Comprehensive exams for Mental Health Q 114
A male client who reportedly consumes one (1) qt of vodka daily is admitted for alcohol detoxification. To try to prevent alcohol withdrawal symptoms, Dr. Smith is most likely to prescribe which drug?
A. Clozapine (Clozaril)
B. Thiothixene (Navane)
C. Lorazepam (Ativan)
D. Lithium carbonate (Eskalith)
Correct Answer: C. Lorazepam (Ativan)
The best choice for preventing or treating alcohol withdrawal symptoms is lorazepam, a benzodiazepine. Lorazepam is a benzodiazepine medication developed by DJ Richards. It went on the market in the United States in 1977. Lorazepam has common use as the sedative and anxiolytic of choice in the inpatient setting owing to its fast (1 to 3 minute) onset of action when administered intravenously. Lorazepam is also one of the few sedative-hypnotics with a relatively clean side effect profile. ff-label (non-FDA-approved) uses for Lorazepam include rapid tranquilization of the agitated patient, alcohol withdrawal delirium, alcohol withdrawal syndrome, insomnia, panic disorder, delirium, chemotherapy-associated anticipatory nausea and vomiting (adjunct or breakthrough), as well as psychogenic catatonia.
Option A: Clozapine is an FDA-approved atypical antipsychotic drug for treatment-resistant schizophrenia.[1] The definition of treatment-resistant schizophrenia is persistent or moderate delusions or hallucinations after failing two trials of antipsychotic medicines. Clozapine is part of a group of drugs known as second-generation antipsychotics or atypical antipsychotics.[1] Antipsychotic drugs are vital in treating the core symptoms of schizophrenia: hallucinations and delusions.
Option B: Thiothixene is used to treat the symptoms of schizophrenia (a mental illness that causes disturbed or unusual thinking, loss of interest in life, and strong or inappropriate emotions). Thiothixene is in a group of medications called conventional antipsychotics. It works by decreasing abnormal excitement in the brain.
Option D: Lithium was the first mood stabilizer and is still the first-line treatment option, but is underutilized because it is an older drug. Lithium is a commonly prescribed drug for a manic episode in bipolar disorder as well as maintenance therapy of bipolar disorder in a patient with a history of a manic episode. The primary target symptoms of lithium are mania and unstable mood. Lithium is also prescribed for major depressive disorder as an adjunct therapy, bipolar disorder without a history of mania, treatment of vascular headaches, and neutropenia. These are off-label uses, meaning they are not FDA-approved. Patients with rapid cycling and mixed state types of bipolar disorder generally do less well on lithium.