[Expert Solution]: reply to this discussion The medication…

reply to this discussion The medication chosen would be based on his symptoms. Olanzapine can be more sedating, but it does come in IV and IM as well as dissolving tablet. This allows for the same antipsychotic to be given many ways. If there was indication that this patient would not take PO then olanzapine would be my first option. Seroquel can be sedating, especially at the lower doses. To achieve the antipsychotic benefit the dose needs to be titrated up. The benefit of Seroquel is that it can be given as needed as well as scheduled so caregivers would have a medication available to manage behaviors if needed. Risperidone would be the medication I would choose for this patient given the presence of paranoia but also has an outwardly calm demeanor. Risperidone is less sedating, which is why I would choose this medication. I would start him on risperidone 0.5mg BID with risperidone 0.5mg BID agitation. There is evidence to support that the first episode of psychosis does not require as high a dose of an antipsychotic. Prior to starting this medication, I would make sure patient has a weight documented as well as vitals obtained including HR and BP. Blood work should be obtained to monitor HgbA1c, lipid profile, and prolactin levels. This provides a baseline that can be referenced as patient continues treatment. Documentation should also include any movement disorders prior to starting medication. Risperidone can cause extrapyramidal symptoms. Weight should be monitored weekly when starting risperidone. After about 6 weeks, weight can be checked at three months and then annually. Blood work should also be repeated 3 months after starting medication