Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Introduction:

This paper is aimed at assessing and treating a Pakistani female with delusional thoughts. Patient is a Pakistani woman aged 27 who suffers from a history psychiatric illnesses for which she receives medication. She believes that she’s being monitored, and her thoughts controlled. These delusions have caused her considerable distress for several months and she sought psychiatric assistance. This document will provide a rationale for each of the available medication choices and discuss what the options are.

First Decision:

The choice of medicine is the first thing that must be made. Psychosis is present if the patient has delusions. According to the American Psychiatric Association’s (2019) guidelines, antipsychotic medications are the primary treatment of psychosis. First-generation and second generation antipsychotics are the options for antipsychotics.

Considering the patient’s condition, the best option for her would be to start with an SGA as they have lower extrapyramidal side effects (EPS) compared to FGAs. SGAs are also known to be effective against both positive and negative symptoms of psychosis (Freudenreich, Goff, & Henderson, 2016). Risperidone out of two SGA options: quetiapine or risperidone, is deemed the more effective option.

Risperidone has shown itself to be superior in its ability to treat positive psychotic symptoms (Komossa and colleagues, 2009). Risperidone is also more effective than quetiapine in treating positive symptoms of psychosis (Komossa et. al., 2009). Accordingly, it was decided to prescribe risperidone for this patient.

Other options included quetiapine or haloperidol. Haloperidol has a much higher EPS compared to SGAs. It is therefore not the right choice for patients. Quatiapine was found to have a lower efficacy than risperidone when treating positive symptoms. Risperidone has been found to be a superior option over quetiapine.

When treating psychotic patients, ethical considerations become crucial. The patient’s delusions can cause her significant distress and affect her quality of life. It is important to establish a trusting and empathic therapeutic relationship with patients. Patients must be educated about the condition they are in, their treatment plan and side effects of prescribed medication. Patients should be allowed to decide on their own treatment and cultural beliefs.

Decide #2

It is important to determine the correct dosage for risperidone. Risperidone dosage is recommended to be between 4-6mg/day. (Freudenreich, et. al. 2016). However, the patient’s pharmacokinetic and pharmacodynamic processes need to be taken into account before deciding on the dosage. The patient is 27-year old Pakistani female, and the ethnicity of a person can influence their metabolism.

The patient may also have a past history of mental illness that can influence the pharmacokinetics. Therefore, a lower dosage of risperidone should be prescribed initially, and the patient’s