: Schizophrenia Cases Case 1 A 40 year old male with schizophrenia is initiated on clozapine therapy after presenting with increased auditory hallucinations and paranoia,
: Schizophrenia Cases Case 1 A 40 year old male with schizophrenia is initiated on clozapine therapy after presenting with increased auditory hallucinations and paranoia, decreased attention and memory, and persistent suicidal ideation. He was also previously treated with olanzapine and risperidone. 1. When considering antipsychotic options, when would the use of clozapine be acceptable? 2. What black box warnings exist for clozapine? 3. In a patient with a normal ANC, how frequently should he be monitored for agranulocytosis during the first 6 months of therapy? 4. What WBC and ANC values would be appropriate for continuation of therapy
Case 2 A 28 yo female with schizophrenia is started on an antipsychotic. She originally was suffering from auditory hallucinations about the devil coming after her. 4 months after starting her medication, her symptoms are controlled, but she presents with complaints of decreased libido and irregular menstruation (her menstrual cycle is longer and her periods seem lighter). Labs: Na 141 mEq/L K 3.7 mEqL CI 98 mEqL CO2 22 mEq/L BUN 13 mg/dL. SC 1.0 mg/dL Gluc 87 mg/dL TSH 2.0 mIU/L Prolactin 35 ng/ml 1. Which SGA was this patient most likely started on and what is your rationale? 2. What other symptoms might she experience? 3. What symptoms would a male experience if they had the same adverse effect?
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