Users' Guides to the Medical Literature
Guyatt G, Rennie D, Meade MO, Cook DJ
Part B Therapy
Chapter 10.5. Measuring Patients' Experience
Toshi A. Furukawa, Roman Jaeschke, Deborah J. Cook, Gordon Guyatt
chlorpromazine, health outcomes, health-related quality of life, incorporating patient values and preferences, measuring patient experience, olanzapine, patient evaluation, schizophrenia
"You are a psychiatrist following a 49-year-old man who has had schizophrenia
for more than 20 years. He had an acute psychotic episode in his
mid-20s and was admitted to a psychiatric hospital for 3 weeks.
He made good recovery and has managed to continue work in a small
factory. He has been taking chlorpromazine 200 mg/d for many
years, still hears occasional hallucinations, and has no close friends
except for his sister's family, who live a block away.
Half a year ago, work stress increased, the patient began to take
medication only irregularly, and he experienced a mild exacerbation,
becoming fearful, developing insomnia, and hearing more voices.
You increased his chlorpromazine dosage to 300 mg/d, and
the patient became less agitated but is still moderately symptomatic.
Taking 300 mg/d of chlorpromazine, the patient has hand
tremors that trouble him, and his movements are stiff. He does not
mind the stiffness, but his family worries because "he
looks odd, aloof, and ill." He and his family now wonder
whether he should try a new antipsychotic drug that had been publicized
at schizophrenia support group meetings they have attended...."
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