Description A psychiatric disease characterized by a distorted interpretation of reality result...
Description
A psychiatric disease characterized by a distorted interpretation of reality resulting in hallucinations, delusions, and disordered thinking and behavior. Contrary to belief it does not mean a split personality. Untreated, the disease can cause severe emotional, behavioral, health, and legal and financial problems. Lifelong treatment is needed, and can enable many patients to live normal productive lives. This is a serious mental disorder with about 10% of patients committing suicide. The disease usually first appears in the teenage years.
Symptoms
Symptoms typically begin gradually and worsen with time and include: trouble sleeping, trouble concentrating, withdrawing from family and friends, bizarre motor behavior in which there is less reaction to the environment (catatonic behavior), false beliefs or thoughts (delusions), hearing voices, seeing things (hallucinations), thoughts race between unrelated topics (disordered thinking).
Tests
Common tests used for diagnosis and treatment
Workup:
A history and physical exam will be performed. Substance abuse (drug use) can cause similar symptoms. Tests may be done to rule out other causes of the symptoms such as thyroid disease, electrolyte problems, drug abuse, and adverse drug interactions.
Tests:
Comprehensive metabolic panel (CMP)
Other Specific Tests: Thyroid studies, urine and/or serum toxicology screen
Do I need this test?
Don't routinely prescribe two or more antipsychotic medications concurrently. Research shows that use of two or more antipsychotic medications occurs in 4 to 35% of outpatients and 30 to 50% of inpatients. However, evidence for the efficacy and safety of using multiple antipsychotic medications is limited, and risk for drug interactions, noncompliance and medication errors is increased. Generally, the use of two or more antipsychotic medications concurrently should be avoided except in cases of three failed trials of monotherapy, which included one failed trial of Clozapine where possible, or where a second antipsychotic medication is added with a plan to cross-taper to monotherapy.
Specialists:
Psychiatry, Pediatric and Adolescent Psychiatry
Workup:
A history and physical exam will be performed. Substance abuse (drug use) can cause similar symptoms. Tests may be done to rule out other causes of the symptoms such as thyroid disease, electrolyte problems, drug abuse, and adverse drug interactions.
Tests:
Comprehensive metabolic panel (CMP)
Other Specific Tests: Thyroid studies, urine and/or serum toxicology screen
Do I need this test?
Don't routinely prescribe two or more antipsychotic medications concurrently. Research shows that use of two or more antipsychotic medications occurs in 4 to 35% of outpatients and 30 to 50% of inpatients. However, evidence for the efficacy and safety of using multiple antipsychotic medications is limited, and risk for drug interactions, noncompliance and medication errors is increased. Generally, the use of two or more antipsychotic medications concurrently should be avoided except in cases of three failed trials of monotherapy, which included one failed trial of Clozapine where possible, or where a second antipsychotic medication is added with a plan to cross-taper to monotherapy.
Specialists:
Psychiatry, Pediatric and Adolescent Psychiatry
Treatment
Treatment depends on the severity of symptoms but may include: antipsychotic medications (haloperidol/Haldol, clozapine/Clozaril, risperidone/Risperdal, olanzapine/Zyprexa, quetiapine/Seroquel, ziprasidone/Geodon, aripiprazole/Abilify, paliperidone/Invega), psychiatric and psychologic counseling, and/or hospitalizations.