Use Of Psychotherapeutic Medications Research Articles

Mental and physical health among students at a private university that held in-person classes during the COVID-19 pandemic

Objective The COVID-19 pandemic is expected to have serious negative consequences on mental and physical health, which may disproportionally affect young adults. The aim of this study was to understand short-term impacts on a population of students at a college that held in-person classes during the pandemic. Participants This study was conducted at a moderately-sized private university in the southeastern United States where approximately 75% of students were enrolled in undergraduate degree programs and 25% in graduate degree programs. Methods A survey was created to assess anxiety and depression symptoms, psychotherapeutic medication use, healthy living, and coping skills. Links to the electronic form were distributed to students via email in Spring 2020 and Fall 2020. Participation was completely voluntary and responses were collected anonymously. Results The rate of anxiety symptoms in the study cohort was higher than the national average (31%) and increased between Spring 2020 (39%) and Fall 2020 (50%). Rates of psychotherapeutic medication use also rose, with benzodiazepine use increasing from 6% to 11% and antidepressant use increasing from 16% to 20%. Compared to the national average, fewer students in the study cohort rated their overall health as “good” or better (72-76% vs. 82%). Physical exercise, nutrition, and alcohol use worsened between Spring and Fall 2020. Problem-focused engagement was associated with significantly fewer anxiety and depression symptoms. Demographic factors such as gender, race, and sexual orientation interacted with several outcomes studied. Conclusions Students at a private university that held in-person classes during the COVID-19 pandemic reported high rates of anxiety that increased between Spring and Fall 2020. Self-reported physical health was below average in Spring 2020 but improved in Fall 2020. Appropriate identification and management of the effects of pandemic-related stressors is critical during this uncertain time. Supplemental data for this article can be accessed online at https://doi.org/10.1080/07448481.2022.2052074 .

Assessing Psychiatric Comorbidity and Pharmacologic Treatment Patterns Among Patients With Neurofibromatosis Type 1.

Background and objectiveNeurofibromatosis 1 (NF1) is a genetic disorder that is accompanied by psychiatric comorbidities such as depression, anxiety, and attention-deficit hyperactivity disorder (ADHD) in more than half of the patients. However, there are limited data describing optimal treatment strategies for these conditions. This study aimed to address that gap in understanding and explore the neurobiological basis of psychiatric comorbidities in NF1.Materials and methodsA retrospective cohort study was conducted among NF1 patients with a comorbid diagnosis of depression, anxiety, and/or ADHD. These disease states were chosen based on their relatively high reported prevalence in NF1 and shared pathophysiological mechanisms via monoaminergic dysfunction. Information regarding demographics, psychotherapeutic medication use, and clinical outcomes was gathered from electronic medical records. Relationships between patient- and medication-related factors and outcome measures were assessed using statistical analysis.ResultsThe study population (n = 82) consisted of NF1 patients with a comorbid diagnosis of depression (76.8%), anxiety (53.7%), and/or ADHD (23.2%). The use of second-generation antipsychotic agent augmentation therapy or hydroxyzine monotherapy was associated with significantly more behavioral health (BH)-related emergency department (ED) visits, admissions, and inpatient days in the study population. Conversely, the use of bupropion augmentation therapy, buspirone augmentation therapy, and stimulants was associated with improved clinical outcomes, though these results were not statistically significant.ConclusionsBased on our findings in this real-world study setting, patients with NF1 and psychiatric comorbidities appear to experience significant benefits from medications that enhance dopaminergic neurotransmission (e.g., bupropion, stimulants) when compared to drugs that oppose it (e.g., second-generation antipsychotics).

Depression, periodontitis, caries and missing teeth in the USA, NHANES 2009–2014

PurposeThis study aimed to investigate the association between self-reported depressive symptoms and oral diseases in US adults, including periodontitis, caries, missing teeth and untreated dental caries.DesignThis study was designed as...

