Phinma University of Pangasinan

Arellano, Dagupan City

College of Allied Health Sciences Department

Schizophrenia in relation to Depressive Disorder

A case study presented by Third Year students from

Bachelor of Science in Nursing to the faculty of
College of Allied Health Sciences

Members:
Sanchez, Caryl Niña S.
Rayat, Bryan Lloyd B.
Revilla, Jefferson U.
Salcedo, Danayel P.
Sambere, Kimberly R.
Samson, Meriah M.
Sandoval, Alju
Santos, Winona Marie M.
Sapiera, Ericka D.
Saplan, Samira D.
Sarmiento, Angeline S.
Servanda, Ghienelyne M.

May 2023
I. INTRODUCTION
On the 10th day of March, 2023, a 26 years old adult female was admitted to Villa Herzon
Mental Health Center accompanied by her cousin after being admitted at Fatima University
and Medical Center on March 5 same year due to trauma. She transferred to the facility in
complaints of having hallucination, paranoia, and has attempted to commit suicide. The
patient claimed she had an affair with a guy that taught her to use marijuana and was also
diagnosed with Obsessive-Compulsive Disorder (OCD) in year 2022 however, she was
noncompliant with the treatment. Upon the interview, the nurse notes that the patient is
conscious and ambulatory but refuses to open her eyes, has poor hygiene, affect is labile and
is in depressed mood, delusions are noted, and has poor insight and judgement. The admitting
diagnosis of the patient is to consider depressive disorder vs. schizophrenia.

Depressive disorder and schizophrenia are both complex type of psychiatric condition
that disturbs an individual’s thoughts, feelings, behavior, or mood. Major depressive disorder
is a mental health condition characterized by a persistently low mood and loss of interest in
daily activities while schizophrenia is a compound mental disorder that impairs a person’s
feelings, thoughts, and perception of reality. Although the difference of both diseases is
evident, their features may mimic or overlap with each other, such as presence of
hallucinations, delusions, and disorganized thoughts, along with mood disorder, that often
misdiagnosed as one of the two. Depression does not cause schizophrenia, however, some
individuals with severe clinical depression experiences symptoms of psychosis which are
also present in those diagnosed to have schizophrenia. With this, different studies rise
regarding the relationship of the two.

According to a study of Samson, J. & Wong, C. (2015) entitled, “Schizophrenia and

Depression Co-Morbidity: What We have Learned from Animal Models”, schizophrenia
patients have an elevated risk for developing depressive symptoms compared to the already
high lifetime prevalence of depression in the general population. Depressive symptoms have
been reported during all stages of the course of schizophrenia increasing the risk of suicide to
diagnosed patients. Conversely, depressed patients have also been shown to be at a higher
risk of developing psychosis. There is an overlap between certain negative symptoms of
schizophrenia and depressive symptoms that some argue that it should be part of
schizophrenia syndrome. This view is supported by the high prevalence of depressive
symptoms in schizophrenia and the association between trait depression and other trait-like
features of schizophrenia. Alternatively, depressive symptoms in schizophrenia could partly
be a side-effect of neuroleptics, secondary to other comorbidities such as substance abuse, or
an understandable reaction to the consequences of the disorder.

In a journal article written by Mosolov, S.N. (2020) entitled, “Diagnosis and treatment
depression in schizophrenia”, depression is one of the most significant deconditioning factors
among patients with schizophrenia reducing the quality of life and the disease prognosis as a
whole. It also increases the frequency of exacerbations and rehospitalizations, and decreases
the quality and duration of remissions; it is associated with more frequent substance abuse,
an increased economic burden with regard to the disease and is also the main cause of
suicide. The risk of suicide among people suffering from schizophrenia is 20 times higher
than among the general population; around 50% of patients with schizophrenia attempt
suicide and around 10% die from suicide. In various studies, the reported data on the
prevalence of depression among patients with schizophrenia vary considerably from 25 to
70%, depending on the methodological approaches used. On average, the prevalence of
depression in schizophrenia at one particular moment is 25% and at lifetime is 54%. Up to
60% of patients with a verified diagnosis of schizophrenia have at least one episode of major
depression; 40-50% of both inpatients and outpatients have mild or moderate depressive
episodes. Depression can develop at any stage of schizophrenia: depression was observed in
the premorbid period before the onset of psychotic symptoms in 50% of patients, in 33% of
patients during the first episode, in 38% of patients during psychotic episodes and in 27% of
patients in remission.

