Administration Of Psychotropic Medications Research Articles

Cognitive-Behavioral Treatment of Panic Attacks

Anxiety affects approximately 30 million Americans at some point in their lives. The most common treatment modalities used to treat the continuum are the administration of psychotropic medications and the application of behavioral therapy. The following case details an adult female who suffered from severe panic attacks for a period of 10 years wherein numerous interventions, including psychotropic medications, had failed to ameliorate her suffering. The patient was treated using the Mastery of Your Anxiety and Panic protocol. Prior to treatment, the patient reported that she experienced an average of seven panic attacks per week, her Beck Anxiety Inventory score was 58, and her Beck Depression Inventory was 23. At the completion of treatment, the patient reported that the number of panic attacks was reduced to one per week. At 4-week, 6-week, and 16-week follow-up, the patient had not experienced any panic attacks.

The psychologist's role in the collaborative process of psychopharmacology.

This is a discussion of a collaborative approach between psychologists, physicians, patients, and others in the administration of psychotropic medication. It is based on a systems point of view. In that perspective, not only are the people indicated above a system, but also the patient is considered from a holistic-systems point of view. It requires that the psychologist not only be a member of the system, and a well-versed in medication member at that; (s)he must also be an observer of the system, be able to take a meta perspective, in order to be able to exercise some unique functions--functions for which psychologists are well-trained.

Mental health nurses' PRN psychotropic medication administration practices.

PRN psychotropic medications (medications given with the aim of changing the patient's mental state on an 'as needed' basis) are frequently prescribed and administered in mental health facilities. Their administration is largely an autonomous nursing role. However, little research has explored this important area of nursing practice in any detail and therefore the use of this intervention by mental health nurses is not fully understood. A descriptive project was undertaken to explore the factors involved in the administration of PRN psychotropic medications. It utilized a retrospective chart audit, conducted at one regional and one urban setting in Queensland, Australia. The results indicate a lack of clarity surrounding psychotropic PRN medication administration practices, confusion surrounding decision-making processes related to this intervention, and poor documentation practices. The study found a high incidence of PRN psychotropic medication administration when compared to similar studies, and an excessive reliance on the use of typical antipsychotics over benzodiazepines. This practice is not supported by contemporary literature. As a result of our findings, we recommend further studies in areas of related importance, in order to increase our understanding of the complexities surrounding this important nursing intervention, and an investigation into documentation practices in inpatient mental health settings.

Disability law and the administration of psychotropic medication in the school setting.

T column provides a general overview of federal law as it relates to psychiatrists who prescribe psychotropic medication that is administered to children in school settings. Specific situations may require further analysis or consultation with an attorney. Furthermore, state law may impose additional requirements, although state law generally cannot reduce the protections provided by federal law.

Nonenteral routes of administration for psychiatric medications. A literature review.

In the treatment of psychiatric patients with complicating medical illness, clinicians may encounter patients who cannot take oral medications. This review will acquaint the practicing clinical psychiatrist with psychotropic medications available by nonenteral routes of administration. A computerized MEDLINE search was conducted of the literature 1981 to 1997. All articles citing nonenteral routes of psychotropic medication administration were reviewed. The results are summarized according to drug class and specific routes of administration (intravenous, intramuscular, sublingual, rectal). Psychotropic medications now available by these alternative routes are also listed in table form. The majority of the information available comes from small case series or case reports. Intravenous and intramuscular routes of administration of psychotropics are the most common. In addition, certain psychotropics are available by less common routes, such as sublingual or rectal administration. Consideration of alterations in pharmacokinetics, including poorer absorption and slower metabolism, are discussed. Clinicians may need to consider these novel routes of medication administration when dealing with patients unable to take oral medications.

THE RIGHT TO REFUSE PSYCHIATRIC TREATMENT

The right to refuse psychiatric treatment has become an important clinical and legal issue in the last twenty-five years. This article briefly reviews the clinical, administrative, and legal aspects of the right to refuse psychiatric treatment, especially medication. Emphasis is placed on the clinical issues including the reasons for treatment refusals, and the management of treatment refusal. Empirical data are provided to illustrate the rights driven and treatment driven models of involuntary psychotropic medication administration.

