Posted: October 12th, 2022

Psychopharmacologic Approaches to Treatment of Psychopathology

Psychopharmacologic Approaches to Treatment of Psychopathology
Psychopharmacologic Approaches to Psychopathology Treatment
Introduction
If not treated properly, regional pain disorder can traumatize patients for years. Providers should conduct a thorough examination and prescribe effective pain medication. One of the best decisions is to prescribe Savella, which is effective in the treatment of chronic pain (Hollander et al., 2020). Patients should also be educated by providers to improve compliance and trust. Clinicians should also follow ethical guidelines to improve treatment quality. To promote recovery and suppress side effects, the prescription of Savella necessitates a careful examination of patient outcomes.
First decision
The first decision is to prescribe Savella 12.5 mg orally once daily on day one, followed by 12.5 mg BID on days two and three, 25 mg BID on days four through seven, and 50 mg BID thereafter.
Rationale
The reasoning behind making the decision and ignoring the other two options is to change how the brain detects pain. According to the Assessment, the patient has a regional pain disorder. As a result of changes in the central nervous system and how it responds to pain, patients with the condition have a low pain threshold in the brain (Staal et al., 2019). As a result of the changes in neurotransmitter levels, patients with regional pain disorder are extremely sensitive to pain. Savella is an effective medication because it interferes with neurotransmitters, reducing pain sensitivity. The drug has the effect of inhibiting serotonin and norepinephrine reuptake (Stahl, 2013). The drug is also responsible for eliciting an analgesic effect on the nerve endings that detect pain. The overall effect relieves pain, improves memory, and decreases fatigue (Stahl, 2013). Savella is thus a disease that is both effective and compatible with the patient’s condition. One of the most important factors to consider when prescribing Savella to a patient is providing drug information. For example, while on treatment, the patient should avoid using other drugs or drinking alcohol (Stahl, 2013). Drug interactions can result in adverse effects such as fainting, dizziness, or death. It is also critical to follow the treatment plan to avoid side effects. Decision #1 also entails ruling out other available options, such as Amitriptyline. The medication is a common antidepressant that is mostly used to treat pain. Drowsiness is one of the side effects of amitriptyline (Chevreau et al., 2017). The drug is ineffective because the patient indicated that he was taking another drowsy medication. Because of the side effects, the patient stated that he did not take the medication on a consistent basis (Chevreau et al., 2017). Prescription of the drug may thus result in noncompliance issues, which may affect pain treatment. Neurontin, an anticonvulsant and antiepileptic drug, is another commonly used pain treatment and management medication. Drowsiness and dizziness are two of the drug’s side effects, which can lead to noncompliance (Goh et al., 2017). Tremors and viral infections have been reported in some cases as a result of the drug. As a result, it is critical to choose an option that is patient-friendly. Outcomes Expected After four weeks, the severity of pain is expected to decrease to three points on a scale of one to ten. A significant reduction in the severity of the pain should allow the patient to move around with minimal Helpance. He should also return to work, even if only in a minor capacity. Savella should also produce a consistent effect that improves a patient’s mood (Birklein et al., 2018). It is expected that the patient will experience side effects such as increased heart palpitations, poor sleep quality, and sweating during treatment.
Actual vs. Projected Results
When the patient returns to the clinic after four weeks, he is walking with minimal limping and without crutches, as opposed to his first visit. According to the patient, the pain had significantly decreased, allowing him to walk and work without the use of crutches. This is in accordance with the expectations following the prescription of the medication. However, the patient reports that the pain is worse in the morning than in the evening. The patient reports pain at a level 4 on a scale of 1 to 10, compared to the expected level 3. He also stated that his sleep was occasionally disrupted by intense pain. Savella also has a common side effect of excessive sweating, which can interfere with sleep quality (Birklein et al., 2018). Sweating, according to the patient, has reduced the quality of his or her sleep. Savella causes heart palpitations, which disrupt sleep and cause bouts of excessive sweating. The patient’s blood pressure was 147/92mmHg, and his pulse rate was 110 beats per minute. There were no reports of suicidal or homicidal thoughts. The drug’s side effects were anticipated, but they will be managed as the treatment progresses. – Best research paper writing services in USA
Decision No. 2
The outcomes and side effects of the first decision inspire decision #2. The patient reported significant improvement, which should last for four weeks. One of the options could be to reduce the dosage to relieve the patient’s increasing heart palpitations, sweating, and poor sleep quality (Birklein et al., 2018). However, abruptly discontinuing the medication may result in a relapse of the pain, causing the patient even more discomfort. As a result, increasing the drug at bedtime to reduce the chances of waking up due to intense pain at night while decreasing the dosage in the morning is the best option. Savella The best option for this decision is to take 25mg orally in the morning and 50mg orally at bedtime to boost positive outcomes and manage negative outcomes (Hollander et al., 2020). According to research, pain management necessitates a critical drug adjustment because pain can occur at various times, resulting in a variety of effects on patients. Changing the drug is not a good idea because the current prescription is already producing the desired results. According to evidence-based practice, switching drugs can have negative consequences for the recovery process (Hollander et al., 2020). The current prescription will require a delicate balance of treatment and suppression of the negative outcome. Outcomes Expected Decision #2 has the effect of suppressing the pain even more and allowing the patient to work and walk without Helpance. Another expectation is that the patient’s heart palpitations will be reduced. He should also experience improved sleep quality and fewer sweating episodes (Staal et al., 2019). For example, because bedtime medication is high, the patient should not complain of waking up in the middle of the night due to pain. A reduction in side effects is critical, especially when it comes to improving a person’s quality of life (Staal et al., 2019).
Actual vs. Projected Results
After four weeks, the patient returns to the clinic. He is still walking without crutches, which is a significant achievement in pain management. He also claims to be able to participate in his workplace with little Helpance. According to the patient, the level of pain is still 4 out of 10. The same thing happened four weeks ago. It is easy to understand the results since the dosing changed to manage the side effects. Evidence-based practice demonstrates that reducing the dosage can interfere with the management of pain (Chevreau et al., 2017). A provider should thus strike a critical balance between managing pain and suppressing the side effects. Additionally, the patient reported that he did not wake up at night due to pain (Chevreau et al., 2017). His quality of sleep had improved but his heart palpitations and heart rate were still evident. He also reports that episodes of sweating had reduced. Another outcome is that the patient did not experience a difference in the severity of pain in the morning and evening. He also denied suicidal or homicidal ideation.
Decision #3
Decision #3 involved continuing with the current medication and dosing since it is generating significant positive progress. One of the major expected outcomes was to help the patient to walk and work without using crutches. The decision involves prescribing Savella 25mg orally in the morning and 50mg at bedtime. During the prescription, it is essential to educate the patient that the treatment is trying to balance between side effects and treatment. The patient should also know that the drug is one of the best options available and that other drugs cause worse side effects (Goh et al., 2017). However, upon recovery, the side effects will abate naturally. It is not advisable to introduce a new drug at this stage since it can comprise treatment (Goh et al., 2017). The provider should also caution a patient against buying medication to treat side effects. However, the provider will take a precaution of examining the heart rate and pulse rate of a patient regularly (Goh et al., 2017). The purpose of regular checkups is to ensure he is within the normal limits. Projected Outcomes The patient should report back to the clinic after four weeks. The results include the ability to work and walk with minimal or no support. It is expected that the patient will rate the severity of pain at 3 out of 10. A reduction in the level of pain should allow the pain to participate in daily activities without struggling (Birklein et al., 2018). It is also expected the patient will indicate they had quality sleep since they did not have to wake up in the middle of the night due to pain (Birklein et al., 2018). Another projected outcome is that the heart rate and the palpitations will have normalized without severe bouts of sweating. The expectations should also involve educating a patient on what they should expect. One of the expected outcomes is that the pain may remain at 3 out of 10 without further subsidizing. Neuropathic pain syndrome may trigger some pain in the long-term (Birklein et al., 2018). However, the patient will participate in his workplace and walk without any support.
Actual vs. Projected Outcomes
The patient reports back to the clinic after four weeks. He reports that the pain had reduced to 3 out of 10 which is manageable. His blood pressure is at 120/84mmhg while the pulse rate is 86 beats per minute. He also reports no suicidal or homicidal ideation. The results and the projected outcomes have great similarities thus showing the treatment was effective. During the assessment, it is essential to alert him that other forms of therapy are necessary to manage the pain in the long-term (Hollander et al., 2020). For example, he needs heat and physical therapy and chiropractic.
Ethical Issues Affecting Treatment Ethical issues affect treatment by ensuring that providers comply with various requirements to provide high-quality treatment (Stahl, 2013). One of the ethical issues is to educate the patient about the treatment to receive informed consent from them (Hollander et al., 2020). A provider should also ensure that all decisions are patient-centered with no intention to harm them. For example, the medication with the least side effects should be selected. Patient autonomy is also necessary to observe (Staal et al., 2019). Ethical requirements state that patients should not be forced or coerced. A clinician should also educate a patient and assess their condition to their safety.
Conclusion
Treatment and management of regional pain disorder require careful analysis and assessment. One of the best medications is Savella at various doses depending on the patient outcomes. Providers should also make decisions depending on the outcomes to improve positive results and minimize side effects. It is essential to educate a patient that they require other forms of treatment to manage the condition in the long-term. Ethical issues also affect communication and treatment. The purpose is to provide treatment to patients to ensure they carry out activities with minimal pain and support.

