Obsessive-Compulsive Disorder (OCD) in Older Adults

The population or group selected is Older Adults and the specific disorder selected is Obsessive Compulsive Syndrome.

            Obsessive-compulsive syndrome is a personality disorder described through anxious thoughts. Such behaviors among adults get indicated by compensatory activities to reduce the stress caused by intrusive thoughts. Obsessions lead to anxiety or discomfort and recurrent psychological or behavioral acts leading to compulsion. Besides, adults feel compelled to execute in either response to the specific obsessive thought or in order to reach some sensation of completeness (Stein et al., 2019). Obsessive-compulsive syndrome is caused by a combination of genetic and familial factors.

FDA Approved Drug

Fluvoxamine

            Fluvoxamine is a drug for treating OCD.  Constant, unpleasant thoughts explained as obsessions and compulsive behaviors, including counting and verifications, can be lessened using this technique. When it comes to serotonin reuptake inhibition, Fluvoxamine is the best-recognized drug (SSRI) (Hasanpour et al., 2019). Serotonin, a naturally occurring chemical in the brain, is the primary target of this medicine. Depending on adults’ medical condition, reaction to therapy, and other drugs taken might get adjusted. If patients take any medication, there is a need to notify healthcare providers for required prescription

One-off -Labelled Drug

Haldol

            Haldol, as an antipsychotic, could also be used in conjunction with SSRIs to treat obsessive-compulsive disorder (OCD). Haldol is a highly successful treatment for OCD symptoms (Kelly, 2020). The drug is more prone than the atypical antipsychotics for eliciting extrapyramidal adverse reactions in induced movement disorders for some persons.

Nonpharmacological Interventions

            Individuals with obsessive-compulsive disorder (OCD) have reported that deep transcranial magnetic stimulation (DTMS) has been demonstrated to safely and successfully reduce their symptoms. This is especially true for patients who have not seen enough progress with typical OCD treatment methods (Chail et al., 2018). It is possible to stimulate the brain non-invasively using transcranial magnetic stimulation (TMS). Outside of the body, TMS devices deliver high magnetic fields to particular brain parts known to be implicated in depression to change central nervous system activity. Unlike medicines and ECT, which can have adverse reactions 

Risks assessment for treatment

            Check for potential interactions with any medications food additives (such as vitamins or natural remedies). Healthcare consumers should use specific pharmacies for medical requirements. Consult a doctor prior to taking new medication or substance, including herbal supplements, to identify possible adverse effects

Benefits and risks of the FDA-Approved Medicine

            Beneficial effects of FDA drugs include blood pressure reduction, infection cures, and pain reduction. When a person uses medication, the danger of experiencing side effects might result in health complications. More significant risks include nausea, vomiting, and liver damage. The FDA will only approve a drug if the benefits exceed the hazards (FDA.gov, 2021). However, before taking any medication, clients need to carefully consider both the advantages and hazards. Patients in care settings should know that various medicinal use medicines got side effects. Supplements, beverages, or other meals may interact with the drug (Singh & Saadabadi, 2019).

Benefits and risks of the off-label drug

            Nearly a quarter of all prescriptions in the United States uses off-label medicines. Using medicine for an unapproved purpose can be both safe and beneficial. Then then, there may be some drawbacks to this option. Off-label drugs get efficacy if the care facility lacks FDA-approved treatment for a person’s illness. The prescription also occurs when the FDA-approved medications for a particular ailment have not worked for the patient. The drugs have worked when FDA-approved medications for a given ailment get expensive or unavailable to the general public. Despite the advantages of using off-label drugs in clinical settings, care consumers can also face adverse effects or probable drug interactions. The heath data suggests a particular medicine is unconducive when used outside of its intended use (Vijay, Becker & Ross, 2018). Risks include long-term health complications and other ailments such as cancer.

Clinical Practice Guidelines for Considerations

There are clinical guidelines that exist for this disorder and below are recommendations that is used to justify the information needed to take into consideration: 

            Maintain a therapeutic partnership: Involve the patient in the decision-making process and pay attention to his or her treatment choices and concerns. Patients should understand the concepts of transfer and counter-transfer. Depression might make it more difficult to form a bond with another person.

Complete the mental health evaluation: healthcare physicians need to assess medical history and current signs and symptoms. The history of the patient’s psychiatric, including symptoms of mania and reactions to diagnosis, is required. Additionally, the patient’s general medical history, family medications, supplements are also required.

Establish the necessary treatment setting:  healthcare providers should determine the least restrictive setting most likely to address patient safety and enhance the client’s condition. The care settings should also assess patients’ overall health, including the intensity of their symptoms, the presence of any co-existing mental health or physical disorders, and the current degree of functioning.

References

Chail, A., Saini, R. K., Bhat, P. S., Srivastava, K., & Chauhan, V. (2018). Transcranial magnetic stimulation: A review of its evolution and current applications. Industrial psychiatry journal27(2), 172. doi: 10.4103/ipj.ipj_88_18

FDA.gov. (2021). Novel drug approvals for 2021. https://www.fda.gov/drugs/new-drugs-fda-cders-new-molecular-entities-and-new-therapeutic-biological-products/novel-drug-approvals-2021

Hasanpour, H., Meibodi, R. G., Navi, K., Shams, J., Asadi, S., & Ahmadiani, A. (2019). Fluvoxamine treatment response prediction in obsessive-compulsive disorder: association rule mining approach. Neuropsychiatric disease and treatment15, 895. DOI: 10.2147/NDT.S200569

Kelly, O. (2020). Antidepressant and antipsychotic drugs used to treat OCD. Retrieved from https://www.verywellmind.com/medications-to-treat-ocd-2510644

Singh, H. K., & Saadabadi, A. (2019). Sertraline. https://www.ncbi.nlm.nih.gov/books/NBK547689/

Stein, D. J., Costa, D. L., Lochner, C., Miguel, E. C., Reddy, Y. J., Shavitt, R. G., … & Simpson, H. B. (2019). Obsessive–compulsive disorder. Nature Reviews Disease Primers5(1), 1-21. DOI: 10.1038/s41572-019-0102-3

Vijay, A., Becker, J. E., & Ross, J. S. (2018). Patterns and predictors of off-label prescription of psychiatric drugs. PLoS One13(7), e0198363. DOI: 10.1371/journal.pone.0198363

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