Treatment of Psychosis

Psychosis

Psychosis is a mental health disorder that interferes with how information is processed by the brain. It affects one’s perceptions and thoughts, leading to loss of touch with the reality (Preston et al., 2017). People with the condition often hear, see, and believe in unreal things. The current essay discusses developments in psychosis development, side effects of antipsychotic medications, neurotransmitters affected, ethical concerns, and challenges faced by mental health professionals. The essay also presents a case study illustrating a client who can benefit from antipsychotic medications, and it proposes a treatment plan.

Major Developments in the Treatment of Psychosis Including Major Drug Classes

Before the 1950s, no attention was given to psychosis. People affected by the condition were simply locked away. However, in the 1950s and 60s, there emerged first-generation antipsychotics such as haloperidol and fluphenazine (Lichtblau, 2011; Wright et al., 2014). These drugs were used to control delusions, hallucinations and other symptoms of psychosis. During the 1970s, there was limited usage of the antpychotic medication due to its side effects and ineffectiveness. This led to the discovery of second-generation (or atypical) antipsychotics. Examples include asenapine, aripiprazole, and clozapine in the 19180s (Lichtblau, 2011; Wright et al., 2014).

The second-generation drugs had little side effects and were fairly effectual. However, again this generation of antipychotics was associated with undesirable effects, including agranulocytosis. From 1990s up to date, research wok on effective antipsychotic drugs for the treatment of psychosis continues. This has led to the introduction of new agents. Examples include iloperidone, lurasidone, and pariperidone (Wright et al., 2014). The usage of such drugs is associated with better patient outcomes.

Severe Side Effects of Antipsychotic Medications and Potential Alternative Treatments

Antipsychotic medications are associated with some severe side effects. One of the side effects is tardive dyskinesia (Capps, 2014). This is a condition that leads to unusual movements of the tongue, jaw and lips. Another serious side effect of the medications is akathisia (Capps, 2014). Akathisia is basically a movement disorder characterized by restlessness as a result of an urge that force one to move. Sexual problems are another side effect of the antipsychotic drugs (Capps, 2014; Preston et al., 2017). This is due to changes in hormones.

Due to the side-effects of antipsychotic medications, it is important to shift attention to alternative treatment of psychosis. Some of the common examples of alternative medications on the same include ayurvedic herb, vitamin B6, estradiol, and ginkgo biloba (Hoenders et al., 2018). These substances can be effective when used alongside the antipsychotic disorders.

Neurotransmitters Involved with and Affected by the Medications

One of the major neurotransmitters that are involved in conveying messages to different parts of the brain is dopamine. Antipsychotic drugs help to block dopamine receptors (Preston et al., 2017, Bansal & Deb, 2020). This leads to the reduction of the messages flowing around the brain. The process plays a significant role in combating psychotic symptoms such as hallucinations and delusions. Apart from dopamine, there are other transmitters affected by the antipsychotic medications. They include serotonin, and noradrenaline (Bansal & Deb, 2020). The blockage of the receptors of these neurotransmitters also helps to relieve symptoms of psychosis.

Ethical Concerns Related to the Treatment of Psychotic Disorders and How to Address Them

The treatment of psychotic disorders raises some ethical concerns. One of the major concerns is one pertaining to the informed consent. Most patients with psychotic disorders lack decision-making capacity due to psychotic symptoms (Jain et al., 2017). This makes it difficult for give their consent. Another concern centers on the issue of confidentiality. Some mental health professionals do not show sensitivity in the diagnosis of the conditions of their clients. They end up sharing their health information with colleagues and family members (Jain et al., 2017). This is harmful to the affected individual. It is also important to note that psychotic disorders raise a concern associated with conflict of interest. For example, some mental health practitioners make poor professional judgment due to the fact that the secondary interest (financial gain) tends to outweigh the primary interest (patient’s welfare) (Jain et al., 2017). This leads to poor patient outcomes.

