20 August 2015- Malaysian Pharmaceutical Society-Young Pharmacist Chapter (MPS-YPC) and IMU Alumni worked hand in hand to successfully conduct a talk entitled ‘Breaking Barriers and Improving Outcomes in Schizophrenia – A Pharmacist’s Experience’. This talk was held at the Theater Room in the Quiet Study Area of International Medical University (IMU) Bukit Jalil Campus library. Laura Kho Sui San, an IMU Alumni, is the first board certified psychiatric pharmacist in Malaysia. She graduated from the IMU-Strathclyde MPharm programme in 2009 and did her pre-registration training at Sarawak General Hospital. She currently practices at Hospital Sentosa, Kuching, one of four specialist psychiatric institutions in Malaysia. For the past five years, she has been working closely with patients across a spectrum of mental illnesses, both in the acute and maintenance phase. Laura is passionate about dignifying mental illness and is an advocate for changing the way we talk about mental health.
In this talk, Laura shared her experience as a psychiatric pharmacist in managing patients with schizophrenia, starting with the nature of the disease, rationale behind the choice of medications and how to engage patients with psychiatric illnesses and discuss ways to encourage medicines optimisation in this challenging group of patients.
According to Laura, schizophrenia is a brain disorder that interferes with a person’s ability to think clearly, manage emotions, make decisions and relate to others. It can be detrimental as it is a brain disorder in which people interpret reality abnormally. The symptoms of schizophrenia can be categorised into positive, negative, affective and cognitive. Positive symptoms are the things that you have but that you wish you didn’t have. You see things that aren’t there, you hear voices and sounds whispering to you nonstop like a radio station that you can’t tune out of. It’s like being in a nightmare that you cannot wake up from. Negative symptoms does not refer to a person’s attitude but instead are the characteristics that you do not have but wish that you had. Cognitive symptoms include poor “executive functioning” (the ability to understand information and use it to make decisions), trouble focusing or paying attention, and problems with “working memory” (the ability to use information immediately after learning it). In terms of affective, patients often seem cheerful or sad in a way that is difficult to understand and in most of the cases, they often are depressed.
The main purpose of the treatment of schizophrenia is to prevent relapse. Laura also shared with us a variety of treatments and medicines available for schizophrenia with mention of the side effects of these medicines. Side effects that affect the central nervous system (CNS) includes ExtraPyramidal Symptoms (EPS), Hyperprolactinaemia, sleep disturbances, seizures and sexual dysfuntion whilst that affects the systemic circulating system includes metabolic syndrome, hypersalivation, anticholinergic side effects and so on. Lastly, she emphasised on the ‘3 E’s’ when treating the patients which are empathy, engage and empower.
In the Question and Answer session, there were many questions, reflecting the keen interest of the audience in the talk. The end of the talk was marked by a presentation of certificate and gift as a token of appreciation to the speaker by Mr Lim Kah Keat, the Vice President of MPS-YPC.