People diagnosed with Schizophrenia, and some who have mental problems admitted in
psychiatric facilities, are most likely involved in stigma where they are defined by their
illness rather than who they are. Discrimination and stereotypes also rise due to this making it
harder for patients to cope with the society resulting to difficulty in treating their condition.
Societal stigma about mental health problems and psychiatric facilities prevents people, who
has been experiencing symptoms, from consulting mental health professionals regarding their
state and chose to suppress or displace it. This allows their problem to worsen that may soon
affect their lifestyle and may need longer period of treatments.
II. PATIENT’S PROFILE AND HISTORY

Patient’s Information

Name: Ms. Z
Sex: Female
Age: 26 y/o
Height: 5 ft
Date of Birth: December 8, 1995
Religion: Baptist
Civil Status: Single
Occupation: (Former) Procurement associate for 3 months
(Former) Recruitment associate for 2 months
Highest Educational College
Attainment:
Course: BSBA Major in Human Resources
Mother: --
Occupation (Mother): Networking Business
Father: --
Occupation (Father): Seaman Overseas Filipino Worker
Placement Among Siblings: Second eldest (among two sons)

Medical Information

Name of Facility: Villa Herzon Mental Health Center

Date of Admission: March 10, 2023
Chief Complaint: Suicidal, (+) Hallucination, (+) Paranoia
Initial Vital Signs: T: 36.7 C BP: 110/70 mmHg
PR: 66 bpm RR: 16 rpm
SPO2: 98%
Admitting Diagnosis: T/C Depressive disorder vs. schizophrenia
Final Diagnosis: --
Medical History
History of March 10, 2023 - Admitted the patient conscious and ambulatory
Present but refuses to open the eyes. Vital signs are
Illness: stable with intact orientation, no impairment in
memory, and no physical injury/ deformity.
Patient exhibits poor hygiene, impoverished eye
contact, and suicidal tendencies. Affect is labile
and in depressed mood with poor insight and
judgement.
- Patient verbalized having an affair with a guy
that taught her to use illicit drugs (Marijuana)
and had trauma.
- Patient claimed she had killed someone and like
there is some live movements in her stomach, as
per relative’s statement.
March 31, 2023 - Patient is timid, always seen on bed and not
enjoying conversation with other patient, affect
is flat, fair insight, and fair appetite.
- Auditory hallucinations and delusions are
PSYCHOLOGICAL noted.
REPORT - Clinical interview, behavioral observations,
intelligence test (Raven’s 2 progressive
matrices – clinical edition), and projective test
(bender visual motor gestalt test, draw a person
test, Rorschach psychodiagnostics test, and
sentence completion series – adult) were
performed and reveled that the patient’s current
intellectual performance generated an average
classification.
Past Medical August, 2019 - Patient revealed of hearing weird voices like
History: there is a presence of a ‘bad’ person and
claimed to have hallucinations of bad images in
the previous month.
Year 2022 - Patient was diagnosed with Obsessive-
Compulsive Disorder (OCD) and was
prescribed to take Olanzapine and Diazepam.
However, she was not complaint with the
March 5, 2023 treatment.
- The patient was admitted for five days at Fatima
 University and Medical Center due to trauma
when she jumped of a moving vehicle and
sustained contusion. Laboratory test were
obtained, including a head CT Scan without
contrast revealing some small contusion
hemorrhages as well as acute subarachnoid
hemorrhage, occipito-temporal acute subgaleal
hematoma, and polysinusitis.
March 10, 2023 - Patient was prescribed medication of
Olanzapine 10mg and Biperiden 2mg.
- Patient was discharged from Fatima University
and Medical Center and was transferred to Villa
Herzon Mental Health Center.
Family -None indicated.
History:
III. MENTAL STATUS EXAMINATION

