NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction

Walden University NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction– Step-By-Step Guide

This guide will demonstrate how to complete the Walden University NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

How to Research and Prepare for NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction

Whether one passes or fails an academic assignment such as the Walden University NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

How to Write the Introduction for NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction

The introduction for the Walden University NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

How to Write the Body for NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction

After the introduction, move into the main part of the NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

How to Write the Conclusion for NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

How to Format the References List for NURS 6630 Assessing and Treating Patients With Impulsivity, Compulsivity, and Addiction

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Sample Answer for NURS 6630 Assessing and Treating Patients with Impulsivity, Compulsivity, and Addiction  

Addiction is characterized by behavioral, psychological, and physical symptoms caused by a person having inadequate control over the use of a substance. One of the addiction disorders is gambling, characterized by frequent and repetitive involvement in gambling. Affected persons are unable to resist the urge to gamble, and this dominates, making them neglect their educational, occupational, and social obligations. The purpose of this assignment is to describe a patient with an addiction disorder and discuss the treatment interventions. 

Introduction to the Case 

The case depicts Mrs. Perez, a 53-year-old woman who reports having problems with alcohol since she was in her 20s. She states that the problems began when her father died in her late teens and has severally attended Alcoholics Anonymous meetings. According to Perez, the last two years have been challenging for her in her efforts to remain sober after a casino was opened near her place of residence. She gambles at the casino, which makes her high. She mentions that she takes some drinks to calm her when gambling, particularly in intense games. The few drinks lead to more drinking and make her gamble irresponsibly. The irresponsible gambling has left her in debt of over $50,000. 

 Mrs. Perez is worried about her smoking pattern, which has worsened in the past two years. She mostly smokes when gambling but rarely smokes when taking alcohol. Her presentation leads to diagnoses of Gambling disorder and alcohol use disorder (AUD). Patient factors that can influence decisions when developing a treatment plan include comorbid medical conditions, the patient’s previous response to AUD therapy, the patient’s level of motivation to achieve abstinence, and treatment adherence.  

Decision #1 

Vivitrol (Naltrexone) injection, 380 mg IM in the gluteal region every four weeks. 

Why I Selected This Decision 

Naltrexone was the drug of choice because it effectively reduces alcohol consumption by decreasing alcohol cravings. Ray et al. (2019) found that Naltrexone reduces craving, reduces stimulation, increases sedation, and increases negative mood, which results in decreased alcohol intake. Besides, a monthly injection formulation would foster treatment adherence, leading to better treatment outcomes.   

Why I Did Not Select the Other Two Options 

Antabuse (Disulfiram) was not ideal because it causes disulfiram ethanol reaction (DER) when a patient takes alcohol and thus requires supervised use. DER is characterized by flushing, tachycardia, hypotension, tachypnea, palpitations, headache, sweating, nausea, vomiting, giddiness, and a sense of impending doom associated with severe anxiety (Castrén et al., 2019). Campral (acamprosate) was not the drug of choice because it is primarily indicated to attain and maintain complete abstinence instead of reducing or preventing relapse in regular alcohol use (Stokłosa et al., 2023). It also requires three times daily dosing, which may lead to challenges with compliance.  

What I Was Hoping to Achieve 

The clinician hoped that Naltrexone would suppress the patient’s craving for alcohol, leading to reduced intake. Stokłosa et al. (2023) explain that Naltrexone suppresses the reward system and reduces the pleasure experienced after consuming alcohol products.  

Ethical Considerations That May Impact the Treatment Plan and Communication  

Ethical principles of beneficence and nonmaleficence may impact the treatment plan since the clinician has to consider a treatment intervention linked with the best outcomes and least harm for patients with AUD. Communication may be affected by the patient’s right to autonomy, given that the clinician has to discuss the treatment plan with the patient.  

Decision #2 

Refer Mrs. Perez to a counselor to address gambling issues.  