Challenges Mental Health Professionals Face in Treating Psychotic Disorders and How to Address Them

There are several challenges that mental health professionals face in the process of treating persons with psychotic disorders. To begin with, some clients refuse to accept their conditions (Preston et al., 2017). This makes it difficult for them to undergo treatment. To address this problem, there is need for mental health professional to provide proper guidance and counseling to a client. The client should be assured his or her condition will change if treated. While some clients drop out of the therapeutic treatment processes, others choose not to adhere to them (Gaebel & Zielasek, 2015; Preston et al., 2017). In order to address this kind of problem, it is important to sensitize such clients on the importance of adhering to treatment procedures. This leads to poor treatment outcomes. Other clients present themselves for treatment with substance abuse (Gaebel & Zielasek, 2015; Preston et al., 2017). This makes it difficult for them to respond well to the treatment they receive. To address the problem, it is important to provide patient education on the harmful effects of substance abuse.

Original and Hypothetical Case Study Illustrating a Client that Would Benefit from Antipsychotic Medications and a Brief Explanation of Treatment Plan

Case Study

Allan is a 21 year-old young man who has been brought to a mental healthcare facility in the company of his parents. He was suspended from college last month after a commotion with his professor. He had accused the professor of giving him bad grades. Allan’s behavior has increasingly become odd over the last one year. In college, he started avoiding friends and did not talk to most of his classmates. He also did not care about his physical appearance since he wore the same clothes for a number of days. Prior to his suspension, he had started missing classes. Back at home, Allan’s mother says he sometimes mumbles to himself and he seems to talk to unseen people.

An examination of Allan reveals that he is poorly groomed. He seems to be preoccupied with something since he is not attentive. His family members report that he has never been on drugs. Drug screening results confirm this since they are negative. The father adds that his son’s great-grandmother had spent many years in a mental health hospital. After other examinations and enquiries, Allan accepts to get admitted into a psychiatric unit of the health care facility for treatment.

Treatment Plan

From the above case study, it is clear that Allan is suffering from schizophrenia. Schizophrenia is one of the major psychotic disorders characterized by abnormal interpretations of the reality (Gaebel & Zielasek, 2015). Some of the major symptoms of the condition include delusions, hallucinations, disorganized thinking, abnormal behavior, and impaired functioning. It is believed that this disorder is due to a combination of genetic factors, environment, and brain chemistry (Gaebel & Zielasek, 2015). If untreated, the condition can lead to anxiety, depression, academic challenges, social isolation, and suicidal feelings.

Schizophrenia can be managed through an effective treatment plan. The condition calls for a lifelong treatment. Allan should be subjected to first-generation antipsychotic drugs such as chlorpromazine and halopperidol. If these drugs cause side effects, he can be given second-generation antipsychotic medicines such as clozapine, lurasidone, and quetiapine. The administration of these drugs can be combined with psychosocial therapy. If all these remedies fail to work, it will be important to use alternative medicines. These may include ayurvedic herb and estradiol.

References:

Bansal, P. K., & Deb, P. K. (2020). Frontiers in Pharmacology of Neurotransmitters. Singapore: Springer

Capps, D. (2014). Understanding Psychosis: Issues, Treatments, and Challenges for Sufferers and Their Families. Lanham: Rowman & Littlefield Publishers.

Gaebel, W., & Zielasek, J. (2015). Schizophrenia in 2020: Trends in Diagnosis and Therapy. Psychiatry and Clinical Neurosciences, 69 (11): 661-673.

Hoenders, H. J. R., Bartels-Velthuis, A. A., Vollbehr, N. K., Bruggeman., Knegtering, H., & de Jong, J. T. V. M. (2018). Natural Medicines for Psychotic Disorders: A Systematic Review. 206 (2): 81–101. doi: 10.1097/NMD.0000000000000782

Jain, S., Kuppili, P. P., Pattanayak, R. D., & Sagan, R. (2017). Ethics in Psychiatric Research: Issues and Recommendations. Indian J Psychol Med., 39 (5): 558-565.  doi: 10.4103/IJPSYM.IJPSYM_131_17

Lichtblau, L. (2011). Psychopharmacology Demystified. Clifton Park, NY: Delmar, Cengage Learning

Preston, J. D., O’Neal, J. H., & Talaga, M. C. (2017). Handbook of Clinical Psychopharmacology for Therapists (8th ed.). Oakland, CA: New Harbinger.

Wright, N. P., Turkington, D., Kelly, O. P., Davies, D., Jacobs, A. M., & Hopton, J. (2014). Treating psychosis: A Clinician’s Guide to Integrating Acceptance & Commitment Therapy, Compassion-Focused Therapy & Mindfulness Approaches within the Cognitive Behavioral Therapy Tradition. Oakland, CA: New Harbinger Publications, Inc.