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Psychopharmacological Approaches to Treat Psychopathology
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Psychopharmacological Approaches to Treat Psychopathology
Schizophrenia and its spectrum disorders are disruptive disorders that significantly impact the normal processes of the brain (Chien & Yip, 2013). These disruptive disorders are linked to significant abnormalities because they interfere with the ability to think. Patients may struggle to function normally when the symptoms of these disruptive disorders are not controlled or managed. However, proper diagnosis and treatment of these disorders under close supervision of a psychiatric mental health practitioner enable patients to thrive. There are different psychotropic agents used to treat patients with psychotic disorders like schizophrenia. Prompt initiation of pharmacological treatment for schizophrenia and other psychotic disorders is essential, particularly within five years of the first acute episode (Patel et al., 2014).
Pathophysiology of Schizophrenia
Based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), schizophrenia refers to a syndrome characterized by a high relapse rate (>70%), mood problems, negative symptoms, and bizarre delusions and behaviors over a long duration (Chien & Yip, 2013). The pathophysiology of schizophrenia is based on abnormalities in neurotransmission in terms of a deficiency or excess of neurotransmitters. Most of the symptoms of this psychotic disorder are associated with abnormal activity at dopamine receptor sites. As shown in Figure 1, four dopaminergic pathways (mesocortical, nigrostriatal, mesolimbic, and tuberoinfundibular) are involved in the development of symptoms of schizophrenia. Low dopamine levels within the nigrostriatal pathway result in motor symptoms whereas a decrease or blockade of dopamine in the tuberoinfundibular pathway increases prolactin levels. While the mesolimbic pathway may play a role in the positive symptoms of this disorder, low dopamine levels in the mesocortical pathway generate cognitive deficits and negative symptoms.
Figure 1: Pathophysiology of Schizophrenia
Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4159061/
Psychopharmacological Medication Agent
Antipsychotic agents are commonly used to treat many schizophrenic patients, particularly within the first five years of the initial acute episode. Pharmacological therapy should be administered immediately if an acute psychotic incident occurs. One of the medications used for the treatment of schizophrenia is loxapine, which is a first-generation antipsychotic agent. According to Chien & Yip (2013), loxapine is a typical antipsychotic agent that helps to reduce positive symptoms of the condition by improving mood, thinking, and behavior. It belongs to a class of drugs known as antipsychotics. The drug is sold under different names depending on the administration route and dosage. For inhalation only, loxapine is sold under the brand names Adasuve and Loxitane. However, it is sold as Loxitane for oral intake. The appropriate FDA indication use for loxapine is to treat symptoms of schizophrenia.
Pharmacokinetics and Pharmacodynamics of Loxapine
As a dibenzoxazepine...…compliance, and safety. When orally administered, the half-life of loxapine is 4 hours while the intramuscular and inhaled route is between 8-23 hours and 6-8 hours respectively (Popovic, Nuss & Vieta, 2015). Some potential adverse reactions or side effects of loxapine include drowsiness, weakness, insomnia, seizures, weight gain/loss, headache, nasal congestion, and constipation.
Necessary Considerations
The treatment of schizophrenia using loxapine requires consideration of comorbidities that can co-occur with the condition. Some of these comorbidities include substance use disorders, depression, panic, and obsessive-compulsive disorders. These comorbidities interact with psychotic symptoms in clinically significant ways and could result in adverse outcomes. Healthcare providers should also make legal and ethical considerations during treatment including the recommended dosage, patient education/consent, potential side effects, safety and efficacy concerns, and FDA recommended uses. Patient education is a critical consideration as it affects safety, efficacy, and compliance with medication. Some pertinent patient education considerations include drug interactions, potential side effects, clinical circumstances, and competency to understand information.
In conclusion, schizophrenia refers to a syndrome characterized by a high relapse rate, mood problems, negative symptoms, and bizarre delusions and behaviors over a long duration. Schizophrenia is treated using pharmacological and non-pharmacological therapy. One of the medications used to treat this condition is loxapine, which is sold under the brand names Adasuve and Loxitane. The appropriate…
References
Chien, W.T. & Yip, A.L.K. (2013). Current approaches to treatments for schizophrenia spectrum disorder, Part I: An overview and medical treatments. Neuropsychiatric Disease and Treatment, 9, 1311-1332.
Medscape. (2021). Loxapine (Rx). Retrieved July 16, 2022, from https://reference.medscape.com/drug/loxitane-loxapine-342975#6
Patel, K.R., Cherian, J., Gohil, K. & Atkinson, D. (2014). Schizophrenia: Overview and treatment options. Physical Therapy, 39(9), 638-645.
Popovic, D., Nuss, P. & Vieta, E. (2015). Revisiting loxapine: A systematic review. Annals of General Psychiatry, 14(1), 1-8.
Smith, D.A., Beaumont, K., Maurer, T.S. & Di, L. (2018). Relevance of half-life in drug design. Journal of Medicinal Chemistry, 61(10), 4273-4282.
Spyker, D.A., Riesenberg, R.A. & Cassella, J.V. (2015). Multiple dose pharmacokinetics of inhaled loxapine in subjects on chronic, stable antipsychotic regimens. Journal of Clinical Pharmacology, 55(9), 985-994.
Schizophrenia Psychosis and Lifespan D Schizophrenia and Psychosis and Lifespan Development Schizophrenia and Psychosis Matrix Disorder Major DSM-IV-TR Categories Classifications Subclassifications Schizophrenia and Psychosis Symptoms Positive (Type I): represent excesses or distortions from normal functioning Delusions Bizarre Nonbizarre Hallucinations Auditory Visual Disorganized Speech Loose Association Neologisms Clang Associations Echolalia/Echopraxia Word Salad Grossly disorganized behavior Catatonic: motoric Waxy Flexibility Negative (Type II): the absence of functioning Apathy Affective Flattening Withdrawal Anhedonia Avolition Poor Concentration Poverty of speech Alogia Schizophrenia and Psychosis Diagnostic Types Paranoid Delusions and Hallucinations Disorganized Disorganized speech Disorganized behavior Withdrawal Affective flattening Catatonic Grossly disorganized behavior Disorganized speech Catatonic Echolalia/Echopraxia Undifferentiated Active symptoms that do not fit other diagnostic types Residual No Type I symptoms but some negative symptoms Schizoaffective
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