Kevin, a 34-year-old man was diagnosed with schizophrenia
Kevin, a 34-year-old man was diagnosed with schizophrenia 11 years ago. Kevin experienced his first psychotic episodes during his first year at college with symptoms of paranoia, anger, social withdrawal, and hallucinations. He also engaged in substance abuse of alcohol and marijuana use. In his second year of college, Kevin was arrested after initiating a fight with the college librarian who caught him ripping out books in the library with the intent to set them on fire. Soon after, he was hospitalized and diagnosed with schizophrenia. Since that time, Kevin dropped out of college, and has not been able to hold on to a steady job for more than several months, spending much of the time smoking marijuana and tobacco. In the early course of his condition, Kevin was prescribed with several trials of various typical antipsychotics including chlorpromazine, haloperidol, and loxapine; however, these drugs were only partially effective in reducing Kevin’s symptoms and caused him some mild tardive dyskinesia. More recently, he was prescribed with different atypical antipsychotics including clozapine, aripiprazole, and lurasidone, but the metabolic side effects of these drugs, which include weight gain, and hyperglycemia have caused Kevin to be intermittently adherent to his therapy. As a result, Kevin has been hospitalized 8 additional times in the last 10 years for acute psychotic episodes, with 4 unsuccessful attempts of suicide. Although Kevin has alienated himself from most of his family and friends, his mother is dedicated to accompanying him to his scheduled medical visits.
Kevin and his mother meet with his pharmacist to discuss how they can help facilitate Kevin’s adherence to his medication, and how to deal with adverse effects associated with his prescribed treatment.
Discuss The Role of the Pharmacist in Improving Outcomes in the Schizophrenic Patient: Balancing Pharmacological, Metabolic, Safety, and Adherence Concerns