Psychopharmacologic Approaches to Treatment of Psychopathology

Psychopharmacologic Treatment of Psychopathology
Week 4 Assignment-Examine Case Study: An Asian American Woman with Bipolar Disorder
Name
Institution
Date
Background
genetics, gender, ethnicity, age, or behavior factors
The client has shown signs of bipolar disorder, and I the past when she was prescribed lithium she had stopped taking the medication after being discharged two weeks ago. Genetics and behavior factors are considered to pharmacokinetic and pharmacodynamic processes that affect the treatment. For the 26y year old female Korean patient with bipolar disorder in decision point one, two and three the choices made are: Begin Lithium 300mg orally BID, Increase Lithium 450mg orally BID” Lithium and consider hospitalization.
Decision Point One
In decision point one, I selected “Begin Lithium 300mg orally BID” and Lithium is commonly prescribed for bipolar depression. I hoped that there would be improvement in the first four weeks after beginning treatment. However, the client stated that she took the her drug “off and on” when she felt she needed the medication. It takes 1-3 weeks for Lithium to work, and especially where to avoid recurrence of symptoms mostly for mania and/ or depression (Stahl, 2014).
The treatment was not effective partly because there was no medication adherence and compliance based on the client’s belief that the extent of her bipolar condition is exaggerated
The other options were “Begin Risperdal 1mg orally BID” and “Begin Seroquel XR 100mg orally at HS”.
Risperdal is often prescribed for bipolar maintenance adjunct to lithium or valproate and the medication is a second generation antipsychotic and mood stabilizer (Stahl, 2014). Since the client has CYP2D6*10 allele, there may be elevated levels of some medications in her system, which causes sedation (Chen et al., 2015).
“Sodium alters sodium transport across cell membranes in nerve and muscle cells, it alters metabolism of neurotransmitters including catecholamines and serotonin” (Ayano, 2016).
Lithium is rapidly absorbed, where the serum concentrations peaks in 1 to 1 ½ hours n the case of standard preparations and in 4 to 4 ½ hours for the slow and controlled release forms (Ayano, 2016).
When considering genetics, the CYP2D6*10 allele is important to regulate the metabolism of risperidone (Stahl, 2014). Additionally, there is drug nonadherence with the patient taking the drug on and off. Pharmacokinetics focuses on the absorption, distribution, metabolism and excretion of medications, an...