Why I Selected This Decision 

The patient was referred to a counselor because psychological intervention is effective in treating gambling addiction, and there is no approved drug to treat the disorder. Eriksen et al. (2023) found that cognitive behavioral therapy (CBT) has the strongest evidence supporting its effectiveness in managing gambling addiction. Besides, Cognitive-behavioral approaches are simple and effective. 

Why I Did Not Select the Other Two Options 

Adding Valium to treat the patient’s anxiety was not ideal because it is a dose-dependent side effect of Naltrexone (Ray et al., 2019). Counseling can help the client identify and manage her causes of anxiety through effective coping mechanisms (Higueruela-Ahijado et al., 2023). Moreover, Chantix (varenicline) was not ideal for the patient’s smoking habit since it is linked with gambling. Thus, it is essential to first address gambling addiction, which will lead to reduced smoking (Eriksen et al., 2023).  

What I Was Hoping to Achieve 

The NP hoped that counseling would help the patient identify the causes of her gambling disorder and address these issues, which would reduce his gambling and smoking and prevent alcohol relapse. In the initial stages, including during detoxification, patients are given supportive psychotherapy in counseling to encourage them and enhance their motivation (Higueruela-Ahijado et al., 2023). 

Ethical Considerations That May Impact the Treatment Plan and Communication  

Beneficence may impact treatment because the NP has to identify the best measure to address the patient’s gambling disorder to avoid a relapse of alcohol use. Furthermore, the NP has to obtain the patient’s consent when initiating a treatment intervention, which may impact communication with the client.  

Decision #3 

Explore Mrs. Perez’s issue with her counselor and encourage her to continue attending GA meetings. 

Why I Selected This Decision 

It was crucial to identify the issues the patient has with her counselor to help address them and motivate the client to continue with therapy. Ruud and Friis (2022) explain that continuity of care and therapeutic relationships (TRs) are considered essential factors by clients in mental health. Addressing issues can help establish and maintain a good TR between Perez and her counselor.  

Why I Did Not Select the Other Two Options 

It would be inappropriate to persuade the client to continue attending counseling without addressing the reasons why she did not like the counselor. This can affect their TR and limit the patient from getting the best from the counseling sessions (Ruud & Friis, 2022). Stopping Vivitrol was inappropriate at this point since it can lead to a relapse, especially when the client has not addressed her gambling issue (Stokłosa et al., 2023). 

What I Was Hoping to Achieve 

The NP hoped that the patient would continue with therapy after exploring and addressing the issues she has with her counselor. The NP also hoped that encouraging Perez to continue attending GA meetings would help her address her addiction problem. Group therapy, such as GA sessions, provides counseling and support to deal with common issues (Eriksen et al., 2023). The groups use educational and operational principles to explain drug abuse as a disease and various methods used to avoid drug-seeking behaviors. 

Ethical Considerations That May Impact the Treatment Plan and Communication  

The NP had to uphold confidentiality when exploring issues with the client, which may impact treatment and communication. For instance, the NP must assure the patient that what will be discussed will be kept confidential to encourage the client to express her concerns with the counselor.  

Conclusion 

Mrs. Perez was diagnosed with Gambling disorder and alcohol use disorder. She started on Naltrexone monthly injection since it decreases alcohol use by reducing craving, reducing stimulation, increasing sedation, and increasing negative mood (Ray et al., 2019). Disulfiram was not prescribed because it requires supervised use due to the disulfiram ethanol reaction (DER) that occurs when a patient takes alcohol (Castrén et al., 2019). Acamprosate was also not selected because it is indicated for patients who are maintaining complete abstinence e (Stokłosa et al., 2023).  

Naltrexone led to alcohol abstinence, but the patient’s gambling problem persisted. Consequently, she was referred for counseling since psychological intervention is effective in treating gambling addiction, and there is no medication for addiction (Eriksen et al., 2023). However, the patient reported disliking her counselor but enjoyed Gamblers Anonymous meetings. The NP explored the issues Perez has with her counselor to help her have a good and effective therapeutic relationship, which is fundamental to achieving the desired therapy outcomes (Ruud & Friis, 2022). She was also encouraged to continue attending GA sessions as they provide counseling and support clients with addictions to deal with common issues. Furthermore, the patient was continued on Vivitrol to avoid relapse in alcohol use until she addresses her gambling issues through counseling. 