Name: Ms. Z Sex: Female

Age: 26 y/o Date of Birth: December 8, 1995

Date of Admission: March 10, 2023

Admitting Diagnosis: T/C Depressive Disorder vs. Schizophrenia
Hospital: Villa Herzon Mental Health Center
Tests Performed: CLINICAL INTERVIEW
BEHAVIORAL OBSERVATIONS
INTELLIGENCE TEST:
- Raven’s 2 Progressive Matrices – Clinical Edition
PROJECTIVE TEST:
- Bender visual motor gestalt test
- Draw a person test
- Rorschach psychodiagnostics test
- Sentence completion series – adult

GENERAL APPEARANCE AND BEHAVIOR

The patient is a brown-skinned adult female with a height of 5 feet and has a moderate
body weight. The patient looks older than the stated age. She has blonde dyed below shoulder-
length hair and is wearing a gray t-shirt, khaki short pants, and pink rubber slippers with poor
hygiene. Her eye contact is limited, but she is cooperative. There are no observed abnormalities
in terms of posture, gait, or motor movement

AFFECT
The patient’s affect is flat since she lacks emotional expression. Her voice is monotonous,
and her face is immobile.

MOOD
The patient’s mood is euthymic as she is feeling relatively neutral and is not extremely
happy or sad.

THOUGHT PROCESS
The patient has a linear and goal-directed thought process because her responses are
relevant and coherent.
THOUGHT CONTENT
The patient has both visual and auditory hallucinations, as she has claimed to have seen
undesirable images like bad people and heard strange voices since 2019. She also admitted to
having homicidal thoughts, by stating, "I want to murder someone in my heart, kasi madami
akong galit sa kuya saka sa mama ko, pakiramdam ko na abandon nila ako, pero ang totoo love
nila ako," along with feelings of hopelessness and suspicion that people are talking about her.

COGNITIVE EVALUATION
The patient is alert. Orientation to time, place, and person was intact; no memory
impairment was noted. Her current intellectual performance yields an average classification. This
implies that, according to age-appropriate criteria, she is capable of comprehending and carrying
out mental tasks; also, difficulties in the application of learned knowledge and experiences, as
well as the application of practical procedures, are minimally expected. Moreover, her sensitivity
to details, reflective thinking skills, planning skills, and abstract reasoning are adequately
operating.

INSIGHT
The patient has fair insight as she is aware of her thoughts, feelings and current situation.

JUDGEMENT
The patient exhibits fair judgment as she displays understanding of her situation,
responds coherently, and makes decisions based on the situations presented to her.

EVALUATION:
The patient’s current intellectual performance generated an average classification. This
indicates within standards ability to comprehend and perform mental tasks when compared to
people of her age group. Furthermore, she has satisfactory intellect and capacity to understand
and employ judgements and decisions based on presented situations to her. Moreso, difficulties
in application of learned knowledge and experiences as well as application of practical
procedures are minimally expected. Lastly, her sensitivity to details, reflective thinking planning
skill and abstract reasoning are adequately operating
IV. PSYCHOPATHOLOGY
V. PROCESS RECORDING

Name: Ms. Z Sex: Female

Age: 26 y/o Date of Birth: December 8, 1995

Date of Admission: March 10, 2023

Admitting Diagnosis: T/C Depressive Disorder vs. Schizophrenia
Hospital: Villa Herzon Mental Health Center

DESCRIPTION OF THE PATIENT

The patient is a 26-year-old female with average size and brown complexion, standing 5
feet tall and having blonde colored below shoulder-length hair, she is well groomed and neat.
Her mood was euthymic, with flat affect and limited eye contact. Her time, place, and person
orientations were all intact, she is cooperative and can verbalize her thoughts. When asked, her
responses were relevant and coherent but in soft, low-toned voice.
In 2022, she was diagnosed with Obsessive-Compulsive Disorder and admitted at Villa
Herzon Mental Health Center in March 10, 2023 with an admitting diagnosis of Depressive
disorder and Schizophrenia for suicidal and murderous impulses. She had a history of using
illicit drugs and marijuana. Good appetite and sleep were affirmed.

