Chapter 56. Schizophrenia
Which of the following is the best way to reduce the risk of relapse?
a. Acute treatment with antipsychotic therapy
b. Acute treatment with nonpharmacologic therapy
c. Maintenance treatment with nonpharmacologic therapy
d. Maintenance treatment with antipsychotic therapy
Answer d is correct. Most patients with schizophrenia require life-long antipsychotic treatment to adequately manage symptoms. Long-term treatment with an antipsychotic will treat schizophrenia and will help prevent the patient from relapsing.
Answer a is incorrect. Acute treatment with antipsychotics temporarily treats and stabilizes the patient’s symptoms, but, in most cases, it is not adequate to prevent relapse without maintenance treatment.
Answer b is incorrect. Nonpharmacologic therapy such as psychosocial support groups and programs may be useful when combined with antipsychotics; however, nonpharmacologic therapy by itself generally will not treat schizophrenia and prevent relapse. Acute treatment with non-pharmacologic therapy alone is not adequate to prevent relapse.
Answer c is incorrect. Nonpharmacologic therapy, such as psychosocial support groups and programs, may be useful when combined with antipsychotics; however, nonpharmacologic therapy by itself generally will not treat schizophrenia and prevent relapse. Maintenance treatment with nonpharmacologic therapy alone is not adequate to prevent relapse.
SW is a 45-year-old woman with a 15-year history of schizophrenia. SW is a healthy woman with a history of asthma and no other medical conditions. She is currently prescribed albuterol and budesonide/formoterol for the treatment of her asthma. Her most recent labs were drawn 3 months ago and were within normal limits. SW was on paliperidone for the treatment of schizophrenia. However, about 2 weeks ago she stopped taking her antipsychotic medication. She recently lost her job and cannot afford her medication. SW’s psychiatrist has prescribed perphenazine and has encouraged SW to maintain adherence with this medication. SW states that she will be able to afford perphenazine and is willing to take this medication because she knows the she needs to remain adherent in order to control her symptoms. SW has now been taking the perphenazine for 2 days. Today she presents with a stiff neck and muscle spasms. Her psychiatrist has identified this reaction as dystonia. Which of the following agents may be used to treat SW’s extrapyramidal symptoms (EPS)?
Answer c is correct. Benztropine is an anticholinergic that can be used to treat dystonia. Anticholinergics such as benztropine and diphenhydramine are usually the preferred drugs of choice for the treatment of this ...