References
Birklein, F., Ajit, S. K., Goebel, A., Perez, R. S., & Sommer, C. (2018). Complex regional pain syndrome phenotypic characteristics and potential biomarkers. Nature Reviews Neurology, 14(5), 272. https://doi.org/10.1038/nrneurol.2018.20
Chevreau, M., Romand, X., Gaudin, P., Juvin, R., & Baillet, A. (2017). Bisphosphonates for treatment of Complex Regional Pain Syndrome type 1: a systematic literature review and meta-analysis of randomized controlled trials versus placebo. Joint Bone Spine, 84(4), 393-399. – Best research paper writing services in USA
https://doi.org/10.1016/j.jbspin.2017.03.009
Goh, E. L., Chidambaram, S., & Ma, D. (2017). Complex regional pain syndrome: a recent update. Burns & Trauma, 5(1). https://doi.org/10.1186/s41038-016-0066-4
Hollander, M., de Jong, J., Onghena, P., & Vlaeyen, J. W. (2020). Generalization of exposure in vivo in Complex Regional Pain Syndrome type I. Behaviour Research and Therapy, 124, 103511. https://doi.org/10.1016/j.brat.2019.103511
Staal, J. B., Klomp, F. P., & Nijhuis-van der Sanden, M. W. (2019). Pain exposure to physical therapy in complex regional pain syndrome: promising enough to warrant further investigation. Canadian Journal of Anesthesia, 66(1), 115. https://doi.org/10.1007/s12630-018-1174-3
Stahl, S. M. (2013). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (4th ed.). New York, NY: Cambridge University Press.

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