Subject: Organic Chemistry Topic: Phases of Drug Metabolism Scenario: Y.H., a 32-year-old female with a history of chronic schizophrenia, presented for a routine follow-up visit to the behavioral health clinic. Her psychotic symptoms had been well controlled on risperidone 3 mg daily. At her previous appointment 1 month ago, Y.H. had reported being depressed, so her psychiatrist initiated a trial of paroxetine 20 mg daily as treatment. As the pharmacist was interviewing Y.H. for a medication history, he noticed that there was a resting tremor in her left hand. Y.H. acknowledged that it had first appeared within the last few weeks. She also stated that she was just starting to feel less depressed. Because both the risperidone and paroxetine appeared to demonstrate a therapeutic effect for Y.H., the pharmacist recommended that the dose of risperidone be decreased to 2 mg daily while continuing paroxetine 20 mg daily. At her next appointment the following month, Y.H. stated that her mood was “getting back on an even keel” and her left hand was no longer shaking. Question: 1. Describe the chemical analysis behind the situation of Y.H in using risperidone and paroxetine.

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Subject: Organic Chemistry 
Topic: Phases of Drug Metabolism

Scenario: Y.H., a 32-year-old female with a history of chronic schizophrenia, presented for a routine follow-up visit to the behavioral health clinic. Her psychotic symptoms had been well controlled on risperidone 3 mg daily. At her previous appointment 1 month ago, Y.H. had reported being depressed, so her psychiatrist initiated a trial of paroxetine 20 mg daily as treatment. As the pharmacist was interviewing Y.H. for a medication history, he noticed that there was a resting tremor in her left hand. Y.H. acknowledged that it had first appeared within the last few weeks. She also stated that she was just starting to feel less depressed. Because both the risperidone and paroxetine appeared to demonstrate a therapeutic effect for Y.H., the pharmacist recommended that the dose of risperidone be decreased to 2 mg daily while continuing paroxetine 20 mg daily. At her next appointment the following month, Y.H. stated that her mood was “getting back on an even keel” and her left hand was no longer shaking.

 

Question:
1.    Describe the chemical analysis behind the situation of Y.H in using risperidone and paroxetine.

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