Psychotropic Medication Essay

A psychotropic medication is a drug that can affect the mind, behavior and emotions.   It can be utilized to treat several mental disorders.   In recent years, with the advancement of mental sciences, there has been a sudden increase in use of psychotropic medications for the treatment of several mental disorders.   However, it is still not clearly understood whether these would be safe and efficient over the long run.   Some of the psychotropic medications, which are increasingly being utilized, recently include antidepressants, antianxiety drugs, antipsychotics, and antiepileptic drugs (Weller, 2007, Thompson, 2001 & Kohen, 2005).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A study was conducted by Freeman et al (1998), to study the efficacy and safety of multi-drug therapy in the treatment of resistant (refractory) bipolar disorder.   In the past, physicians and researchers have faced a lot of difficulties in the treatment of bipolar disorders.   The severity of the disease and the range of symptoms that can develop vary hugely from one individual to another.   The length of the illness, response to treatment, chances of recurrences, outcomes, etc, vary from one case to another and depends on several factors. However, during the last half a century, the use of medications has really helped to improve the outcome of bipolar disorders.   Several drugs have come into the picture in the treatment of bipolar disorders, which have been utilized during various periods.   Some of the drugs include lithium, chloropromazine, carbamazepine, haloperidol, calcium-channel blockers, clozapine, risperidol, lamotrigine, gabapentin, olanzapine, etc.   Although, a variety of drugs are currently available for the treatment of bipolar disorder, it remains a real challenge to manage.   The range of symptoms are so vast that it is often difficult to manage it with a single drug.   Hence, a combination of drugs has to be utilized for a short-term period. The author researched various drugs utilized in the treatment including lithium, lamotrigine, carbamazepine, valproate, verapamil, olanzapine, nimodipine, benzodiazepines, amlodipine, neuroleptics, gabapentin, clonazepam, clozapine, and risperidone.   Studies conducted in patients consuming lithium and sodium valproate have demonstrated that the chances of recurrences were much lesser.   The chances of adverse effects were also slightly higher.   But, weighing the disadvantages against the advantages demonstrated that valproate and lithium combination was efficient.   On the other hand lithium utilized along with carbamazepine demonstrated that only in certain cases this combination was effective and safe. However, in comorbid disease of the brain, the combination was best avoided.   Studies have shown that the valproate carbamazepine combination has a synergistic effect, but there are associated dangers of serious side effects.   Hence, it would be advisable from preliminary tests itself to avoid this combination.   To several extents, the data currently available seems to be inconsistent and there is an urgent need to conduct comprehensive drug trials.   The physician should be able to determine the risk of developing adverse effects and accordingly modify the treatment. The main issue of combination therapy is that there are greater chances of damage occurring due to associated drug interaction and individual actions of the drug.   However, as the drugs may have a synergistic effect, the potential for huge amount of benefits also exist.   Another adverse issue that exists with combination therapy is the potential for not complying with the treatment plan.   The patient may stop taking the drugs due to the several side effects (Freeman et al, 1998).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Studies have demonstrated that in spite of a dearth of long-term studies (to determine the safety and efficacy of the drug), many drugs are being utilized in children.   This is the most sensitive age group, and any negative reaction can have a life-long effect.   Currently the drugs utilized in children have been only assessed for their short-term and medium-term effect.   Many drugs, which seem to be safe, are seldom effective for long-periods of time.   However, many drugs that do seem effective may not in fact be safe. In a study conducted by Hussain on children suffering from ADHD, he found that about 25 % of the patients administered olanzapine and 30 % administered risperidone stopped the drug due to several reasons.   The main reasons for stopping the drug included poor response during the initial stages of drug therapy and the development of several side effects (such as sedation, confusion, agitation, nausea, vomiting, etc).   After a period of three months, there was an improvement in the symptoms and signs of ADHD. Another issues, which also need to be considered in adolescents, are the issue of drug compliance.   Children are more likely not to comply with treatment compared to adults.   Children may not comply with the doses when the side effects associated with the drug are high.   Many children would not be consuming the drug as they feel that it would not be beneficial in any way.   However, scientists do feel that with the advent of advanced studying techniques and the development of safer drug profiles, the chances of developing side effects have significantly dropped in children (Weller, 2007).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   During the breast-feeding period, it is important for the physician to note that any drug consumed by the mother would not only have an adverse effect on her, but also on the baby.   This is because the drug or its metabolite may be expressed in the breast milk.   Previously, women in urgent need of psychotropic medications were advised to avoid breastfeeding the child.   However, nowadays, the physicians would have to give a judgment call depending on the nature of the drug consumed and the risk of potential side effects. The chances of ill effects developing in the child depend on the quantity of drug expressed in the breast milk.   