Importance of New Psychiatric Medication Guide

1728 words (7 pages) Essay in Medical

22/11/17 Medical Reference this

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CHAPTER 1:

THE IMPORTANCE OF A NEW PSYCHIATRIC MEDICATION GUIDE

PREFACE:

Over the last decade, I’ve served as the medical director of multiple mental health clinics. I’ve worked with thousands of clients amidst a variety of challenging circumstances. Throughout my experience, I became increasingly aware of the challenges that clinicians face about quickly and comprehensively understanding the complexities of psychopharmacology.

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I’ve seen clinicians spend hours browsing through massive manuals when seeking information about medications, potential side effects, drug interactions and related questions. Although a number of resources and books about psychopharmacology are available in print, no definitive guide of psychopharmacological resources has been created before. Some resources are concerned with defining psychopharmacology, while some concentrate on a specific class of drugs. Those that do attempt to provide a comprehensive overview of psychopharmalogical resources generally do so in a complicated and discursive manner.

Until now, clinicians have lacked a single, comprehensive book about psychopharmacology that conveys this vital knowledge in a simple, concise format. To address this challenge effectively, I have compiled this guide that allows mental health clinicians to find all relevant information about important psychiatric medications in shortest possible time.

By practicing psychiatric medicine for many years, skimming through hundreds of books and thousand of articles, giving lectures, speaking with fellow clinicians, and treating clients in various settings, I was able to condense relevant information on psychiatric medications into the following guide. This resource changes the way in which clinicians work, equipping them with the necessary tools and information to allow them to provide the best possible care to their clients. In doing so, this book not only covers the essential facts about each psychiatric drug, but it also provides clinically actionable information about every drug and its class, such as latest dosing protocols, clinical indications, side effects and related content. All these aspects are presented in a concise, elegant manner without superfluous intricacy.

I’ve intentionally structured this book according to concept learning, categorizing and explaining various drugs in their specific pharmacological classes. Consequently, the guide incorporates the most up-to-date knowledge and practices in straightforward and clinically sound terms. Every drug class is addressed in its own chapter, and important pharmacological agents would be further expanded upon. Heading and sub-headings further elaborate the data. Additionally, helpful pictures, diagrams and tables are included in full-color to summarize concepts efficiently.

Moreover, this book’s pocket-sized format is priced affordably and is designed for the busy clinician in practice, the young medical professional in training, and anyone else seeking a clear, quality resource on psychopharmacology. It is my hope that this guide will enable you to glean current, comprehensive information about psychotropic drugs to strengthen your daily practice.

INTRODUCTION:

Despite decades of research and medical advancements, mental health challenges continue to plague the world’s population in epidemic proportions. The World Health Organization (WHO) predicts that mental illness will become the leading contributor to the global burden of disease by the year 2020. According to the National Institute of Mental Health (NIMH), about 1 in 4 Americans (approximately 61.5 million people) have been diagnosed with some form of mental illness (PhRMA 2014). Mental illnesses are also expensive, costing the US over $317 billion each year (PhRMA 2014).

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As clinical psychiatry struggles to keep up with the growing burden of disease, the need for better medications and enhanced understanding of the psychopathology of mental illnesses is of utmost importance. Efforts to combat this growing problem have resulted in the creation of new drugs, which are incessantly entering and flourishing in the market, replacing many of the older drugs, now obsolete due to their poor efficacy or harmful side effects. Currently, more than 119 medicines with novel mechanisms of action are being developed to treat a variety of mental health conditions (PhRMA 2014). Some of these innovative approaches include intranasal medication for treatment-resistant depression, a cocaine vaccine, and a rapidly dissolving tablet for autism. Additionally, the discovery of the glutamate system marks a major breakthrough for many psychiatric conditions, such as depression and suicide. Triple reuptake inhibitors, brain-derived neurotropic factor (BDNF), corticotropin-releasing hormone (CRH), and melatonin are just a few of the mechanisms recently receiving significant attention from researchers. Similarly, the NMDA-receptor antagonist ketamine has shown promising results for the rapid treatment of severe depression and acutely suicidal patients. It seems possible that before long, physicians will be developing personalized treatment plans via gene scanning, RNA fingerprinting, brain mapping, and brain imaging. In light of these breakthroughs and developments, prescribers have a responsibility to their patients to stay updated on the latest psychopharmalogical advancements.

