SCHIZOPHRENIA Flashcards
17 yo w/ dx of schizophrenia for 2 yrs believes people can read his thoughts
and has AH, currently on risperidone 6
mg, hx of high dose olanzapine and
haldol. What is next line? (2x)
Discontinue Risperidone and start
Clozapine
Most participants on anti psychotics
drop out of the Treatment of Early Onset
Schizophrenia Spectrum study (TEOSS)
due to lack of efficacy and? (2x)
Weight gain
Why should anticholinergic medications
given to prevent EPS be gradually
tapered after stabilization? (2x)
Decrease cognitive burden of
anticholinergics
What differentiates primary psychosis
from psychotic symptoms related to
trauma? (2x)
Disorganized thought and behavior
Youth develops tardive dyskinesia with
long term risperidone, even with reducing
dose and trials of nearly every other
atypical? Next step?
Switch to Clozapine
Why should you administer clozapine twice a day?
Lower daily peak concentration
Efforts focused on developing selective
interventions to prevent onset of psychosis have focused on?
Screening children whose parents have schizophrenia
Early onset (less than 18 yo) schizophrenia
have what genetic finding as compared to
adult onset schizophrenia?
Higher rates of rare genomic deletion or duplication mutations
What describes the relationship between prodromal state in later development of psychotic disorder?
Less than half of prodromal patients will go
on to develop a psychotic disorder
Treatment of Early-Onset Schizophrenia Spectrum Disorders (TEOSS) clinical trial showed what impact on cognitive functioning at one year?
Minimal neurocognitive improvement
Characteristic of childhood-onset
schizophrenia that differs from adult-onset?
Presents with greater illness severity
16 yo w/ schizophrenia has gained
excessive weight w/treatment of
olanzapine. Histamine rebound would most likely occur with which cross taper?
Aripiprazole
Primary treatment medication for
catatonia?
Benzodiazepine
16 yo with psychosis, on risperidone,
gained 20 pounds since 2 months. Unable to lower dose because symptoms worsen.
Next step?
Cross taper to aripiprazole or ziprasidone
Medication with most evidence for treating inappropriate weight gain in pediatric patients on second-gen antipsychotics
Metformin
Kindergarten child on quetiapine for 6 months reports seeing a hero-like figure that talks to the patient. Only upsetting when hero gives him incorrect answers in school. Family agrees to start psychotherapy. What should be done about medication?
Observe them off of Quetiapine
Higher levels of aggressive/antisocial behavior is an indicator of poorer outcomes in which disorders?
Psychotic and substance use disorders
Most appropriate ECT indication in
adolescents?
Refractory Catatonia
ECT is appropriate in adolescents w/
refractory MDD, bipolar, and _____?
Refractory Schizophrenia
16 yo with stable schizophrenia on
medication. Therapeutic approach?
Supportive
Which antipsychotic should be avoided for
early onset schizophrenia?
Ziprasidone
Greatest risk factor for schizophrenia?
Identical twin with schizophrenia
Response After an Initial Schizophrenia
Episode (RAISE) study showed that a
shorter duration of untreated psychosis provides?
Greater improvement in quality of life
High dose of what supplement shows
preliminary evidence in preventing
progression of schizophrenia in youth?
Omega-3 Fatty Acids
