurrence of schizophrenia is almost equal in women and men. The management of schizophrenia includes social interventions, psychotherapy and drugs (Hazra et al. 2011). Therefore, it can be said that the role of a pharmacist in the treatment of schizophrenia is very important. The role of a pharmacist is to provide proper drugs and treatment to the patient in order to achieve specific outcomes, which can help in the improvement of the patient’s quality of lifestyle. Such outcomes are treatment of the disease, reduction and eradication of symptoms experienced by a patient, slowing down the progression of the disease and prevention of the disease. In schizophrenia disease, pharmacists play a key role since application of medicine to the schizophrenia is vital (Lane et al. 2010). The pharmacists need to cooperate with schizophrenia patients and other health care professionals in implementing, monitoring and designing a therapeutic process, which may produce better therapeutic outcomes for the schizophrenia patients. To aid the patients who are suffering from schizophrenia, pharmacists need to identify actual and potential problems that may be faced by them as well as resolving actual drug related issues. Prevention of drug related issues is important in the treatment of patients with schizophrenia, since many drugs are used for the treatment of schizophrenia, which have side effects and potentiality to harm the patient (Hoch, 2011).
The exact cause of schizophrenia is not known. However, many researchers suggest many reasons behind the development of schizophrenia, such as genetics, physical, psychological and environmental factors (Lane et al. 2010). Apart from these factors, changes in the level of neurotransmitters, pregnancy and birth complications and several trigger factors such as stressful events, drug abuse and bereavement can cause schizophrenia among the common people. It is found from the research that only full psychiatric assessment can diagnose schizophrenia properly (INTO & CPD, 2012). In general, there are seven types of schizophrenia diagnosed among the common people, such as hebephrenic schizophrenia, catatonic schizophrenia, paranoid schizophrenia, undifferentiated schizophrenia, simple schizophrenia and cenesthopathic schizophrenia (Schellack & Matlala, 2014). Therefore, it is certain that there are different treatments used by the pharmacists and the health care experts to treat different types of schizophrenia. However, there are mainly two types of treatment can be provided by the pharmacists such as non-pharmacological treatment and pharmacological treatment. In non-pharmacological treatments, psycosocial and cognitive rehab can be suggested to the patient (INTO & CPD, 2012). On the other hand, Clubhouse model-deinstitutionalization and supportive psychotherapy are essential to help the schizophrenia patients. However, it is observed that apart from all types of psychiatric therapy, family therapy is most helpful to treat a schizophrenia patient (Ried, 2010).
Medication is considered as the cornerstone in the treatment of schizophrenia. However, the serious side effects of these drugs make the patients with schizophrenia reluctant to consume the medicines (Schellack & Matlala, 2014). Therefore, the pharmacists need to implement proper intervention for each unique patient and insist him or her to consume proper medicine in correct doses. It is found that antipsychotics drugs are used as first line treatment of schizophrenia disease. These medicines are used as a short-term treatment to control psychotic symptoms such as delusions, disorganized thinking, hallucinations etc. most of the pharmacists commonly used these antipsychotic medicines to treat schizophrenia (WANG & YANG, 2012). These drugs are used to control symptoms of schizophrenia by affecting “the brain neurotransmitters”, serotonin and dopamine. The pharmacists need to convince the schizophrenia patients to consumer their medicines by following the prescription (Guevremont et al. 2011). If a pharmacist fails to convince patient to consume the medicine pills, then he need to implement other methods to help the patient, such as giving injection of the drugs instead of medicine pills. In addition, it is the duty of a pharmacist to monitor the condition of a patient after administration of medicine. It is found that administration of some medicine may cause agitation to the patient, in that case the pharmacists can administer benzodiazepine (such as lorazepam), which may be administered with the combination of antipsychotic drugs (O’Reilly et al. 2013).
The first generation medications such as chlorpromazine, fluphenazine, haloperidol and perphenazine has potential and frequent neurological side effects, which include the possible development of “movement disorder”, which may not be reversible. These medicines are still available in the market in cheaper rate than the new medicines (Hoch, 2011). The new, second generation medications are now mostly preferred by the pharmacists because lower risks of side effects than first generation antipsychotic medications. These second generation of medicines are paliperidone (invega), ziprasidone (geodon), iloperidone (Fanapt), asenapine (Saphris), aripiprazole (Abilify), lurasidone (Latuda), risperidone (risperdal), Clozapine (Clozaril), quetiapine (seroquel) and olanzapine (Zyprexa) (Fatima et al. 2011). There are 100 trillion neurons in the human brain, which lose, as the body grew older. However, psychotropic medications affect these neurotransmitters. Some of the drugs mainly target dopamanergic neurons and they used as dopamine blockers. These drugs are also harmful since they affect nigrostriatal tract and mesolimbic tract. Apart from these the use of conventional antipsychotics can cause akathesia (uncontrolled restlessness), Parkinsonism (shuffling gait, masked faces tremor, and stiffness), dystonic reactions (such as muscle spasms, usually neck, tongue, back and eyes) (Ashton & Todd, 2014). Therefore, the uses of atypical agents are increasing among the pharmacists. The reason of increasing use of atypical agents is its efficacy. These atypical agents do not affect nigrostriatal tract, as much-less EPS. However, these atypical agents could affect mesocortical and mesolimbic tracts. Therefore, while choosing an atypical agent a pharmacist need to consider several factors such as side effect profile of an agent, any absolute contraindications or medical risks, etc. On the other hand, pharmacists also need to take care of drug to drug interactions (Burghart, 2013). However, another factor also needs to be considered while prescribing a drug is cost. In addition, while prescribing drugs for the patient doctor’s prescription and patient’s insurance need to be consider.