An epidemiologic study of prn/stat medication use in a state psychiatric hospital.

The prevalence of prn/stat psychotropic medication administration and the characteristics and concomitants of high use of these medications were examined via a retrospective medical record review in a 973-bed state hospital. While 22.9% of the total hospital population received at least 1 prn/stat dose during the study month, 27 patients (2.8% of the total population) received 44.4% of the prn/stat doses, averaging 9.7 doses per patient. Examination of high-prn/stat use patients whose disruptive behavior and prn/stat use was "intermittent" throughout the month (N = 16) vs those who exhibited these characteristic for only a "discrete period" with resolution (N = 11) suggested that the prescription of antipsychotic drugs as prn/stat doses as well as increases in or institution of these medications was significantly associated with the latter group's resolution of disruptive behavior. The findings suggest the need for clinical protocols as guides for clinicians in the establishment of effective pharmacotherapy for patients with agitated, threatening behavior, including the use of plasma levels to ensure adequate dosage of psychotropic medication.

Applying a DRO schedule and compliance training to reduce aggressive and self-injurious behavior in an autistic man: A case report

An autistic man who displayed aggressive, self-injurious, and destructive behavior in a psychiatric hospital ward despite administration of psychotropic medications and repeated application of physical restraints was treated with a differential reinforcement of other behavior (DRO) schedule and compliance training. These were employed in conjunction with ongoing medical interventions. After introduction of behavioral procedures, the frequency of applying restraints for violent behavior declined from an average of more than once per day to less than once per month. Data taken while the program was maintained over a 1-year period showed that violent behavior remained at a very low level.

A discriminant validity study of negative symptoms with a special focus on depression and antipsychotic medication

If the construct validity of the negative symptom syndrome is to be established, the conceptual and operational overlap between negative symptoms and other syndromes such as depression and the effects of medication must be explained. The author assessed 26 patients with schizophrenia and 21 patients without schizophrenia, most of whom had depression, at the end of an average 2-week drug washout period and after approximately 2 months of psychotropic medication administration. Negative symptoms were remarkably consistent in patients with schizophrenia despite pharmacological intervention. In contrast, the patients without schizophrenia manifested significant decreases in negative symptoms.

Psychotropic drug practice in nursing homes.

This study examined the administration of psychotropic medication to Medicaid recipients who resided continuously in an Illinois nursing home during 1984. Of these residents, 20,037 (60%) received at least one such medication during the year, with administration most likely for those from the ages of 45 to 74 years. Haloperidol, thioridazine, and flurazepam were the most frequently prescribed drugs of those examined. The study also investigated the relationship of demographic and institutional variables to the probability of drug administration and the amount administered. These variables were most strongly related to the probability of antipsychotic, antiparkinson, and antimanic (lithium) administration. The association of these variables with the amount of drug administered was strongest for antimanic and antipsychotic medications, particularly the latter. In all analyses, the addition of institutional variables increased goodness of fit minimally over that produced by demographic variables alone. This finding supports the conclusion that the prescription of psychotropic medication is more influenced by individual patient characteristics than by the nature of the institutional setting in which the patient resides.

Aggressive behavior in persons with dementia who live in the community.

Aggressive behavior in persons with dementia who are living in the community was explored in a pilot study using a newly developed instrument, the Ryden Aggression Scale. Factors affecting this kind of research are addressed, including reliability and validity of the instrument, sample bias, diagnostic workup, and control groups. Results of a pilot survey of caregivers revealed aggressive behavior in 65% of a sample of 183 subjects, occurring weekly or more often in 31% and daily in 16%. Verbal and physical aggression were most prevalent (50% and 46%, respectively), while sexual aggression appeared less frequently (18%). Aggression was significantly related to degree of cognitive impairment and prior history of aggressive behavior, but not to diagnosis nor administration of psychotropic medications. Men showed significantly more sexual aggression. Further research to verify these findings is needed.