DESCRIPTION OF ENVIRONMENT
The environment is well-lit and well ventilated, it is also spacious that can accommodate
patients and perform various therapies/activities. The wards are clean and hygienic, it is well
maintained every day. There are railings as a safety measure for the patients and the windows are
covered to protect the patients’ identity and confidentiality.

OBJECTIVES
• Establish rapport, acceptance, trust and personal boundaries with the patient.
• Gather important and necessary information that is related with the issues of the patient.
• Introduce the patient on what she could expect on the nurse-client interaction and therapies
on the duration of the contract.
• Inform the patient regarding the termination of nurse-client interaction.
 PROCESS RECORDING
(Orientation Phase)
NURSE (Verbal & Non- THERAPEUTIC PATIENT (Verbal & ANALYSIS
verbal) TECHNIQUE Non-verbal)
“Good morning po, Giving Recognition “Good morning din, ayos THERAPEUTIC.
kumusta po kayo?” lang.” made the patient fe
am aware and ackn
her presence.
“Ako po ay isang student Giving Information “Ah four days lang kayo THERAPEUTIC.
nurse galing sa Phinma dito.” *nods* oriented the
University of Pangasinan, regarding the dur
ako po ang magiging nurse our therapy.
niyo this May 8 hanggang
May 11.”
“Ano pong gusto niyong Giving Broad Opening “Siguro yung experiences THERAPEUTIC.
pag-usapan ngayong araw?” ko nung hindi pa ako na- patient took the ini
admit dito. Kasi may mga introducing the topi
bumubulong sa akin para
gumawa ng mga
masasamang bagay.”
“Pwede niyo po ba ikwento Exploring “Yung onetime kasi THERAPEUTIC.
yung mga nangyari?” tumalon ako sa jeep, may made the patient s
nagsabi kasi sa akin non explore her thought
and parang sinunod ko na
lang.”
“Okay po, ituloy niyo lang Accepting “Tapos nagha-hallucinate THERAPEUTIC.
po.” *Nods din ako, may bumubulong patient feels hea
sa akin at aware ako na bad listened to, encoura
person siya.” to continue verbali
thoughts.
“Itong bumubulong sa inyo, Focusing “Marami siyang sinasabi, THERAPEUTIC.
ano sinasabi niya sayo? may times na gusto niya client is encour
ako pumatay or gumawa ng focus and commun
bagay na ikakapahamak symptoms and cond
ko.”
Nandito kami para mag Changing the Subject “Okay. Salamat.” NONTHERAPEU
conduct ng therapies tulad have changed the t
ng play therapy, music & the activities
arts therapy, bibliotherapy, conducted while
at occupational therapy. sharing her experien