References 

Castrén, S., Mäkelä, N., & Alho, H. (2019). Selecting an appropriate alcohol pharmacotherapy: Review of recent findings. Current Opinion in Psychiatry, 32(4), 266-274. doi:10.1097/yco.0000000000000512  

Eriksen, J. W., Fiskaali, A., Zachariae, R., Wellnitz, K. B., Oernboel, E., Stenbro, A. W., Marcussen, T., & Petersen, M. W. (2023). Psychological intervention for gambling disorder: a systematic review and meta-analysis. Journal Of Behavioral Addictions, 12(3), 613–630. https://doi.org/10.1556/2006.2023.00034 

Higueruela-Ahijado, M., López-Espuela, F., Caro-Alonso, P. Á., Novo, A., & Rodríguez-Martín, B. (2023). Efficacy of cognitive-behavioral therapy in improving the quality of life of people with compulsive gambling, a systematic review. Archives Of Psychiatric Nursing, 43, 127–142. https://doi.org/10.1016/j.apnu.2022.12.014 

Ray, L. A., Green, R., Roche, D. J. O., Magill, M., & Bujarski, S. (2019). Naltrexone effects on subjective responses to alcohol in the human laboratory: a systematic review and meta-analysis. Addiction Biology, 24(6), 1138–1152. https://doi.org/10.1111/adb.12747 

Ruud, T., & Friis, S. (2022). Continuity of care and therapeutic relationships as critical elements in acute psychiatric care. World Psychiatry: Official Journal Of The World Psychiatric Association (WPA), 21(2), 241–242. https://doi.org/10.1002/wps.20966 

Stokłosa, I., Więckiewicz, G., Stokłosa, M., Piegza, M., Pudlo, R., & Gorczyca, P. (2023). Medications for the treatment of alcohol dependence-current state of knowledge and future perspectives from a public health perspective. International Journal of Environmental Research And Public Health, 20(3), 1870. https://doi.org/10.3390/ijerph20031870 

Tigh, J., Daniel, K., & Balasanova, A. A. (2022). Impact of Hospital-Administered Extended-Release Naltrexone on Readmission Rates in Patients With Alcohol Use Disorder: A Pilot Study. The Primary Care Companion for CNS Disorders, 24(6), 43569. https://doi.org/10.4088/PCC.21m03213

Sample Answer 2 for NURS 6630 Assessing and Treating Patients with Impulsivity, Compulsivity, and Addiction

The case study examines Mrs. Perez, a 53-year-old Puerto Rican woman who seeks treatment at the clinic for her alcohol and gambling addictions. The patient indicates experiencing difficulties with alcohol use after the death of her father during her late adolescence. She has intermittently participated in Alcoholics Anonymous for over 25 years. Over the last couple of years, her need for gambling has intensified due to the establishment of the new “Rising Sun” casino near her residence. Consequently, she resorted to withdrawing more than $50,000 from her retirement savings in order to settle her mounting gambling obligations. Remarkably, she has managed to conceal this financial predicament from her spouse. Mrs. Perez displayed attentiveness and awareness during the mental status assessment, while her eye contact tended to avoid direct engagement. She expressed experiencing sadness, and her ability to regulate her impulses was compromised. Her presentation led to a diagnosis of a gambling problem and alcohol use disorder.

