HPI: patient is an 18 yo male college student brought in by police after being f

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HPI: patient is an 18 yo male college student brought in by police after being f

HPI: patient is an 18 yo male college student brought in by police after being found running on the highway. He is extremely paranoid and reports that the mafia is coming for him. When asked, he does admit to auditory hallucinations, mostly a commanding male voice telling him to hurt himself and his family.
His father reports that over the past several months he has secluded himself to his room and can hear him talking “with someone” every once in a while.
Social History: He still lives with his parents.
PMH & PPHx: His father denies any previous medical or psychiatric history for PA
Current Meds: He is not currently taking any medications.
Family history: Father reports DM2, dyslipidemia (father, paternal grandfather), and schizophrenia (maternal aunt).
Labs: All pertinent labs and vitals are WNL, urine drug screen is negative.
Plan: He is admitted to the acute inpatient psychiatric unit for his first psychotic episode.
Include in your discussion:
What treatment do you recommend for patient’s first psychotic episode? Be specific in your answer and support your choice with a neurobiological rationale. Do not go into detail about the disorder at the expense of detail regarding the current treatment of the patient.
Choose your treatments as you would if the patient were in front of you. Do not give vague or generalized treatment plans; choose a treatment and explain why you chose it instead of any other options.
Include any and all considerations that accompany your choice of the treatment plan. For instance, do any diagnostics need to be done prior to initiating a drug?

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