Mental health medications

Gottschalk LA, Bates DE, Fox RA, et al Psychoactive drug use patterns found in samples from a mental health clinic and a general medical clinic. Arch Gen Psychiatry 25 395-397, 1971... 

Changes in perceived physical and mental health status of a schizophrenia patient population following initiation of a conventional or an atypical antipsychotic medication. Poster presented at the American Psychiatric Association Annual Meeting, Toronto, June 1998. 

Sajatovic M, Gerhart C, Semple W (1997). Association between mood-stabilizing medication and mental health resource use in the management of acute mania. Psychiatr Serv 48, 1037M1. 

Lifestyle modifications should be started early and continued throughout treatment because they may improve ADL, gait, balance, and mental health. The most common interventions include maintaining good nutrition, physical condition, and social interactions. Patients should avoid medications that block central dopamine, as they may worsen PD.1,18 A multidisciplinary approach using the expertise of nutritionists, speech therapists, physical therapists, occupational therapists, and social workers may optimize care but may not be covered by insurance. Patients should maintain regular visits with their optometrist or ophthalmologist and their dentist. The dentist should be informed that the patient has PD, as PD medications that decrease saliva flow may increase the risk of dental caries. 

Obtain a family medical history, focusing on headache or mental health disorders in first-degree relatives. 

Kleinman, A. M. (1988). A window on mental health in China. Am. Sci., 76(1), 22-7. Lain-Entralgo, P. (1982). El diagnostics medico (Medical diagnosis). Barcelona Salvat. 

The cross-national prescribing database using the same methodology provided a useful and valid comparison of patterns of prescribing psychotropic medications in mental health services in Australia, Thailand, and Malaysia (Ng et al, submitted). The study was carried out in three outpatient mental health centres in North Western Mental Health (NWMH) in Melbourne (September to November 2002), Prince of Songkla University Hospital in Hat Yai (January to March 2003), and Hospital Kuala Lumpur (January to March 2003). The proportions of outpatients treated with a primary diagnosis of a psychotic illness were 91%, 41%, and 75% in the Australian, Thai, and Malaysian samples respectively. Considering psychotropic prescriptions in schizophrenia alone, the majority of patients were prescribed antipsychotics Australia (93.7%), Thailand (92.9%), and Malaysia (97.7%). 

Coveil, N.H., Jackson, C.T., Evans, A.C. Essock, S. M. (2002). Antipsychotic prescribing practices in Connecticut s public mental health system rates of changing medications and prescribing styles. Schizophr. Bull., 28( 1), 17-29. 

The collaboration between mental health services and members of families of people with mental illness and their other carers is of essential importance in developing a useful and successful mental health service. Collaboration with carers is not in existence in many of the Third World countries, and in places where it exists it is at present often restricted to a one-way communication of instruction of what the carers should do to assist in the realization of the treatment plan established by the medical practitioners. Advice from carers and information about the effects of treatment can both be of great value in the treatment of individual patients and in deciding the best use of medications and other treatments in health services in general. 

The availability of medications that are effective in the treatment of mental disorders, and safe even after extended use, is essential for the success of programs directed to the improvement of mental health care. It is essential but not sufficient because such programs must - if they are to be successful - also include efforts to improve knowledge, skills, and attitudes of health workers involved in the provision of mental health care additional investment into mental health programs and a... 

Depression, we are told over and over again, is a brain disease, a chemical imbalance that can be adjusted by antidepressant medication. In an informational brochure issued to inform the public about depression, the US National Institute for Mental Health tells people that depressive illnesses are disorders of the brain and adds that important neurotransmitters - chemicals that brain cells use to communicate - appear to be out of balance . This view is so widespread that it was even proffered by the editors of PLoS [Public Library of Science] Medicine in their summary that accompanied our article. Depression, they wrote, is a serious medical illness caused by imbalances in the brain chemicals that regulate mood , and they went on to say that antidepressants are supposed to work by correcting these imbalances. 

Center for Addiction and Mental Health and Department of Pharmacology, Rm 4326 Medical Sciences Building, 1 King s College Circle, University of Toronto, Toronto, ON, Canada M5S 1A8 r,tyndale utoronto.ca... 

Cyclophosphamide VA Medical Research Services National Institute of Mental Health... 

When is medication indicated in the treatment of psychiatric illness There is no short answer to this question. At one end of the continuum, patients with schizophrenia and other psychotic disorders, bipolar disorder, and severe major depressive disorder should always be considered candidates for pharmacotherapy, and neglecting to use medication, or at least discuss the use of medication with these patients, fails to adhere to the current standard of mental health care. Less severe depressive disorders, many anxiety disorders, and binge eating disorders can respond to psychotherapy and/or pharmacotherapy, and different therapies can target distinct symptom complexes in these situations. Finally, at the opposite end of the spectrum, adjustment disorders, specific phobias, or grief reactions should generally be treated with psychotherapy alone. 

Patterson J, Peek CJ, Heinrich RL, Bischoff RJ, Scherger J. Mental Health Professionals in Medical Settings A Primer. New York WW Norton, 2002. 

It does bear special mention that many mental health practitioners consider lorazepam (Ativan) to be the most versatile of the benzodiazepines. Lorazepam has an intermediate onset and duration of action. Because it is easily metabolized, lorazepam is preferred when a benzodiazepine must be used to treat medically compromised or elderly patients. Most importantly, lorazepam is the only benzodiazepine that can be administered via oral, intramuscular, and intravenous routes. As a result, the transition between inpatient and outpatient care is rendered much easier with lorazepam than other benzodiazepines. 

The referral for mental health care is often not made until an extensive medical evaluation has been completed. This medical assessment is often warranted, but a delay in recognizing the presence of panic disorder can result in an unending battery of expensive, unnecessary, and sometimes unpleasant medical tests. 

Abuse. We have all heard the terms substance abuse, drug abuse, alcohol abuse, cocaine abuse, and so on. In one sense, any illicit use of a substance is abuse. For example, from the legal point of view, whenever someone smokes crack (even if it is the only time), (s)he has broken the law and abused cocaine. Likewise, if you borrow a prescription sedative or pain reliever from a friend, then you have similarly abused that medication. That is an appropriate use of the term in many cases, but this is not customarily the way that mental health specialists use the term. From our perspective, substance abuse involves a pattern of repeated use over time that results in problems in one or more areas. These include compromised physical health and well-being, legal proceedings, job status, and relationships as well as overall day-to-day functioning. 

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