solved

To Prepare:
Choose one of the two following specific populations: either pregnant women or older adults. Then, select a specific disorder from the DSM-5-TR to use.
Use the Walden Library to research evidence-based treatments for your selected disorder in your selected population (either older adults or pregnant women). You will need to recommend one FDA-approved drug, one non-FDA-approved “off-label” drug, and one nonpharmacological intervention for treating the disorder in that population.
By Day 3 of Week 9
Recommend one FDA-approved drug, one off-label drug, and one nonpharmacological intervention for treating your chosen disorder in older adults or pregnant women.
Explain the risk assessment you would use to inform your treatment decision making. What are the risks and benefits of the FDA-approved medicine? What are the risks and benefits of the off-label drug?
Explain whether clinical practice guidelines exist for this disorder, and if so, use them to justify your recommendations. If not, explain what information you would need to take into consideration.
Support your reasoning with at least three current, credible scholarly resources, one each on the FDA-approved drug, the off-label, and a nonpharmacological intervention for the disorder.
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Week 9 Discussion Main Post
Most people with schizophrenia struggle to understand the severity of their symptoms. Some of their ideas about their illness indicate that health professionals should provide more thorough education about their condition (Irawani & Asniar, 2022). The patients with schizophrenia of various ages. The nature of schizophrenia spectrum disorders with onset in middle or late adulthood remains controversial. Our study aimed to determine patients aged 60 and older (Smeets-Janssen et al., 2020).
Younger patients with schizophrenia have experienced fewer adverse of the illness than older patients. Antipsychotic use in the elderly is related to severe side effects. (Targum et al., 2017). Careful consideration of comorbidity and polypharmacy is imperative (Behrman, Burgess & Topiwala, 2018). In this discussion, I will discuss schizophrenia in older adults and talk about one FDA-approved drug, one non-FDA-approved “off-label” medication, and one nonpharmacological treatment.
The United States Food and Drug Administration has approved the administration of antipsychotic medications in treating schizophrenia in older adult populations in older adults with schizophrenia. In contrast to traditional antipsychotics, Seroquel is an atypical antipsychotic medication that is recommended. Atypical antipsychotics are available in various doses, but the recommended Seroquel dosage for elderly adults with schizophrenia should start from 50 mg at night, which helps also sleep. Seroquel doses will adjust depending on the patient’s condition,
An off label such as lithium has been used in studies to help enhance mood and conduct in some patients but does not have an antipsychotic effect. They are used for the treatment of mania and depression. Lithium is the gold standard therapy for bipolar disorder (BD) but its effectiveness differs widely between individuals., it is also sometimes used to treat schizophrenia (Leucht, Helfer, Dold, Kissling, & McGrath 2015).
The nonpharmacological intervention recommended for older adults with schizophrenia is psychosocial therapy. A long history of research has been conducted on psychosocial interventions aiming at enhancing independent functioning and social skills in schizophrenia. These therapies may be particularly beneficial in elderly patients since many fails to respond completely to antipsychotic medications (Cooper et al., 2020). Recent work has evaluated the benefits of a new, combined Cognitive Behavioral, Social Skills Training (CBSST) intervention in groups of older patients with primarily early-onset schizophrenia. Cognitive Behavior Therapy (CBT) combines the Social Skills Training (SST) elements of problem-solving and role-playing with the Cognitive Behavior Therapy (CBT) techniques of thought identification and challenging (Rajji, Mamo, Holden, Granholm, Mulsant 2021).
If the behavior is not under control, antidepressant medications with shorter half-lives may avoid drug accumulation, causing sedation, memory problems, and an increased risk for falls. Elderly patients are more susceptible have caused severe side effects—for example, extrapyramidal symptoms(EPS)and tardive dyskinesia. (Grover, Chakrabarti, Kulhara, & Avasthi, 2017).
Patients and caregivers must look for side effects. Clinicians’ practice guidelines allow noncompliance and therapy-associated adverse effects when creating a thorough treatment plan to manage schizophrenia (Patel, Cherian, Gohil, & Atkinson 2018).
The American Psychiatric Association’s (APA’s) clinical practice standards are critical in helping healthcare practitioners select healthcare options for schizophrenic patients. The therapeutic procedures for schizophrenia are founded on proven medication and nonpharmacological therapies. To the guidelines, mentally ill persons like people with schizophrenia should be treated with an antipsychotic drug, and their efficacy and adverse reactions should be monitored carefully.
References
Behrman, S., Burgess, J., & Topiwala, A. (2018). Prescribing antipsychotics in older people: A mini-review. Maturitas, 116, 8-10. https://doi.org/10.1016/j.maturitas.2018.06.015
Cooper, R. E., Laxhman, N., Crellin, N., Moncrieff, J., & Priebe, S. (2020). Psychosocial interventions for people with schizophrenia or psychosis on minimal or no antipsychotic medication: A systematic review. Schizophrenia Research, 225, 15-30. https://doi.org/10.1016/j.schres.2019.05.020
Grover, S., Chakrabarti, S., Kulhara, P., & Avasthi, A. (2017). Clinical Practice Guidelines for Management of Schizophrenia. Indian journal of psychiatry, 59(Suppl 1), S19-S33. https://doi.org/10.4103/0019-5545.196972
Irawani, F. H., & Asniar, M. (2022). The Symptoms and Causes of Schizophrenia Perceived by Indonesian People with Schizophrenia: A Phenomenology Study. International Journal of Nursing Education, 14(2), 95-101. https://doi.org/10.37506/ijone.v14i2.18000
Leucht, S., Helfer, B., Dold, M., Kissling, W., & McGrath, J. J. (2015). Lithium for schizophrenia. The Cochrane database of systematic reviews, 2015(10), CD003834. https://doi.org/10.1002/14651858.CD003834.pub3
Patel, K. R., Cherian, J., Gohil, K., & Atkinson, D. (2018). Schizophrenia: overview and treatment options. P & T : a peer-reviewed journal for formulary management, 39(9), 638-645.
Rajji TK, Mamo DC, Holden J, Granholm E, Mulsant BH (2021). Cognitive-Behavioral Social Skills Training for patients with late-life schizophrenia and the moderating effect of executive dysfunction. Schizophr Res. 2022 Jan;239:160-167. doi: 10.1016/j.schres.2021.11.051. Epub 2021 Dec 9. PMID: 34896870.
Smeets-Janssen, M. M. J., Aderka, I. M., Meesters, P. D., Lange, S., Schouws, S., & Rhebergen, D. (2020). Admixture analysis of age at onset in older patients with schizophrenia spectrum disorders. International Psychogeriatrics, 32(6), 781-785. https://doi.org/10.1017/S104161022000085X
Targum, S. D., Risinger, R., Du, Y., Pendergrass, J. C., Jamal, H. H., & Silverman, B. L. (2017). Effect of patient age on treatment response in a study of the acute exacerbation of psychosis in schizophrenia. Schizophrenia Research, 179, 64-69. https://doi.org/10.1016/j.schres.2016.09.034
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