Saturday, October 01, 2011

All Psychiatrists Should Be Experts in the Use of Psychotropic Medications

By Stephen Daniels

Prescribing medication for their patients is an important component of the practice of psychiatry. One of the primary reasons is that many mental illnesses respond well to drug therapy. In addition, most therapists who work with mentally ill patients are not licensed to write prescriptions, so patients who are recognized as those who would benefit from medications are often referred to psychiatrists just for this purpose. Chronic depression treatment , for instance, commonly involves the judicious administration of an antidepressant such as Prozac, to minimize the symptoms and help an individual live a more normal life.

In the semi-recent past, psychiatry came under fire for being too receptive to the demands of pharmaceutical companies, and over prescribing was the hot-button issue. Today, it is increasingly common for professionals, and most specifically psychiatrists, to focus more on treating the whole patient, rather than just the symptoms. This approach has led to the revitalization of talk therapy as well as the integration of natural approaches to therapy.

As medicine continues to evolve, the focus of treating every condition as isolated is changing as well. Total care of every patient is becoming the focus of more medical professionals in an effort to help people lead more healthy life styles, and hopefully avoid the onset of illness, including mental illness. Psychiatrists, along with other physicians are adopting more multi-faceted approaches to treatment. Changes in diet, regular exercise and other behaviors can have a very positive impact even on mentally ill patients.

Still, drugs are often necessary either to achieve mental balance and stability or for maintenance therapy. Because pharmaceuticals are such a big part of psychiatric treatment plans, it is critical that patients be confident that their physician is an expert in the use of psychotropic medications.

Psychotropic or psychoactive medications are designed to treat the symptoms of mental illness. While they rarely offer a cure, per se, they offer relief, allowing a person to function more normally. Affecting the central nervous system, some of these medications can powerfully alter a person's behavior and/or personality. Selective Serotonin Reuptake Inhibitors or SSRIs, commonly known as antidepressants, cerebral stimulants and antipsychotics are the most frequently prescribed by psychiatrists.

Part and parcel with this new approach is careful, individualized treatment with regard to medication. These drugs can have powerful side effects, both physical and mental, and they can also be addictive. For these reasons, it is not uncommon for patients to stop taking their meds, even without their doctor's approval. Side effects, which vary with the drug and the individual can include:

* Major weight gain

* Blurred vision

* Dizziness

* Muscle spasms

* Skin rashes

* Menstrual problems for women

Other, more serious side effects include depression, even suicidal thoughts, onset diabetes (from the weight gain), internal organ damage and, in the case of long-term use of antipsychotics, tardive dyskinesia, the often permanent involuntary movement of muscles, especially around the face.

Because every person has a unique body chemistry, each individual can react or respond to any given drug differently. To avoid unforeseen side effects as much as possible, close monitoring of anyone on medication is important. First and foremost, it's important to keep dosages as low as possible. Also psychiatrists need to make sure that any drugs prescribed are compatible with other meds the patient may be taking.

Extended use of any pharmaceuticals can result in an individual's system building up a tolerance to psychotropic medications. In this case, the dosages is usually increased to offset the tolerance. This can lead to a dependence on the drug, just to function at the same level. Clearly this is a serious problem that must be avoided. Ritalin, a drug used to treat childhood ADHD, is an example of an addictive medication. In some cases it can have the opposite effect on a patient, stimulating them rather than helping alleviate symptoms. Should ones tolerance to it rise, it can create the same psychological dependence as illegal amphetamines.

Psychiatrists are quickly recognizing that it is vital to treat each patient individually and to consider alternatives to drug therapy whenever possible.

* Meditation is one effective form of treatment that can help bring a sense of peace and quiet to a person's mind.

* Changes in diet have been shown to be very effective. This is especially true when an unknown food allergy is the culprit causing mental illness type symptoms.

* There are vitamin and herbal supplements that have been found to help to increase blood circulation in the brain, while an increase in protein intake may help people be more alert.

Naturalistic treatment for depression and other mental illnesses may not be cure-alls, but are worth exploring, especially considering the potential pitfalls of strong psychotropic drugs, and the fact that proper diet and exercise, in and of themselves tend to make most people feel better. In today's world, as newer and often more potent medications are arriving on the scene all the time, it is imperative that a psychiatrist have a high level of expertise with regards to all pharmaceuticals. He must be especially keen to the warning signs that a medication is not doing what it is supposed to do or to the fact that a patient is not reacting as anticipated. In striving to always "prescribe gently," doctors are prescribing medication expected to be effective without becoming addictive, harmful or worse.

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