Children having liver function defects or those born prematurely are at a greater risk of developing side effects.   Besides, the heart and the kidney function also play an important role.   During the nursing period, the physician should be able to determine the chances of developing risk, and accordingly advise the mother.   It is very important to study the extent of the mental health disorder, the support from the family members, women’s chances of complying and adhering to the treatment, etc. It is important to note that during the nursing period, a healthy mother would be in a better situation to take care of the baby, than an ill mother.   It is also important to note that any drug, which has a beneficial effect on the body, would also be having a side effect.   Thus it is found that a single drug utilized in low doses would be having minimal amount of side effects compared to other drugs.   However, the psychiatrist may want to choose a combination of two or more drug in order to improve the benefits. In such cases, the risk for side effects would be high, especially in the baby.   The psychiatrist should work in close coordination with the mother, family members and the pediatrician In all cases, the chances of benefits should outweigh that of the risks from occurring.   In cases, the health of the mother is at stake, and she requires a combination of drugs, it would be advisable to stop breastfeeding and return to this healthy practice only when the drug therapy is completely stopped (Kohen, 2005). Recently, newer antidepressants drugs are being available in the market.   These antidepressants have fewer side effects, are more effective and act very fast.   Although, the chances of developing minor side effects were small in number, the chances of developing the more serious ones occurred on fewer occasions.   However, the recent drug trials have been unable to determine the long-term side effects. In this regard, more number of drug trials need to be conducted.   Many researchers have suggested that as chances of serious side effects are also present, it would be advisable to follow certain precautions. These include closely monitoring the drug therapy, administering for short periods of time, using other treatment measures such as psychotherapy as first line, starting from a low dosage and slowly increasing it depending on the patient’s response, stoppage of alcohol and other drugs, etc.   Certain warning signs need to be looked into to determine the chances of side effects from developing.   Studies have shown that usually minor side effects occur more frequently than the major ones. Studies conducted through clinical trials have demonstrated that the chances of side effects were particularly higher in those who consumed the drug than the placebo.   However, it would also be interesting to note that patients receiving the placebo took longer time to recover from the disease than those who received the drug.   If a drug has only minor side effects are well tolerated in the body, then it should be preferred to one that causes major side effects.   Psychiatrists prefer to use psychotropic medications for short period of time, in order to avoid the chances of side effects from developing (Jureidini et al, 2005). Another approach that also seems to be beneficial includes combining the drug with other drugs in order to decrease the dosage.   In all cases, the patient’s treatment with drug therapy needs to be closely monitored in order to determine the chances of side effects and benefits from developing.   As the effects of several drugs on the developing baby are not known, its use should be restricted during pregnancy and lactation.   Further research needs to be conducted in this regard (Jureidini et al, 2005, Kohen, 2005, Gazley, 2004 & Freeman, 1998). Psychotropic medications have the potential of causing side effects and also helping to improve the outcome of the condition.   The risk of side effects may be difficult to manage and to predict.   However, if certain measures are followed, they could be kept to a minimal.   Some of the measures that are required include:- Conducting detailed drug trials to asses the potential side-effects and benefits Ensuring that the drug trials are conducted for determining the long term effects Monitoring the drug administration of the patient Making a thorough risk assessment (weighting the risks and the benefits) in each and very case. Making sure that the factors, which would result in the development of side effects, are discussed and addressed appropriately. Taking care whilst administering drugs to pregnant women and nursing mothers. Taking care whilst administering drugs to sensitive groups such as children, elders, etc. Taking care whilst administering combination drugs (as they could have a synergistic effect) Seeking patient’s compliance and adherence to the drug therapy. Modifying the other factors that alter the course of the disease. To ensure that the drug are administered in low doses for short period of time. Using psychotherapy as an adjuvant.    References: Freeman, M. P. & Stoll, A. L. (1998). â€Å"Mood Stabilizer Combinations: A Review of Safety and Efficacy.† Am J Psych, 155, 12-21. http://ajp.psychiatryonline.org/cgi/content/full/155/1/12 Gazley, J. (2004). â€Å"Sample Email Answer 7 – Psychotropic Drugs. What are the side effects?† Retrieved on December 12, 2007, from Ask the internet Therapist Web site: http://www.asktheinternettherapist.com/counselingarchive_psychotropic_drugs.asp Jereidini, J. N., Doecke, C. J., Mansfield, P. R. (2004). â€Å"Efficacy and safety of antidepressants for children and adolescents.† BMJ, 328, 879-883. http://www.bmj.com/cgi/content/full/328/7444/879 Kohen, D. (2005). â€Å"Psychotropic medication and breast-feeding.† Advances in Psychiatric Treatment, 11, 371-379. http://apt.rcpsych.org/cgi/reprint/11/5/371.pdf Thompson, L. L. (2001). â€Å"Neuropsychological Testing.† In. Jacobson (Ed), Psychiatric Secrets, Philadelphia: Hanley & Belfus. Weller, E. B. (2007). â€Å"Issues in Child and Adolescent Psychopharmacology.† Medscape. http://www.medscape.com/viewarticle/420268