Various patient variables might influence the process of providing medicine for Mrs. Perez. The variables include her past alcohol and gambling dependency, increase in body weight, tobacco consumption, apprehensions about the detrimental impact of smoking on her well-being, and her recent withdrawal of $50,000 from her retirement fund to settle her gambling obligations. Additionally, one must also take into account her compromised ability to regulate impulses and her worries about anxiousness and thoughts of suicide when on Campral. These patient considerations emphasize the significance of tailored and comprehensive treatment strategies for persons grappling with addiction and the need for thoughtful deliberation when selecting a suitable drug choice. This paper provides a detailed analysis of the patient’s issues with gambling and alcohol use, as well as the therapy choices made to achieve favorable results.

Decision Point One

Selected Decision and Rationale

For the first choice, the chosen course of action was administering a Vivitrol (naltrexone) injection, with a dosage of 380 mg, into the gluteal area every four weeks. Mrs. Perez had experienced severe difficulties sustaining her sobriety as a result of her high-risk gambling behavior. Naltrexone is a pharmaceutical agent that inhibits the physiological responses of opioids, such as endorphins, which are generated during wagering and produce a gratifying sensation comparable to that of consuming alcohol (Kedia et al., 2022). According to studies, naltrexone may help people with gambling addictions by lowering their frequency of gambling and their impulse to gamble (Grant & Chamberlain, 2020). In addition, given Mrs. Perez’s alcohol use problem, naltrexone may assist her in maintaining sobriety by diminishing the enjoyable effects of alcohol intake. Naltrexone demonstrates efficacy in decreasing the frequency and quantity of alcohol intake among those afflicted with alcohol dependency (Ford & Håkansson, 2020).

The administration of disulfiram was unnecessary, given that its deleterious effects were intended to deter alcohol consumption. The possible negative consequences, such as rapid or irregular heartbeats, low blood pressure, dizziness, severe headaches, and sudden skin reddening, might pose further risks to the patient’s overall health (Di Nicola et al., 2019).  Hence, the recommended regimen for delivering Campral requires three doses per day, which raises the likelihood of patients failing to comply with the prescription and resulting in suboptimal adherence (Grant & Chamberlain, 2020).

Expected Outcome

It is expected that when the patient comes back to the clinic after taking naltrexone for four weeks, there will be a reduction in both the desire for alcohol and its use (Ventricelli & Peterson, 2021). Reducing alcohol use should lead to a restoration of her body mass to its natural state. Moreover, enhancing her capacity to control her impulses is expected to influence her overall well-being and satisfaction positively. She should reduce the frequency of her gambling activities.

Ethical Consideration

According to the code of ethics in the nursing profession, patient-centered care requires patients to actively participate in making decisions regarding their treatment (Koob, 2024). Therefore, it is critical to furnish the client with comprehensive information regarding each treatment alternative, encompassing their advantages and disadvantages, to enable them to make an informed decision.

Decision Point Two

Selected Decision and Rationale

As an additional intervention, upon evaluating the results of each of the three alternatives, it was determined that the most optimal course of action for Mrs. Perez was to recommend her to a counselor in order to tackle her gambling problems. The choice was made based on the client’s main worry, which is the gambling problem, and the possible advantages of receiving counseling with her existing pharmaceutical regimen. Studies have shown the efficacy of counseling and treatment in addressing gambling problems, namely via the use of cognitive-behavioral therapy and motivational interviewing (Kedia et al., 2022). Therapeutic counseling may assist the client in recognizing and dealing with the fundamental causes of their gambling behavior, acquiring effective strategies for managing it, and enhancing their belief in their ability to make positive changes and their desire to do so (Grant & Chamberlain, 2020). In addition, counseling may provide continuous assistance in sustaining abstinence and mitigating the likelihood of relapse (Ford & Håkansson, 2020).

Patients with a drug addiction problem should not be prescribed Valium since benzodiazepines, including Valium, have addictive properties (Di Nicola et al., 2019). Conversely, the use of Chantix was deemed unnecessary due to its association with heightened negative consequences when combined with naltrexone, such as anxiety, restlessness, sleeplessness, and dizziness (Grant & Chamberlain, 2020).

