How I Treat: Schizophrenia With Dr Citrome, Part 2 Case Presentation

Case 1: Frank's Initial Course

• During his stay at the inpatient psychiatric facility, Frank is diagnosed with schizophrenia based on a careful diagnostic interview and is prescribed lurasidone 80 mg hs.
• Frank seems to “snap out of it” relatively quickly, expresses surprise that he is in a hospital, and is eager to return to school. He is given a prescription for lurasidone with instructions to return home in 1 month for a follow-up visit.
• Upon return to the fraternity house, Frank becomes worried about what his fraternity brothers will say about his “crazy pills” and, thus, he throws them out, telling himself that he feels fine.
• About 3 weeks later, Frank barricades himself in a bathroom and shouts repeatedly that he is in mortal danger. The campus police are called, and Frank is brought to the local emergency department for an emergency evaluation. He is admitted to the locked inpatient psychiatric unit under the emergency commitment statutes.

Case 2: Roger's Initial Course

• While he is under care at the locked inpatient psychiatric unit, Roger is initially treated with risperidone 3 mg hs and appears to respond well. His delusions are no longer intrusive, and he feels that he is able to “think more clearly."
• Roger’s doctor offers him the option to “take a medication only once a month, and then maybe only once every 3 months instead of every day.” Roger is very interested in this opportunity, and although he is surprised to hear that the medication would be administered by injection, it sounds very convenient to him. Additionally, he would be able to avoid having to explain to his roommate why he has to take pills.
• Roger is able to return to college for a summer session and eventually catches up to the rest of his class. He goes on to graduate.