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Psychosis

mental health condition characterized by:


Delusions Hallucinations Illusions paranoia

May be acute or chronic Causes:


Pathology Genetics Unidentifiable cause

Individual cannot function normally in society

Schizophrenia
Most common psychiatric disorder Generally symptoms appear in early adulthood Symptoms may occur suddenly or may take months or years to develop Apparent genetic component May also be r/t NT imbalances Symptoms include:
Hallucinations, delusions, paranoia Rambling statements, made-up words Rapid alteration between hyperactivity and stupor Indifferent/detached Strange or irrational action Deterioration in hygiene, work or academic performance Withdrawal from social interaction or interpersonal relationships

Schizoaffective Disorder
condition in which client exhibits symptoms of both schizophrenia and mood disorders Deep depression follows acute symptoms In time, both positive and negative symptoms will manifest Must rule out other conditions causing bizarre behavior
Chronic amphetamine or cocaine use Certain complex partial seizures Brain neoplasms, infections, or hemorrhage

Pharmacologic Management of Psychoses


Mechanism of action of all antipsychotics:
Act by entering dopaminergic synapses and competing for dopamine, thus blocking the majority of dopamine receptors.

Compliance decreases when undesirable side effects are produced Primary goal:
Reduce psychotic symptoms to level that allows client to function as a normal member of society.

Atypical Antipsychotics
Second generation broader spectrum, control both positive and negative symptoms Produce effect without causing extrapyramidal symptoms Mechanism of action: unknown; thought to block several different receptor sites in the brain

Atypical Antipsychotics
Prototype: clozapine (Clozaril) p. 219 Others:
Olanzapine (Zyprexa) Risperidone (Risperdal)

Adverse effects:
Tachycardia, transient fever, sedation, dizziness, headache, somnolence, anxiety, nervousness, hostility, insomnia, n/v, constipation, parkinsonism, akathisia Serious: neurolepic malignant syndrome, agranulocytosis