Our vision for the future

Carla Cobb, PharmD, BCPPWith Positioning, Advancement, Awareness and Development have become key words in my vocabulary in my daily life as a psychiatric pharmacist and in my work as CPNP Legislative Committee Chair, member of the Behavioral Health Care Pharmacist Integration into Primary Care Task Force, and CPNP Foundation Board Member.Although the key words included in the CPNP Psychiatric Pharmacy Manifesto may not use these exact key words, the same theme is evident throughout the manifesto. The manifesto envisions a future we should all should be striving toward, both as a member of CPNP and as an individual practitioner. Although we can each impact our practices and the daily lives of our patients, we have the great benefit of our membership in CPNP and other pharmacy associations where we can work together in large numbers to craft this future. CPNP is making progress towards Positioning, Advancing, Increasing Awareness and Developing but much more can be done.Let's make our future together by:Together as CPNP members, we can accomplish much.Ashley E. Little, PharmDJose A. Rey, PharmD, BCPP“Bath As a psychiatric pharmacy practice resident and residency coordinator, we ponder what our roles within the health care system may be ten years from now. Our primary goal is to improve the overall care for patients with psychiatric and neurologic illnesses. We would like our profession to function independently and collaboratively as practitioners to improve medication treatment outcomes for patients with mental diseases. Also, we will be participating in the development and training of future psychiatric pharmacists by being engaged and competent preceptors to students of pharmacy and the other healthcare disciplines. All healthcare students should have an increased understanding of mental illness and the use of psychotherapeutic medications. It is important to educate students regarding this underserved patient population, and demonstrate how they can positively influence the care for these patients. We envision the majority of us becoming board certified psychiatric pharmacists and continuing the endless pursuit for knowledge.It is very important for patients with psychiatric and neurologic illnesses to be given proper and evidence-based care. To achieve this, we will actively work within the health care multi-disciplinary team. This will include active assessment, interpretation, and evaluation of the patient's medication history, laboratory parameters, current clinical status, and how they are responding to and tolerating their current medication regimen. We will work diligently to elucidate potentially negative outcomes that can be avoided or better tolerated. Ten years from now, our specialized skill set and abilities will be globally recognized, and sought after, by other types of health care providers, including the general medical community. It will not be uncommon for a facility or healthcare system to have a psychiatric pharmacist on their treatment teams, and patients will be able to get the proper and more immediate care that they need through our interventions resulting in optimal drug therapy outcomes.In a decade, the quality of research in neuropsychiatric pharmacotherapy will be improved. As psychiatric pharmacists, we will actively participate in conducting research to advance the evidence for the appropriate use of psychotherapeutic medication. There will be new (and hopefully not “me too”) medications and guidelines for optimal patient treatment. Future research will allow us to provide the most effective treatment based on the patient's psychiatric or neurologic illness, social status, and other co-morbid medical conditions. Having a psychiatric pharmacy practitioner on the treatment team will assist in the appropriate and evidence-based prescribing of neuropsychiatric medications, whether by a psychiatrist or other type of physician, and even other types of prescribers, including pharmacists (e.g., VA clinical pharmacy specialists).Psychiatric and neurologic pharmacists are essentially unknown to the lay public or even the general medical community. In ten years, we will be working closely with community practice pharmacists and other general practitioners to assure the appropriate pharmacotherapeutic care for patients with mental illness. We will also be nationally and globally recognized and reimbursed for the clinical services we provide. The public will be educated about the value of a psychiatric pharmacist due to our interactions with advocacy groups and initiatives locally and nationally. Our employment will be both secure and in high demand since more psychiatric pharmacists will be needed to provide our specialized and unique skills to the care for individuals with mental illness. In conclusion, our future as psychiatric or neurologic pharmacists is bright because we will be able to provide a unique perspective and contribution to the mental health care team and thus ensure optimal treatment outcomes for the person requiring neuropsychiatric care.

Psychotherapeutic Medication Prevalence in Medicaid-Insured Preschoolers

To update knowledge of the prevalence of the use of psychotherapeutic medications in preschoolers with Medicaid insurance as requested by the Best Pharmaceuticals for Children Act of 2002 (BPCA). Prescription, enrollment, and outpatient visit data from 7 state Medicaid programs were used to identify 274,518 youths continuously enrolled in 2001 and aged 2 to 4 on January 1, 2001. Annual prevalence of use was defined as one or more dispensed prescriptions for a psychotherapeutic medication and adjusted for anticonvulsant and anxiolytic/sedative/hypnotic use according to ICD-9 diagnostic groupings. Prevalence ratios adjusted for age, race/ethnicity, and gender were estimated. 2.30% (CI = 2.24, 2.36) of preschoolers received one or more dispensings for a psychotherapeutic medication in 2001, approximately doubling the usage of comparable youth from 2 other state Medicaid programs studied in 1995. Boys were 2.4 times more likely than girls to receive psychotherapeutic medication. Whites were 4 times more likely than Hispanics and twice as likely as Blacks to receive medication for psychiatric or behavioral conditions. Since the mid-1990s, usage increased, especially for atypical antipsychotics and antidepressants. The prominent use of anticonvulsants (78.8%) and anxiolytic/sedative/hypnotic drugs (91.4%) in those with no psychiatric diagnosis, but with other medical diagnoses, shows that much use therein reflects treatment for seizures, rather than mood stabilization, and for minor medical conditions, rather than psychiatric disorders. Preschool psychotherapeutic medication use increased across ages 2 to 4 for stimulants, antipsychotics, and antidepressants, reflecting use for psychiatric/behavioral disorders. However, the use of anxiolytic/sedative/hypnotics and anticonvulsants was more stable across these years, suggesting medical usage. Additional research to assess the benefits and risks of psychotherapeutic drugs is needed, particularly when such usage is off-label for both psychiatric and nonpsychiatric conditions.