“Mabalik po tayo doon sa Paraphrasing “Oo, kasi hindi ko naman THERAPEUTIC.
bumubulong sa inyo, gusto talaga intensyong manakit patient is encour
niya po na manakit kayo o pero talagang ang kulit elaborate her id
gumawa ng bagay na niya.” thoughts and focu
makakasama sa inyo?” symptoms of schizo
“Matanong ko po kung Exploring “Sa kuya at saka mama ko, THERAPEUTIC.
meron kayong kamag-anak galit na galit ako sa kanila chance to know the
o kakilala na sa tingin niyo kasi feel ko inabandon na people that the
may kinalaman sa situation nila ako.” recognizes as fa
niyo ngayon?” causing her conditio
“Sa tingin niyo inabandona Reflecting “Oo, pero ang totoo love THERAPEUTIC.
kayo kaya kayo nagagalit sa nila ako. Ako lang ang patient accepted
kanila?” malayo sa kanila.” feelings and felt
opinion and point
has value.
“Ganon po ba? Tutulungan False Reassurance “Sure ka? Sana nga.” NONTHERAPEU
namin kayo maayos ang The patient hav
problema niyo.” assurance and ma
therapeutic inter
that could be mislea
“Opo, hindi po kami Defensive Resposes “Okay.” NONTHERAPEU
nagsisinungaling.” Becoming defensiv
that the patient i
with her opinion.
“Mahirap na po siguro Sharing Empathy “Oo nga, parang yung THERAPEUTIC.
magtiwala kasi naloko at boyfriend ko dati… Siya patient felt unders
nagamit na kayo.” kasi nag introduce sa akin accepted, and that
gumamit ng drugs.” perceived her rea
emotions accurately
“Naniniwala po ako na kaya Sharing Hope “Oo, kakayanin ko to.” THERAPEUTIC.
niyong harapin yang patient is encour
situation niyo, given na ang persevere throug
dami niyo nang current condition.
napagdaanang pagsubok sa
buhay.”
“Yan ang spirit ate, thank Giving Recognition “Thank you rin.” THERAPEUTIC.
you po sa pagparticipate at patient feels ackno
pag pakiki-cooperate sa and appreciated w
ating NPI!” participation.
EVALUATION
• Established rapport, acceptance, trust and personal boundaries with the patient by being
respectful and listening to the patient’s concerns. MET
• Gathered important and necessary information that is related with the issues of the patient by
encouraging her to verbalize her experiences, history, and problems. MET
• Introduced the patient on what she could expect on the nurse-client interaction and therapies
on the duration of the contract by informing her of the activities that we will do. MET
• Informed the patient regarding the termination of nurse-client interaction. MET
 VI. NURSING CARE PLAN

