Antipsychotic medications, also referred to as major tranquilizers or neuroleptics, should be administered for the treatment of psychosis affecting KN who is a 26-year-old male. They eliminate symptoms linked to psychotic conditions including senile psychoses, psychotic depression, bipolar, drug-induced psychoses, and organic psychoses. In some cases, people with psychosis can be dangerous to others as well as to themselves. It is necessary to evaluate the benefits of starting anti-psychotic medication against the possible side effects (Fusar-Poli et al., 2020). While antipsychotic medications have a long-term effect of lowering the likelihood of developing psychotic episodes, it is associated with short-term sedative effects. This paper intends to evaluate the major difference between atypical and the older typical antipsychotics, psychosis medication, efficacy and side effects, and lithium treatment.
The Major Difference Between Atypical and the Older Typical Antipsychotics
Atypical and typical antipsychotics are varying classes of drugs and belong to different pharmacological divisions as noted in their side effects, actions, and mechanisms. The two drugs have opposing effects in the field of neurogenesis and neuron survival. The antipsychotic drugs tend to reduce the neurotrophin levels such as the Nerve Growth Factor (NGF), Brain-Derived Neurotrophic Factor (BDNF), and Neurotrophin-3 (NT-3). Haloperidol is an example of a typical antipsychotic which uses a free radical-induced mechanism to cause neuron apoptosis. This is involved in the caspase 3 activation, cytochrome c translocation, and B-cell lymphoma-extra large (Bcl-xL) Bcl-XS, P53 protein stimulation (Fusar-Poli et al., 2020). Haloperidol tends to reduce neuroprotection by lowering the BDNF levels to influence haloperidol’s toxic effects.
Contrary to typical drugs, atypical drugs usually come with an opposing effect. These drugs promote neurogenesis and cell survival by increasing the BDNF levels. Moreover, atypical drugs reverse or prevent induced toxicity caused by haloperidol drugs. The reversal mechanism entails the inverse agonism of 5HT receptors especially the 2A subset though the process is usually complicated (Fusar-Poli et al., 2020). Atypical antipsychotics entail new generation drugs while typical antipsychotics belong to an old generation. Typical agents are associated with potent D2 receptor antagonism and extrapyramidal side effects while atypical agents tend to show reduced extrapyramidal symptoms (EPS) and bind multiple receptors (Fusar-Poli et al, 2020). This implies that atypical medications are more effective in the treatment of psychosis.
Atypical antipsychotics are newer drugs that come with an extra action on psychosis symptoms. Atypical antipsychotics have a high degree of occupancy of the serotoninergic receptors 5-HT2A, as well as reduced occupancy and affinity for the dopaminergic receptors. They work on serotonin receptors and dopamine receptors, implying that they influence positive and negative symptoms of the condition (Fusar-Poli et al., 2020). On the contrary, typical antipsychotic drugs usually work on the dopaminergic system where it blocks the dopamine type 2 (D2) receptors.
Medication to Treat the Patient
I would treat the patient with antipsychotic medications because they have a lower risk of pyramidal adverse effects which is an important factor in many patients. They are effective in relieving devastating symptoms such as hallucinations and delusions. The medication can help reduce anxiety, stabilize moods and clear and calm confusion among patients with acute psychosis. Although antipsychotic medications do not address underlying conditions, they are effective in controlling symptoms and preventing psychotic episodes. Psychosis usually occurs following excessive dopamine activities in the brain and the medication tends to block the chemical effort. The obstruction of these activities renders the symptoms less preoccupying and commanding (Fusar-Poli et al., 2020). Although sometimes delusions and hallucinations continue, patients gain the ability to distinguish unreal feelings, and it becomes possible for them to focus on important activities such as family or work.
The best treatment option for the condition is antipsychotic medicine since it is recommended for the first cases. However, it is necessary to monitor the patient since side effects can become overwhelming to a level that the medication should be changed. The adverse impacts and their severity tends to differ from one person to the other (Fusar-Poli et al., 2020). However, some of the negative impacts include weight gain, drowsiness, restlessness, trembling, shaking, blurred vision, muscle spasms and twitches, constipation, dry mouth, and low libido (Fusar-Poli et al., 2020). Antipsychotic medicine can sometimes cause devastating impacts and it’s necessary to monitor patients’ responses.
The patient should be encouraged to report any side effects, particularly in case they become troublesome. Medication should be continued unless otherwise advised by the concerned health professional. Stopping medication in the wrong period or manner can influence symptoms to return. Moreover, patients with cardiovascular disease and epilepsy should be monitored closely and stop the medication in case of complications. The medication can be administered orally or through injections, whereas slow-release antipsychotics can be given once every 1 to 4 weeks (Fusar-Poli et al., 2020). This help reduces adverse effects related to sudden or excessive administration of the medication.
Monitoring for Efficacy and Side Effects of the Medication
Antipsychotics have been proven effective in the improvement of quality of life and reduction of psychosis symptoms during medical interventions. However, the medication usually fails to generate intended results in some individuals, implying that they need alternative interventions. According to Fusar-Poli et al. (2020), antipsychotics are twice as effective as placebo in the treatment of psychosis. The efficacy of the medication usually outweighs the affective and negative effects, suggesting that patients should not fear taking it. Moreover, the medication improves the social functioning and life of patients, particularly in the short-term administration. However, long-term treatment can result in a lower recovery rate and influence the development of brain atrophy. The patient should also be monitored for adverse effects such as shakiness and stiffness, akathisia, slowness and sleepiness, weight gain, constipation, and tardive dyskinesia (Fusar-Poli et al., 2020). It is also necessary to monitor the patient for diabetes, high cholesterol, and seizures.
Lithium as an Alternative Treatment
Antipsychotics should be stopped in case of poor response after two years and replaced with lithium since it is an effective mood stabilizer. The Advanced Practice Nurse (APN) should check the patient for hypoparathyroidism and other side effects such as diarrhea, nausea, edema, tremor, hair loss, and frequent urination. It is also necessary to monitor weight gain and take the necessary intervention to address the problem. Moreover, the APN should examine organs most likely to be affected such as the thyroid, parathyroid, and kidneys, and discontinue the drug in case there are chances of causing a devastating impact on the patient (Fusar-Poli et al., 2020). Other side effects that need to be checked from time to time are Nephrogenic diabetes insipidus and cognitive dysfunction. Excess thirst (polydipsia) and urination (polyuria) occur when the ability of kidneys to produce concentrated urine is affected by the drug.
In conclusion, atypical and typical antipsychotics have many differences in various aspects, including side effects, actions, and mechanisms. Since antipsychotics are a new generation of medication, they offer an effective intervention for the treatment and management of psychosis, particularly for the first incidence cases. Their efficacy usually outweighs their negative effects for the majority of patients. This implies that KN should be monitored for possible adverse reactions that could affect his health and quality of life. The noted adverse effect after two years suggests that antipsychotic drugs should be replaced with lithium and further monitoring continued to identify possible adverse effects.
Fusar-Poli, P., Pablo, G. S., Correll, C. U., Meyer-Lindenberg, A., Millan, M. J., Borgwardt, S.,… & Arango, C. (2020). Prevention of psychosis: advances in detection, prognosis, and intervention. Jama Psychiatry, 77(7), 755-765. Web.