A Comparison of Health Care Utilization and Costs of Children With and Without Autism Spectrum Disorders in a Large Group-Model Health Plan

Data on the current costs of medical services for children with autism spectrum disorders are lacking. Our purpose for this study was to compare health care utilization and costs of children with and without autism spectrum disorders in the same health plan. Participants included all 2- to 18-year-old children with autism spectrum disorders (n = 3053) and a random sample of children without autism spectrum disorders (n = 30529) who were continuously enrolled in the Kaiser Permanente Medical Care Program in northern California between July 1, 2003, and June 30, 2004. Data on health care utilization and costs were derived from health plan administrative databases. Outcome measures included mean annual utilization and costs of health services per child. Children with autism spectrum disorders had a higher annual mean number of total clinic (5.6 vs 2.8), pediatric (2.3 vs 1.6), and psychiatric (2.2 vs 0.3) outpatient visits. A higher percentage of children with autism spectrum disorders experienced inpatient (3% vs 1%) and outpatient (5% vs 2%) hospitalizations. Children with autism spectrum disorders were nearly 9 times more likely to use psychotherapeutic medications and twice as likely to use gastrointestinal agents than children without autism spectrum disorders. Mean annual member costs for hospitalizations (550 dollars vs 208 dollars), clinic visits (1373 dollars vs 540 dollars), and prescription medications (724 dollars vs 96 dollars) were more than double for children with autism spectrum disorders compared with children without autism spectrum disorders. The mean annual age- and gender-adjusted total cost per member was more than threefold higher for children with autism spectrum disorders (2757 dollars vs 892 dollars). Among the subgroup of children with other psychiatric conditions, total mean annual costs were 45% higher for children with autism spectrum disorders compared with children without autism spectrum disorders; excess costs were largely explained by the increased use of psychotherapeutic medications. The utilization and costs of health care are substantially higher for children with autism spectrum disorders compared with children without autism spectrum disorders. Research is needed to evaluate the impact of improvements in the management of children with autism spectrum disorders on health care utilization and costs.

Substance use and psychotherapeutic medications: A likely contributor to menstrual disorders in women who are seropositive for human immunodeficiency virus

Objective: The purpose of this study was to evaluate the impact of substance use and psychotherapeutic medications on menstrual characteristics in women who are human immunodeficiency virus seropositive and seronegative. Study Design: Menstrual calendars were prospectively collected for 1075 women who were human immunodeficiency virus seropositive and seronegative and who were enrolled in the Women's Interagency Human Immunodeficiency Virus Study or the Human Immunodeficiency Virus Epidemiology Research Study; several of the women were substance users or recipients of psychotherapeutic medications. Results: Women who received methadone maintenance and who used injection drugs had substantially increased odds of a cycle of ≥90 days (odds ratio, 2.28; 95% CI, 1.23-4.22; and odds ratio, 3.87; 95% CI, 2.16-6.95, respectively). The use of psychotherapeutic medications increased the odds of having very short cycles, <18 days, and cycles of ≥90 days (odds ratio, 1.69; 95% CI, 1.16-2.45; and odds ratio, 1.86; 95% CI, 1.03-3.36, respectively). Conclusion: Clinicians should evaluate substance use, participation in methadone maintenance programs, and the use of psychotherapeutic medications and consider the neuroendocrinologic effects of these medications as a potential cause of menstrual disruptions. (Am J Obstet Gynecol 2003;188:881-6.)

Appropriate Use and Regulatory Control of Benzodiazepines

Appropriate Use and Regulatory Control of Benzodiazepines

Psychic distress, life crisis, and use of psychotherapeutic medications: national household survey data.

Findings are reported from a nationwide survey of a cross-section probability sample (N = 2,552) of US adults. Data on psychic distress were obtained from a shortened version of the Hopkins symptom checklist, data on life crises from a shortened version of the Holmes-Rahe social readjustment rating scale. Methods for collecting data on use of psychotherapeutic medications were validated in a separate study. Data are presented on the prevalence of high levels of psychic distress and life crisis among various age, sex, and other demographic subgroups; on the relation between life crisis and psychic distress; and on the relation of life crisis and psychic distress to use of psychotherapeutic medications and alcohol. The findings suggest an illness behavior model for the use of psychotherapeutic medications in outpatient practice, and the lend little support to a "self-indulgent consumer" interpretation.