Name: Ms. Z Sex: Female

Age: 26 y/o Date of Birth: December 8, 1995

Date of Admission: March 10, 2023

Admitting Diagnosis: T/C Depressive Disorder vs. Schizophrenia
Chief Complaint: Suicidal. (+) Hallucination, (+) Paranoia
Hospital: Villa Herzon Mental Health Center

ASSESSMENT ANALYSIS PLANNING INTERVENTIONS RATIONALE EVALUATION

Subjective: Patients with Short – Term: Independent: Short Term:
schizophrenia
“Dahil and some After 1 day of  Assess the patient’s  To know the After 1 day of
tumalon ako patients with nursing understanding of her appropriate ways nursing
sa jeep, sabi depressive intervention, the condition. of educating and intervention,
ng utak ko disorder, one patient will be helping the the patient:
yun, of the able to: patient about her
pakiramdam problems that condition.
ko talaga can be  Establish safety  Established a
yun, experienced is plan with the  Assess the patient’s  The patient’s safety plan
maraming auditory nurse, including perception on the adherence to with the
bumubulong hallucination, the identification nurse,
importance of medications can
sa utak ko… also called of triggers, including the
Ina-associate paracusia,, is coping complying to determine identification
ko kung ano hearing strategies, and prescribed treatment success. of triggers,
and dapat something emergency medications. coping
kung gawin without the contacts. strategies, and
sa mga presence of an  Assess coping  Current negative emergency
bulong, tapos external behaviors currently thinking may contacts.
nag- stimulus. It used. preclude looking (Goal Met)
hahallucinate can be in the at positive
na ako ng form of the behaviors in the  Verbalized
mga bad sounds of  Verbalize and past that would and
images na music, demonstrate demonstrated
help in the
last month animals, compliance with compliance
patient’s current
lang nag nature, and the medication (such with any
start, parang like. In Ms. as Olanzapine) condition. medication or
may bad Z’s case, it’s or treatment plan treatment plan
person” as hearing voices. within the next  Provide an  To prevent the within the next
verbalized by A subtype of days environment that is escalation of days. (Goal
the patient. auditory calm, quiet, and free of hallucinations Met)
hallucination stimuli.
is command
hallucination,
 where the  Maintain  To avoid
Objective: patient straightforward reinforcing Long Term:
receives Long Term: communication. manipulative
 Timid internal behavior. After 3 days of
 Always directives After 3 days of nursing
seen on bed which can lead nursing intervention,
 Monitor the patient for  Early detection of
 Flat affect to committing intervention, the the patient:
 Limited eye suicide or patient will be signs of adverse adverse effects
contact violence. This able to: effects of taking the can help prevent
 Euthymic is why suicide prescribed the worsening of
Mood prevention  Express thoughts medications. the patient’s  Expressed
 Diagnosed should be and feelings in a condition as thoughts and
with OCD prioritized in coherent, logical, having feelings in a
in 2022. the care for goal-directed hallucinations. coherent,
Ms. Z. manner logical, goal-
Vital Signs: directed
 Encourage expression  This
T: 36.7°C of feelings and make acknowledges the manner. (Goal
PR: 66 bpm Met)
time to listen to reality that
BP: 110/70 concerns. feelings are okay
RR: 16 rpm  Perform  Shows
activities that and helps the compliance on
SPO2: 98%
could not put her patient understand not performing
life at risk. the situation and activities that
look at other could put her
NURSING alternatives. life at risk.
DIAGNOSIS (Goal Met)
 Assist the patient to  Violent behavior
 Verbalize that distinguish between in patients with  Verbalized
Risk for delusions that delusions
reality and major mental
Suicide related decrease to a have been
to auditory hallucinations. disorders may be
manageable decreased to a
hallucinations in response to
level. manageable
and history of command level. (Goal
prior suicide hallucinations. Met)
attempt.
After 2 weeks of  Encourage the patient  This releases After 2 weeks of
nursing to engage in physical endorphins and nursing
intervention the activity. promotes feelings intervention the
patient will: of self-worth and patient:
improving sense
 Demonstrate the of well-being.  Demonstrated
ability to the ability to
function without  Develop a safety plan function
 To help the
responding to without
in collaboration with patient manage
persistent responding to
delusional the patient. suicidal persistent
 Give positive
thoughts. reinforcement for the tendencies. delusional
patient’s efforts.  To encourage the thoughts. (Goal
continuation of Met)
desired behaviors.
 Be observant of the
warning signs of suicide  This can help
such as verbalization of prevent the patient
ideas about committing from continuing or
suicide and death, ensuing harm on
becoming withdrawn or herself and/or to
euphoric, behaving others.
recklessly, and the like.

 Maintain close
observation of the
patient and check the  To increase the
environment for hazards patient’s safety and
that could be used to reduce the risk of
inflict pain to herself or impulsive
others. behaviors.

