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Case Description
Prescribing a medication that will be beneficial for a patients condition often requires significant effort from the physician. In specific cases where a severe mental disorder is present, choosing the right drug and its dosage is crucial for positively affecting the individuals condition and alleviating the negative symptoms. On the other hand, administering incorrect medicine might have a devastating effect on the patients condition, harming the rehabilitation process (Chen et al., 2016). In the provided case, special attention is needed to select a drug that will diminish Pams manifestations of paranoia. The present paper discusses Pams case, suggesting Fluphenazine Decanoate as a medicine useful for decreasing the patients paranoid behavior, as well as highlighting the positive and negative effects of this drug in schizophrenia treatment.
Case Overview and Choice of Medication
In the described scenario, the patient Pam is suffering from a chronic schizophrenia disorder, having been prescribed the same medicine for the past 20 years. However, the woman reports that in the past two months, she started experiencing strong feelings of paranoia, which manifested in her perception of unsafety and paranoid behaviors, such as disassembling electronic devices around the house. The discussed symptoms might be connected to increasing feelings of anxiety, which often occur in chronic schizophrenia patients (Abbas et al., 2017). Thus, it would be beneficial for Pam to take an antipsychotic that could help reduce the agitation. A suitable drug could be Fluphenazine Decanoate, a first-generation antipsychotic administered to patients with schizophrenia and acute agitation related to various psychotic disorders.
Fluphenazine Decanoate
Biological Actions and Effects
Biologically, Fluphenazine Decanoate is a phenothiazine that affects the central nervous system and influences the behavioral manifestations of psychotic disorders. By blocking dopamine D1a and D2 postsynaptic receptors throughout the limbic system, cortical system, and basal ganglia, this drug diminishes the occurrence of hallucinations, delusions, and paranoid feelings (Abbas et al., 2017). Fluphenazine Decanoate has been reported to have weak sedative effects and depress the reticular activating system, which, in turn, influences extrapyramidal activity.
Behavioral and Psychological Effects
From a behavioral perspective, Fluphenazine Decanoates impact is antipsychotic, connected to the suppression of dopamine receptors. The medication blocks the effects of dopamine on the central nervous system, decreasing the emergence of hallucinations and delusions connected to schizophrenic and acute psychotic conditions (Abbas et al., 2017). As a result, behaviors associated with the influence of delusive thoughts are reduced, allowing for the establishment of normal activities (Ostuzzi et al., 2017). Psychologically, these effects alleviate the toll of psychosis, promoting mental stability and acting as a partial sedative. Fluphenazine Decanoate is highly effective in the long-term treatment of schizophrenia, but it can also be used for short-term administration during the acute stages of the disorder.
Treatment of Chronic Schizophrenia with Fluphenazine Decanoate
Given the information presented in the case, the patient suffers from chronic schizophrenia. This disorder is associated with frequent delusions, hallucinations, and confused thinking that affect a persons ability to distinguish between reality and delusive thoughts. Lack of motivation, depression, and paranoia can also occur in schizophrenic patients, negatively impacting their ability to function in society and fulfill their daily needs (Movsisyan et al., 2019). Symptoms of the disorder include episodes of unreal experiences, distorted perception of reality, lack of emotional response, disorganized thinking and speech, and issues with logical thinking.
As a first-generation antipsychotic, Fluphenazine Decanoate acts to establish a balance in the release of dopamine, preventing the emergence of schizophrenic symptoms. A reduced amount of dopamine in the central nervous system leads to the reduction of primary symptoms, such as hallucinations, delusions, and paranoid ideas. In addition, the behavior of the patient is affected, improving their ability to perceive reality and act according to the surrounding conditions (Movsisyan et al., 2019).
Given the broad effects of the drug and its strong influence on the patients behavior, Fluphenazine Decanoate is a beneficial medication for treating schizophrenia and other psychotic disorders in their acute form (Movsisyan et al., 2019). In addition, in comparison with other phenothiazine derivatives and antipsychotic agents, Fluphenazine Decanoate is more potent, less likely to have depressive effects, and can improve neurotransmission (Schellack & Matlala, 2017). As a newer phenothiazine, this medication can decrease the risk of developing hypotension.
Nevertheless, as a strong antipsychotic medication, Fluphenazine Decanoate can elicit severe biological and behavioral consequences. As Fluphenazine Decanoate is a neuroleptic drug, it often causes a decrease in the production of some white blood cells and liver damage (Chen et al., 2016). Furthermore, it has been reported that phenothiazines have the most toxic effects when compared with other neuroleptics (Schellack & Matlala, 2017). It is also essential to note that this medications exact mechanism of action is still unknown, and it is not clear whether its antipsychotic impact is connected to the blockage of dopamine receptors (Abbas et al., 2017). Similar to other antipsychotics, Fluphenazine Decanoate can originate a high number of health conditions, from headaches to neuroleptic malignant syndrome (PDR, n.d.). From this perspective, the administration of Fluphenazine Decanoate should be conducted with excessive caution.
References
Abbas, F., Rajab, T., Alsamarrai, O., Alhalabi, N., Zaher Addeen, S., Mheish, O., Aljojo, A., & Essali, A. (2017). Fluphenazine decanoate (timing of administration) for people with schizophrenia. The Cochrane Database of Systematic Reviews, 2017(10). Web.
Chen, M., Suzuki, A., Thakkar, S., Yu, K., Hu, C., & Tong, W. (2016). DILIrank: The largest reference drug list ranked by the risk for developing drug-induced liver injury in humans. Drug Discovery Today, 21(4), 648653. Web.
PDR. (n.d.). Fluphenazine decanoate Drug summary. Web.
Movsisyan, M., De Coen, L. M., Heugebaert, T. S. A., Verlee, A., Roman, B. I., & Stevens, C. V. (2019). Continuous-flow synthesis of phenothiazine antipsychotics: A feasibility study. European Journal of Organic Chemistry, 2019(6), 13501354. Web.
Ostuzzi, G., Bighelli, I., So, R., Furukawa, T. A., & Barbui, C. (2017). Does formulation matter? A systematic review and meta-analysis of oral versus long-acting antipsychotic studies. Schizophrenia Research, 183, 1021. Web.
Schellack, N., & Matlala, M. (2017). Providing an overview on antipsychotics: Schizophrenia a psychiatric challenge? A 2017 Update. SA Pharmaceutical Journal, 84(3), 1623. Web.
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