The interplay of evolving treatment options, new diagnoses, redefined disorders, and changing treatment recommendations from various professional and regulatory organizations places a tremendous burden on prescribers who need to keep their knowledge current. In the wake of these dynamics, it is highly necessary to update information about new or adjusted medications, not only for medical professionals, but also for the patient. To a prescriber, however, maintaining a robust scientific literacy can involve an overwhelming amount of information that may seem just as daunting as the problem of mental illness itself. Consequently, using a comprehensive and up-to-date guide to stay abreast of new psychiatric medications and regimens is vital for mental health professionals.

As the medical director of multiple bustling mental health clinics and having treated thousands of patients over the last decade, I recognize the obstacles faced in day-to-day psychopharmacology practices. I found myself surprised by the lack of any portable, comprehensive resource on psychiatric medications. I have observed professionals waste so much time trying to find just fundamental information about medications, like dosing, side effects, interactions, precautions, withdrawals, and use in special populations. Clinicians lack informative support, as there is not a single book currently available that provides all the essential information about psychiatric medications and psychopharmacology in a concise, reliable, and elegant way. With those challenges in mind, these contents serve as a relevant “one-stop shop” guide of psychiatric medications for mental health clinicians.

Designed for any mental health professionals looking for simple information about the treatment of mental health issues, the material in this book contains a full listing of important information on psychopharmacology. Scouring hundreds of references, lecturing, speaking with other clinicians, and treating patients in multiple settings have allowed me to condense all of the pertinent knowledge in this short resource. Hence, this guide is the result of decades of experience, dedication, and hard work.

This book presents that treasure of knowledge—hitherto dispersed across bulky, obscure, and expensive reference texts—in a readily digestible form. It replaces booklets written by non-clinicians, which often lack sufficient detail. It displaces texts that focus solely on basic overviews or on specific classes of drugs. It replaces other lengthy manuals that attempt to encompass all relevant material but which do so in a complicated, discursive manner. Rigorously composed and updated, this guide covers existing as well as new psychiatric medications and their latest dosing protocols. It is my hope that the integration of basic psychiatry and psychopharmacology with the most current guidelines, recommendations, and best practices of prescribing render this information both comprehensive and reader-friendly.

This resource thoroughly and clearly covers every topic that is encountered daily by mental health clinicians in the field. The bulk of this text consists of chapters organized by disorder with emphasis on the important classes or individual drugs for that particular diagnosis. Essential information covering every aspect of the medications is provided including:

  • Generic & brand names
  • FDA approved indication(s)
  • Off-label uses
  • Medication form(s)
  • Dosage
  • Mechanism of action (MOA)
  • Pharmacokinetics
  • Warnings
  • Drug interactions
  • Common side effects
  • Contraindications
  • Lab tests recommended
  • Overdose information
  • Tapering/withdrawal
  • Special Populations: use in pregnancy, lactation, elderly, and comorbid illnesses (e.g., hepatic and renal impairment)
  • Important notes: evidence-based clinical pointers for further clinical context

Having this material handy will change how clinicians work by equipping them with all of the necessary tools so that they can care for their patients in the best possible way.

The guide further examines some of the most prevalent psychiatric disorders, including major depression, substance abuse, bipolar disorder, ADHD, psychosis, and schizophrenia. In addition, the book has dedicated sections for the following major topics: must-know changes in the DSM-5, substance abuse, eating disorders, dementia or cognitive disorders, and personality disorders. Other current mental health issues are explored in detail, including psychiatric emergencies (such as suicide/homicide or violence), PTSD, and future medications. This guide also discusses medication use in special populations in-depth, addressing areas such as use in pregnancy, lactation, the elderly, children, and comorbid illnesses (e.g. renal and hepatic impairment). Material is uniquely presented with additional vital information on special cases.

Moreover, due to the growing interest surrounding the use of alternative medications in the treatment of psychiatric ailments, a separate chapter is devoted to the various dietary, herbal, and OTC drugs available. In addition to focusing on psychiatric medications, this guide also expands upon the emerging non-pharmacological psychiatric interventions that are being used in current practice. Electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), deep brain stimulation (DBS), and trans-cranial direct current stimulation (tDCS) are covered thoroughly, enabling physicians to sharpen their interventional knowledge and related skills.

The contents of this guide are a vital tool for clinicians, allowing them to save valuable time and to succeed in the modern era of medicine through its straightforward presentation, portability, and reliability. As a result, it will be of tremendous help to any prescribing physician who requires a short, clearly presented account of the latest medications used in psychiatry. As a text that intersects clinical psychiatry with psychopharmacology, this guide is intentionally accessible to students, residents, counselors, therapists, psychologists, family physicians, pediatricians, and psychiatrists alike. Simple, concise, current, evidence-based and written from clinical expertise, this book is a vital guide for those responsible for prescribing, dispensing or administering drugs for patients with mental health disorders.

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