Question

A 35 year old man presents to his physician with neck pain that began suddenly while at rest four hours ago. His past medical history is significant for a ten-year history of disorganized schizophrenia, which has been treated unsuccessfully with a number of medications including olanzapine, risperidone, and haloperidol, and he has been recently switched to thiothixene. Examination shows a disheveled male with a flat affect, holding his head twisted to the right. There is limited cervical range of motion and pronounced muscle contraction of the sternocleidomastoid and paracervical muscles. Which of the following is the most appropriate pharmacologic intervention for this patient's condition?

A. IV dantrolene
B. Increase po thiothixene
C. Add clozapine
D. Oral ibuprofen
E. Oral diphenhydramine

Answer 1

The most appropriate pharmacologic intervention for this patient's condition would be to add clozapine. Clozapine is an atypical antipsychotic medication that is known for its efficacy in treating treatment-resistant schizophrenia. It is effective in reducing symptoms of schizophrenia and has fewer extrapyramidal side effects compared to other antipsychotics.

Step-by-step explanation:

The most appropriate pharmacologic intervention for this patient's condition would be to add clozapine.

Clozapine is an atypical antipsychotic medication that is known for its efficacy in treating treatment-resistant schizophrenia. This patient has a history of unsuccessful treatment with several antipsychotic medications, indicating that his schizophrenia is treatment-resistant. Clozapine is often reserved for patients who do not respond to other antipsychotics.

Clozapine has been shown to be effective in reducing symptoms of schizophrenia, such as hallucinations and delusions. It is also less likely to cause extrapyramidal side effects, such as muscle contractions and limited range of motion, compared to other antipsychotics like haloperidol.