Psychopharmacology

1 Psychopharmacology Mental illnesses have significant social, mental, and psychological health impacts on individuals. The symptoms that typify these conditions, including abnormal thinking, poor cognition, mood changes, irrational thinking and violent behavior make it almost impossible for an individual to participate in normal life activities (Geddes & Andreasen, 2020). Some common mental health disorders are depression, bipolar disorder, addiction, and anxiety disorders. Studies show that most of these illnesses persist throughout life (Anderson & McAllister-Williams, 2015). Fortunately, they can be controlled through appropriate treatment. Psychotherapy and the use of pharmacological agents are the recommended interventions in the treatment of psychological disorders. These interventions aim to lower the severity of the symptoms, reduce the risk of relapse, and improve the health and lifestyle of an individual (Geddes & Andreasen, 2020).

A wide range of medications has been approved for the treatment of different mental health disorders. The determination of the medication and the psychotherapeutic intervention to apply is dependent on the mental health needs of a person (Anderson & McAllister-Williams, 2015). The psychiatric mental health practitioner (PMHNP) assesses the client and develops a treatment plan that suits his/her health needs. This discussion explores the treatment of the bipolar disorder.

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HPI and Clinical Impression The client selected for this exercise is a 37-year-old Pakistani female patient brought to the facility by her uncle. The uncle stated that the client has been delusional for about two weeks.

Within the last two weeks, the client presented with uncharacteristic bouts of aggression and moodiness. At times she looks confused and inattentive. Her appetite has also decreased significantly. The client has been previously hospitalized with a brief psychotic disorder. During the previous hospital visit, the client was prescribed Geodon 40 mg Bid with meals. However, she has been noncompliant.

Psychopharmacologic Intervention The most suitable pharmacologic intervention for the client is Lurasidone 40 mg PO qDay initially. The dosage can be increased or decreased per the client's response to treatment.

Latuda was administered to help the client overcome non-compliance with treatment (Franklin, Zorowitz, Corse, Widge & Deckersbach, 2015). The most likely cause of non-compliance for this client is the side effects of Geodon. Latuda was recommended since it is taken once per day.

The side effects are less severe and tolerable. Lurasidone effectively rebalances neurotransmitter levels in the brain, subsequently improving thinking, behavior, mood, memory, and attention (Franklin, Zorowitz, Corse, Widge & Deckersbach, 2015).

Psychotherapy The most appropriate psychotherapy for the client is Cognitive Behavioral Therapy. CBT requires about 8 sessions to complete with each session lasting for approximately 90 minutes.

This therapeutic intervention is effective in improving the bipolar symptoms in addition to eradicating the risk of relapse. CBT is also effective in improving the psychosocial functioning

3 of a person (Chiang, Tsai, Liu, Lin, Chiu & Chou, 2017). In this intervention, the client is shown how to breakdown overwhelming problems into smaller, manageable portions. The client is also trained on how to tackle current issues contributing to depressive symptoms rather than focusing on past issues (IBPF, 2020). CBT is intended to eradicate some of the symptoms that were not addressed with medications such as decreased appetite and non-compliance.

Medical Management Needs The primary care needs for the client include mood stabilization, reduction of anxiety, and alleviation of relapse of depressive symptoms. These symptoms appear to have affected the client's social capabilities. She finds it hard to interact with her family and concentrate on family matters. The treatment plan, therefore, needs to focus on improving the psychosocial functioning of the client. Moreover, the client needs the education to avert the risk of non-compliance with treatment.

Community Support The presence of community support resources is essential in the management of bipolar depression. Family support, for instance, is important since it ensures that the patient is guaranteed a safe home environment. The client can also obtain social support from communitybased agencies such as the Depression and Bipolar Support Alliance (2020). This organization provides education, peer support, and inspiration to individuals presenting with various forms of depressive disorders. The international bipolar foundation could also be helpful to the client.

This organization provides support services such as counseling and therapy to persons with bipolar disorder.

Follow-up Plan

4 A one-month follow-up plan is suitable for the client. The client can, however, visit the facility in case the symptoms persist. One month was selected since some medications, including Latuda, take approximately four weeks to achieve the intended therapeutic effects. The client was also be referred to as a psychological counselor for further assessment and counseling.

Conclusion Due to the devastating impacts of depressive symptoms on patients, treatment should be initiated promptly before the disease progresses to critical stages. The use of pharmacological agents and psychotherapy can improve the mental health of a person. Clients should be followedup closely due to the possibility of side effects and non-compliance among patients.

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References Anderson, I. M., & McAllister-Williams, R. H. (Eds.). (2015). Fundamentals of clinical psychopharmacology. CRC Press.

Chiang, K. J., Tsai, J. C., Liu, D., Lin, C. H., Chiu, H. L., & Chou, K. R. (2017). Efficacy of cognitive-behavioral therapy in patients with bipolar disorder: A meta-analysis of randomized controlled trials. PloS one, 12(5), e0176849. https://doi.org/10.1371/journal.pone.0176849 Depression and Bipolar Support Alliance (2020). Depression and Bipolar Support Alliance. https://www.dbsalliance.org/ Franklin, R., Zorowitz, S., Corse, A. K., Widge, A. S., & Deckersbach, T. (2015). Lurasidone for the treatment of bipolar depression: an evidence-based review. Neuropsychiatric disease and treatment, 11, 2143. https://dx.doi.org/10.2147%2FNDT.S50961 Geddes, J. R., & Andreasen, N. C. (2020). New Oxford textbook of psychiatry. Oxford University Press.

IBPF. (2020). International Bipolar Foundation. https://ibpf.org/learn/resources/