Risperidone was first introduced in 1993 and should be administrated above 6 mg daily. Weight gain, high prolactin and sedation are the most common side effects of this drug (Phan & VandenBerg, 2012). Olanzipine is also used to treat schizophrenia, which is very sedating and responsible for weight gain. Quetiapine is also used, which is very sedating, moderate for weight gain and used in low doses for “sleep-off label” (O’Reilly et al. 2013). Ziprasidone was first introduced in the market in 2001; this drug can be administered to the patient intravenously. This drug is also used against acute agitation. This is also helpful to lower the incidence of metabolic syndrome (Ashton & Todd, 2014).
When it is found that doctors are not doing their job properly, the pharmacists need to take over the condition. They need to assess the conditions of the patient’s health and then prescribe medicine to them (Fatima et al. 2011). In addition, they need to educate the patient and the family about the schizophrenia and the benefit of proper medication. To resolve the patient’s problems, pharmacists need to recommend the patient for psychological assessment as well as other tests (Roller & Gowan, 2012). If the patient is feeling other problems, such as muscle cramping, eyesight problem, etc. then the pharmacists need to reduce the doses of medicine or change the medicine if necessary (Burghart, 2013). It is found that clozapine, a common drug used to treat Schizophrenia can cause constipation, sleepiness, blurred vision, dizziness, tiredness and headache (WANG & YANG, 2012). Therefore, pharmacists need to change this drug and suggest another drug to patient in order to avoid these complications. Sometimes, it is found that patients who are suffering from Schizophrenia, are submitted into the mental hospital and for their safety the authority lock them in prison (Guevremont et al. 2011). However, this is not the right way to treat a patient with Schizophrenia disease (Phan & VandenBerg, 2012). Therefore, a pharmacist needs to interfere in this treatment process. Pharmacists need to take care of the situation by communicating with the patient’s family as well as with the doctors who are involved in the treatment procedure of that patient. In addition, they also need to talk with the patient and convince him or her for psychological treatment (Hazra et al. 2011). Use of medicine is a cornerstone in the treatment of Schizophrenia patient, however, medicine should be used in minimum doses, since the medicines used in the treatment of Schizophrenia patients have major side effects.
A pharmacist plays a central role in providing patient education. One of the leading reports suggests that individuals suffering from schizophrenia tend to be very loyal to the healthcare provider (reference). The primary healthcare provider in addition to the psychiatrist involves the pharmacist. Pharmacists educate patients regarding the benefit of the basic medication purpose associated with Schizophrenia. Pharmacist also enlists their assistance in proper monitoring of the improvement process (Hoch et al. 2011). Pharmacists help in discussing about other suitable therapeutic strategies with the patients and the physician in order to provide highest beneficial effect from the corresponding treatment.
Patients need be made aware regarding the potential risks in terms of using the antipsychotic drugs that includes sexual dysfunctioning, elevation of the prolactin level and hormonal imbalance. In context to the viewpoint of the pharmacists, patients suffering from schizophrenia need to have a detailed and clear knowledge regarding the optimal dose of the widely available psychotic drugs. Excessive use of these drugs may also lead to worsening of the present condition, which may be termed as a method of drug abuse. In recent day technology, pharmacists are involving strategies for initiating active participation of the patient in improving their own health condition and care (Agid et al. 2010). The pharmacists also emphasize to raise the standards of the treatment methods for providing better medication and care to improve the functioning of the patients. Finally, the end goal treatment of all medication technology involves the improvement of the patients functioning not only in terms of symptomatic improvement of several hallucinations and delusions but also the overall involvement of patient’s entire mental and physical condition.
Pharmacists also provide an instruction regarding the flow of the necessary drug information between the primary mode of care and the psychiatry method of intervention that would provide a larger area to improve the overall health condition and well being of the schizophrenic patient.
In accordance with the present essay, we can conclude that Schizophrenia is one of the most common mental disorders that are characterized by a large number of symptoms including false beliefs, confused thinking and delusions.
The present essay also provides information regarding the effective role of the pharmacists in association with implementation of proper and important medical care plan to the individuals suffering from Schizophrenia. The essay also provides a clear idea regarding definition of the and background history of the present topic which primarily emphasizes on the high ratio of people suffering from the disease, mortality rate with the disease and the specific problems associated in terms of people with different age groups.
The role of pharmacists in context to the present topic provides information regarding the disease pathophysiology, management and various kinds of medicine formulation that provides proper patient care in terms of social advice and ethical value (Crump et al. 2011). The role of pharmacists in the specific management of the disease includes understanding of the pharmacological and non-pharmacological treatment given in different doses for providing proper medical treatment to the individuals suffering from Schizophrenia.
References:
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