Expected Outcome

The patient is expected to have a reduction in symptoms of anxiety over the following month (Ventricelli & Peterson, 2021).  The patient is anticipated to effectively manage their gambling behavior within the specified period by regularly attending and ultimately committing to treatment sessions focused on addressing gambling addiction. It is anticipated that the patient will give up gambling and smoking.

Ethical Consideration

According to Koob (2024), legal and ethical requirements require that the well-being and enjoyment of the patient should be given the utmost priority. To maximize patient satisfaction and build trust in the therapeutic method, it is essential to address all patient concerns, which may include anxiety, tobacco use, or gambling.   

Decision Point Three

Selected Decision and Rationale

It was advised that Mrs. Perez’s counselor discussed the situation with her and strongly encouraged her to participate in Gamblers Anonymous meetings as the third course of action. The choice was made in light of the client’s admission that she did not like her counselor and the possible advantages of dealing with this matter and carrying on with Gamblers Anonymous. Studies have shown that establishing a favorable therapeutic connection between the individual receiving therapy and the therapist is crucial for achieving good treatment results (Kedia et al., 2022). Patients with a favorable rapport with their psychiatrist are more inclined to actively participate in therapy, experience a sense of being supported, and achieve advancements in their treatment objectives (Grant & Chamberlain, 2020). Hence, it is essential to resolve Mrs. Perez’s counselor’s matter to sustain her involvement in counseling and enhance her treatment results (Ford & Håkansson, 2020).

If the negative attitude of the patient toward her gambling counselor is disregarded, she will exhibit a lack of dedication to her treatment and will often skip appointments (Di Nicola et al., 2019). It is recommended to continue Vivitrol treatment for chronic alcoholism for a minimum of three months, indicating that discontinuing the medication at this juncture is unnecessary (Grant & Chamberlain, 2020).

Expected Outcome

It was anticipated that the client would have conveyed her issues to her counselor and actively engaged in treatment sessions during the next month (Ventricelli & Peterson, 2021). It is expected that she will successfully overcome her dependency on smoking and gambling throughout this period. Smoking should be reduced since it is associated with gambling, which needs regulation now.

Ethical Consideration

Recognizing and addressing any ethical concerns the patient may have about their counselor is essential to optimize treatment results and promote increased patient participation. Implementing this may improve the patient’s overall well-being and satisfaction. Before the patient consented to engage in the gambling sessions, it is essential to address her worries since she has the autonomy to make decisions about her well-being (Koob, 2024).

Conclusion

To address Mrs. Perez’s alcohol and gambling addictions, there was a blend of pharmaceutical and psychological therapies. The first decision was to deliver the Naltrexone (Vivitrol) injection, with a dosage of 380 mg, intramuscularly in the gluteal area every four weeks. The efficacy of Naltrexone in diminishing alcohol cravings and avoiding relapse among individuals diagnosed with alcohol use disorder (Kedia et al., 2022). The patient had a positive response to this treatment, with decreased alcohol intake and enhanced abstinence (Ford & Håkansson, 2020). To treat her gambling condition, it was recommended that she seek counseling to specifically target her gambling difficulties and strongly advised her to actively engage in Gamblers Anonymous meetings (Di Nicola et al., 2019). The client expressed a sense of being supported and actively involved in the Gamblers Anonymous group, which resulted in a reduction in her anxiety levels and an improvement in her gambling behaviors (Ventricelli & Peterson, 2021). Regarding the third choice point, it was proposed to investigate Mrs. Perez’s problem with her counselor and motivate her to attend Gamblers Anonymous gatherings (Grant & Chamberlain, 2020).

In summary, the integration of pharmaceutical and psychosocial therapies proved to be efficacious in addressing Mrs. Perez’s alcohol and gambling issues. Ethical issues were carefully considered throughout the treatment plan to preserve the patient’s autonomy and privacy. Acknowledging that each patient has distinct characteristics, treatment strategies should be customized to address their requirements and concerns (Koob, 2024). When making treatment decisions, clinicians must consider the patient’s medical background, other health conditions, personal preferences, and possible advantages and disadvantages of different therapy choices. Hence, continuous evaluation and adjustment of the treatment strategy are necessary for achieving favorable results.

