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of neurodevelopment, perhaps resulting from a viral infection in the mother.
- The double hit theory requires a genetic predisposition, as well as the prenatal insult.
- Imaging techniques have enabled researchers to identify areas of the brain which are affected, e.g., the frontal and temporal lobes. Refinements include actual counting of brain cells;
- Brain alteration associated with schizophrenia;
- Brain development peaks in adolescence; shortly thereafter, the number of brain cells decreases slightly
- At age 13, parietal volume loss
- At age 18, temporal & frontal lobes
- Ages 8-18, prodromal symptoms
- Ages 18-45, acute onset of the disease
- Ages 45-65, behavioral stabilization
- Age 65+, cognitive decline
Dr. Powers summarized: the good news--much progress has been made; the bad news--these are VERY complex diseases.
Improved Treatment Options for Psychiatric Emergencies
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Presented
by Dr. Andree Stoves, Assistant Professor of
Psychiatry and Behavioral Neurobiology, UAB
Reported by Howard Fry
Dr. Stoves discussed the use of the Intramuscular
(IM) drug Geodon to manage acute agitation in
emergency room (ER) environments. She stressed
the importance of quickly stabilizing patients
from the acute phase so treatment of the primary
symptoms can proceed. Timely relief reduces
the chance of injury to self and staff.
Research has shown that a patient's subjective
view of the ER experience has an impact on their
recovery. Good experiences increase recovery
success; negative experiences prolong recovery
and reduce it's likelihood. Positive early clinical
response improves post -release treatment compliance.
While useful for ER intervention, Geodon has
minimal side effects. Geodon (ziprasidone) is
a multi-receptor, multi-mechanism drug. It's
half-life in the blood stream is 2-5 hours,
has minimal effects on the liver, and does not
interfere or interact with other medications.
The preferred does is 20 mg IM. Patients respond
within 30 minutes.
Geodon is not recommended for elderly patients
with a history of heart problems.
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