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Biomedical subjects

R Aquila

Publications and source records attributed to R Aquila.

9 recordsLinked to original sources
PubMed2001

Recovery and realism.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
PubMed1999

Predictors of management problems in supported housing: a pilot study.

The study examined predictors of management problems among residents of a supported single room occupancy hotel (SRO) for persons with severe and persistent mental illness (SPMI). Case workers completed questionnaires on the prior six months. We found that medication-compliant residents without drug abuse were rarely disruptive, while those with co-morbid substance abuse were often disruptive. Residents non-compliant with medication also tended to cause management problems whether or not they abused drugs. Supported residences should be staffed and organized to minimize medication non-compliance and substance abuse which are associated with behavioral disruptiveness.

Adult↗
PubMed1999

Compliance and the rehabilitation alliance.

Expectations for the treatment of schizophrenia have historically been modest, with emphasis on eliminating positive symptoms and keeping patients out of the hospital. Noncompliance with traditional antipsychotic agents, which have limited efficacy and are associated with numerous adverse side effects, has contributed to these low expectations. The atypical antipsychotics can improve compliance because of their better safety, efficacy, and tolerability and thus help raise treatment expectations from mere removal of symptoms to fuller rehabilitation. This rehabilitation can even include the reintegration of patients with schizophrenia into the community. Compliance with any drug regimen, however, does not in itself guarantee the return to a normal life for patients with schizophrenia. Instead, compliance must occur within a rehabilitation alliance--a supportive network that includes the patient, the treating physician, family members and friends, and other caregivers.

Antipsychotic Agents↗
PubMed1998

Long-term considerations after switching antipsychotics.

The so-called "atypical" antipsychotics are rapidly becoming the de facto standard pharmacologic treatment of schizophrenia. This article reviews some common psychopharmacologic and psychological issues that may arise after an outpatient with schizophrenia is switched to one of the newer antipsychotics. Important issues to consider in the first few months after switching include assessment of response to the new medication, dealing with subsequent psychological reactions, and management of an unsatisfactory response. Once the response is established, there are other pharmacologic and psychological issues that arise during the next year or two. Pharmacologic issues that emerge later on include the role of long-term combination antipsychotics, management of new side effects, and deciding whether and when to switch again. Some of the long-term psychological issues include changes in self-image that arise from being less visibly ill, sexuality and intimacy concerns, and recovery issues.

Acute Disease↗
PubMed1997

Switching antipsychotic medications.

Compared with conventional antipsychotics, the so-called "atypical" antipsychotics promise improved side effect profiles and better control of the symptoms of schizophrenia. Therefore, most patients currently taking conventional antipsychotics could potentially benefit from a switch to an atypical antipsychotic. Often, the key issue in deciding whether to switch is the presence of countervailing factors that mitigate against the change. This paper discusses the indications and contraindications for switching antipsychotics, plus issues that require consideration before a switch is made. Also, the advantages and disadvantages of various switching techniques are discussed, with a particular focus on the newer antipsychotic olanzapine.

Ambulatory Care↗
PubMed1996

Atypical antipsychotic drugs and long-term outcome in schizophrenia.

Long-term outcomes for patients with schizophrenia have been disappointing. The article discusses how the typical antipsychotics (clozapine and risperidone) as well as several agents that should be available in the near future (olanzapine, sertindole, quetiapine, and ziprasidone) might improve outcome and then focuses on antipsychotic relapse rates and the newly released antipsychotic olanzapine. Considerable evidence shows that relapse rates for compliant patients maintained on atypical antipsychotics are substantially lower than rates for those maintained on conventional antipsychotics. Also, the decreased extrapyramidal symptom liability of the newer medications will make it easier to prescribe more effective doses of antipsychotic that can maximize relapse prevention without simultaneously interfering with the patient's quality of life or motor functioning. The authors describe clinical observations of olanzapine based on their 3 years of clinical experience using this agent in a phase 3 clinical trial. They suggest that as atypical antipsychotics like olanzapine are more widely used, some problems associated with the long-term use of conventional antipsychotics will diminish, but other issues and concerns will be more common. In particular: (1) Despite their better side effect profiles, atypical antipsychotics will not solve the noncompliance problem. A significant proportion of patients with schizophrenia will still need depot therapy. (2) There will be problems arising from "awakenings" phenomena where patients will become more in touch with their losses and painful inner feelings. It seems likely that the need for rehabilitation services will be increased as more patients improve to the point where they will be amenable to psychiatric rehabilitation.

Adult↗