References

Di Nicola, M., De Crescenzo, F., D’Alò, G. L., Remondi, C., Panaccione, I., Moccia, L., Molinaro, M., Dattoli, L., Lauriola, A., Martinelli, S., Giuseppin, G., Maisto, F., Crosta, M. L., Di Pietro, S., Amato, L., & Janiri, L. (2019). Pharmacological and Psychosocial Treatment of Adults with Gambling Disorder: A Meta-Review. Journal of Addiction Medicine, 14(4), e15–e23. https://doi.org/10.1097/adm.0000000000000574

Ford, M., & Håkansson, A. (2020). Problem gambling, associations with comorbid health conditions, substance use, and behavioral addictions: Opportunities for treatment pathways. PLOS ONE, 15(1), e0227644. https://doi.org/10.1371/journal.pone.0227644

Grant, J. E., & Chamberlain, S. R. (2020). Gambling and substance use: Comorbidity and treatment implications. Progress in Neuro-Psychopharmacology and Biological Psychiatry, p. 99, 109852. https://doi.org/10.1016/j.pnpbp.2019.109852

Kedia, S., Ahuja, N., Dillon, P., Jones, A., Kumar, S., & Satapathy, S. K. (2022). Efficacy of Extended-Release Injectable Naltrexone on Alcohol Use Disorder Treatment: A Systematic Review. Journal of Psychoactive Drugs, 1–13. https://doi.org/10.1080/02791072.2022.2073300

Koob, G. F. (2024). Alcohol Use Disorder Treatment: Problems and Solutions. Annual Review of Pharmacology and Toxicology, 64(1), 255–275. https://doi.org/10.1146/annurev-pharmtox-031323-115847

Ventricelli, D., & Peterson, A. M. (2021). Substance use disorders. In Elsevier eBooks (pp. 759–768). https://doi.org/10.1016/b978-0-12-820007-0.00040-4  

NURS 6630 Discussion Assignment Patient Medication Guide Sample

Oral or Injection 

Used to treat Schizophrenia and schizoaffective disorders in adults. 

FDA approved. 

Non-FDA approved for: 

• Bipolar disorder 

• Behavioral disturbances 

• Impulsive behavior disorders 

• Other appropriate atypical psychiatric disorders (Morris & Tarpada, 2017). 

Mechanism of action: 

• Not fully understood. 

• Believed to work as a dopamine D2 and serotonin 5-HT2A receptor antagonist. 

Pharmacokinetics: 

• Low water solubility. 

• Dissolves slowly before being hydrolyzed to paliperidone and absorbed into systemic circulation. 

• Not extensively metabolized. 

• Mostly metabolized in the kidneys. 

• Primarily renally excreted (Janssen Science, 2023). 

Pharmacodynamics: 

• Blocks dopamine and serotonin. Restoring balance in the brain. 

• Centrally acting as a dopamine type 2 and serotonin type 2 antagonist. 

• Helps improve mood and CNS function (Termine & Balottin, 2013). 

Dosing Information: Following chart courtesy of (Drugs.com, 2024). 

• Extended-release oral dosing: Starting dose 1.5mg the 3mg. 

• Dose can be increased in 3mg increments up to 9mg (Invega Sustenna (paliperidone) dosing, 2024). 

• Injection dosing below. 

Invega Sustenna Considerations: 

• Not recommended for pregnant women due to withdrawal symptoms in neonates. 

• Not recommended for elderly patients due to increased risk of death. 

• There is no significant information on use and effectiveness in children and adolescents. 

• Not recommended for individuals experiencing suicidal behavior (Fabrega et al., 2015). 

Half-Life: The amount of time it takes for half the drug to be eliminated from the body. 

• Half-life of Invega Sustenna is 25-49 days. 

• Half-life is vital to knowing how often a medication needs taken. 