 Maintain a therapeutic
nurse-patient
relationship, providing  To work with the
consistent caregiving. patient and better
understand the
problem to affirm
the patient’s ability
Dependent:
to solve the current
 Administer medications situation.
(antipsychotic) ordered
by the doctor, taking  The chemistry of
care not to overdose the the brain is changed
patient. by early violence
and has been shown
to respond to
serotonin which
play a role in
restraining
aggressive
impulses.
 Report any sign of
medication adverse
 effects to the physician.  This is important in
order to know
which action is
Collaborative:
appropriate to take
 Negotiate a no-suicide next.
contract and crisis safety
plan with the patient, in
coordination with  The safety plan
facility staff. made in
collaboration with
the patient, is
personalized in
order to identify the
triggers and coping
strategies. Involving
the staff is also
important because
they too, oversee
 Determine nutritional the care and safety
needs of the patient in of the patient.
collaboration with a
 VII. DRUG STUDY
DRUG – OLANZAPINE
NAME OF MECHANISM CONTRAINDICATION SIDE ADVERSE NURSING
DRUG OF ACTION EFFECTS EFFECTS RESPONSIBILITIES
GENERIC NAME The activity of Contraindicated in The The patient  Assess the
olanzapine is patients with a medication taking this patient for
OLANZAPINE achieved by the known may exhibit medication history of allergy
hypersensitivity to should watched to olanzapine and
antagonism of the following
BRAND NAME the product and its out for the its components.
multiple components. It could side effects: following
neuronal also exacerbate, adverse reaction  Assess history of
Zyprexa receptors possibly precipitate, 
headache in: past and present
including the diabetes mellitus, 
dizziness medications and
CLASSIFICATION low white blood cell CNS: monitor the
dopamine 
drowsiness
receptor in the count or liver Somnolence, patient for many
dysfunction. 
feeling tired severe headache possible drug
Pharmacologic brain, the
class: or restless and dizziness, interactions.
serotonin Use cautiously in the  increase in nervousness,
Thienobenzodiaz
epine receptors, the elderly, and with appetite akathisia,  Inform the
alpha-1 renal or hepatic  dry mouth personality patient of
Therapeutic adrenergic impairment, disorders, possible side
illnesses of  constipation impaired speech, effects and
class: receptor, the
Antipsychotic histamine metabolism or tardive adverse effects
hemodynamic dyskinesia, and encourage
receptor H1, and
INDICATION response, pregnancy, dystonia, tremor, them to report or
multiple lactation, patients extrapyramidal verbalize the
Olanzapine is muscarinic with suicidal effects, effects once felt.
indicated for: receptors. its ideations, mania, or neuroleptic
antagonistic seizure disorders. malignant  Prior to taking
Patients over 13 effect towards syndrome, coma. the drug, advise
years old with the dopamine D2 the patient to
schizophrenia CV: void in order to
receptor in the
and bipolar Orthostatic decrease the
mesolimbic hypotension, anticholinergic
disorder
including mixed pathway is key peripheral effects of urinary
or manic as it blocks edema, retention.
episodes. dopamine from tachycardia
having a GI:  In the event that
Short term Constipation, the patient shows
potential action
treatment of abdominal pain concerns about
at the post- weight gain,
acute manic or synaptic
mixed episodes Respiratory: inform her that it
receptor. The Cough, happens during
associated with
bipolar I disorder binding of pharyngitis, the initial period
in adults in olanzapine to the dyspnea of taking the
combination dopamine D2 drug.
with lithium receptors is Other: Fever,
(valproate). easily severe weight  Advise the
gain or weight patient to rise
dissociable and
Treatment of loss, flulike slowly when
hence, it allows symptoms, and standing or
episodes of
depression for a certain death. sitting up in
associated with degree of order to reduce
bipolar disorder dopamine the chances of
type 1 and neurotransmissio feeling
treatment- n. Given this lightheaded or
resistant dizzy.
action,
depression in
Olanzapine  Emphasize the
patients over 10
years old in provides importance of
combination therapeutic medication
with fluoxetine. effects by compliance.
decreasing
DOSAGE AND manifestations of  Immediately
FREQUENCY report any signs
psychosis.
of adverse effects
to the physician.
Dosage:
10mg/ tab
Route:
Oral
Frequency:
OD

Maximum dose:
20 mg orally OD
 DRUG –
NAME OF MECHANISM CONTRAINDICATION SIDE ADVERSE NURSING
DRUG OF ACTION EFFECTS EFFECTS RESPONSIBILITIES
GENERIC NAME The The patient 
medication taking this
may exhibit medication
should watched
the following
BRAND NAME out for the
side effects: following
adverse reaction
 in:
CLASSIFICATION

Pharmacologic
class:

Therapeutic
class:

INDICATION

(med) is
indicated for:

DOSAGE AND
FREQUENCY

Dosage:
Route:
Frequency:

Maximum dose:
 VIII. REFERENCES
https://www.webmd.com/schizophrenia/mental-health-schizoaffective-disorder#:~:text=Schizoaffective
%20disorder%20has%20the%20features,as%20one%20of%20the%20two.
https://consortium-psy.com/jour/article/view/51
https://psychcentral.com/schizophrenia/schizophrenia-depression#can-depression-cause-schizophrenia
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4332163/

https://go.drugbank.com/drugs/DB00334