• Half-life gives an estimation of how long a drug will remain effective (Hallare, 2023). 

Side effects and adverse reactions: Most Common 

• Injection site reaction 

• Dizziness 

• Weight gain 

• Heart rate irregularities 

• Somnolence 

• Restlessness 

• Hypotension 

• Abnormal muscle movements 

Serious Side Effects: 

• Neuroleptic malignant syndrome 

• Seizures 

• Heart rhythm issues 

• Hyperglycemia 

• Neurological such as tardive dyskinesia 

Contraindications: 

• Do not use if you have a history of heart arrhythmias or heart failure. 

• Do not use if you have an allergy to paliperidone or risperidone (Al-Mahrougi et al., 2021). 

Extrapyramidal Side Effects (EPS) and Tardive dyskinesia (TD): 

• Associated with reduced social functioning. 

• Can be life -altering. 

• May not go away. 

Screening tools for EPS and TD: 

• Abnormal Involuntary Movement Scale (AIMS): Assesses the presence and severity. 

• Simpson-Angus Scale (SAS): Used to assess for EPS an parkinsonism. 

• Drug induced EPS Scale (DISCUS): Used to assess a wide range of EPS symptoms (Musco et al.,2019). 

Interactions: 

• May interact with benzodiazepines, opioids, antihypertensives, certain antibiotics and supplements. Talk to your doctor about any medication being taken.  Some drugs may lead to overdose if interactions occur. 

Labs to Monitor Effectiveness, Safety, and Adverse Effects Include: 

• Liver function tests. 

• Renal function tests. 

• Glucose testing. 

• Weight and Vital Signs (Di Lorenzo et al., 2022). 

Social and Ethical Considerations: 

• Quality of life. 

• Risk of dependance. 

• Stigma and public ridicule 

• Access to treatment. 

• Shared decision making. 

• Public health impact. 

Patient Education: Education on the reason for the medication, dosing, common and dangerous side effects, dosing schedules, monitoring for efficacy, compliance, lifestyle considerations, drug interactions, and emergency situations (when to call 911). 

CONTRAINDICATIONS: Not FDA approved for dementia-related psychosis. Contraindicated for patients with hypersensitivity to paliperidone or risperidone. 

USES: Long-acting drug used to treat schizophrenia and schizoaffective disorders in adults. Given as an extended-release tablet or by intramuscular injection. 

DRUG: INVEGA SUSTENNA (paliperidone palmitate) 

ACTION: Mechanism of action is unclear.  Is believed to have a therapeutic effect that is mediated through dopamine and serotonin types 2 receptor antagonism. 

(National Center for Biotechnology, 2024). 

References 

Al-Mahrouqi, T., Al-Kindi, A., & Al-Harrasi, A. (2021, February 27). Crippling side effects induced by paliperidone palmitate treatment: A case report. Cureus. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8006656/ 

Di Lorenzo, R., Iorio, A., Pinelli, M., Magarini, F., Marchi, M., Sacchetti, A., Calogero, C., Galeazzi, G. M., Ferri, P., Rovesti, S., & Minarini, A. (2022, April 12). Effectiveness and quality of life with paliperidone palmitate 3-monthly in comparison with other long-acting drugs. Neuropsychiatric disease and treatment. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9013412Links to an external site. 

Drugs.com. (2024). Invega Sustenna Dosage Guide. https://www.drugs.com/dosage/invega-sustenna.htmlLinks to an external site. 

Fàbrega, M., Sugranyes, G., & Baeza, I. (2015). Two cases of long-acting paliperidone in adolescence. Therapeutic advances in psychopharmacology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4622123/ 

Hallare, J. (2023, June 20). Half life. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK554498/ 

Invega Sustenna (paliperidone) dosing, indications, interactions, adverse effects, and more. Medscape. (2024, June 27). https://reference.medscape.com/drug/invega-sustenna-invega-trinza-paliperidone-342992Links to an external site. 

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