Side Effects Of Psychotropic Drugs Research Articles

Types of Medication Non-adherence & Approaches to Enhance Medication Adherence in Mental Health Disorders: A Narrative Review

Background: Medication non-adherence (MNA) presents a significant obstacle that negatively impacts treatment effectiveness in mental health disorders. The objective of this review is to study different types of MNA and interventions designed to enhance medication adherence among individuals with mental health disorders. Methods: We conducted an electronic search on PubMed and Google Scholar using keywords such as adherence, non-adherence, compliance, non-compliance, mental health disorders, psychotropic drugs, major depressive disorder (MDD), schizophrenia, anxiety disorders, and bipolar disorders (BD). From the search results, we selected studies pertinent to the objective of the review. Results: Non-adherence can be categorized into primary nonadherence (not starting medication) and secondary non-adherence (not taking the medication as directed). Generally, we can group the reasons for non-adherence into unintentional and intentional. Unintentional non-adherence (UNA) arises when patients genuinely desire to comply with their prescribed course of therapy but are hindered by factors beyond their control. When addressing UNA, interventions should simplify medication regimens, utilize long-acting injectable (LAIs) medications, offer tools to manage medication and provide follow-up reminders. When a patient deliberately decides not to follow their treatment plan, this is known as intentional non-adherence. To improve intentional non-adherence, the focus should be on patient-centred care and shared decision-making, psychoeducation, effective doctor-patient communication, cognitive-behavioral strategies, and addressing concerns related to the side effects of psychotropic drugs. Conclusion: It is crucial to understand that there is no universal solution to address non-adherence in mental health disorders. Each patient has distinct needs and characteristics, making personalized strategies and interventions of utmost significance.

Therapy of mental disorders in patients with hematological malignancies

To assess the possibilities of therapy with minimal effective doses (MED) of psychotropic drugs for mental disorders (MD) that manifest during the treatment of hematological malignancies (HM). A prospective study was conducted at the National Medical Research Center for Hematology of the Russian Ministry of Health (Moscow), which included 204 (39.4%) men and 314 (60.6%) women (518 patients in total), aged 17 to 83 years (median 45 years), with various HM, in which the manifestation of MD occurred during the treatment of the underlying disease. To minimize the side-effects of psychotropic drugs and given the relatively mild level of MD, psychopharmacotherapy of patients was carried out mainly at MED. The severity of MD, manifested in patients, was assessed by the illness severity scale of the Clinical Global Impression (CGI) scale, and the effectiveness of the treatment was assessed by the improvement scale (CGI-I). Mainly mild (188, 36%) and moderately pronounced (270, 52%) MD were noted in patients with HM during the treatment of the underlying disease. Severe psychopathological disorders (60, 12%) were observed much less often. Because of psychopharmacotherapy with MED, patients experienced a very significant (97, 19%) and significant improvement (354, 68%) of their mental state, less often the improvement was regarded as minimal (67, 13%). Therefore, almost all patients showed a stable relief of MD; in 87% (95% CI 84-90) of patients, this improvement was significant. The tactics of treatment MD that manifest in patients with HM with MED of psychotropic drugs turned out to be therapeutically effective according to the results of the assessment on CGI scales.

Ведение пациентов с синдромом дефицита внимания с гиперактивностью с использованием цифровых технологий.

Introduction. Attention deficit hyperactivity disorder (ADHD) is a disease of the group of neuropsychiatric developmental dis- orders, the main symptoms of which are hyperactivity, attention deficit and impulsivity. Behavioral disorders in ADHD, the childhood age of most patients, the need to control the side effects of psychotropic drugs, and limitations in the availability of medical care сan lead to the need for searching for alternative options for the management of patients with this disorder, such as telemedicine and methods of remote monitoring of the disease. The aim of this review is to analyze modern methods of professional medical care for patients with ADHD. Materials and Methods. Literature review was conducted using PubMed, Scopus, and GoogleScholar databases, and the study included literature sources not older than 5 years. Results. We conducted a literature review and analyzed current trends in the management of patients with ADHD using remote technologies. Currently, all these steps can be achieved by using of telemedicine technologies: remote teleconsultations, the use of digitized questionnaires and cognitive tasks, the introduction of psychotherapeutic tools into patients' daily lives through augmented and virtual reality technologies, and the use of apps and wearable devices for symptom tracking. Conclusion. In summary, the analysis has demonstrated the certain aspects of managing patients with attention deficit hy- peractivity disorder using telemedicine technologies. Modern technologies make it possible to achieve control over the course of ADHD, reduce the severity of its symptoms and improve the quality of life of patients with ADHD.

SİDE EFFECTS OF PSYCHOTROPİC DRUGS USED İN THE TREATMENT OF VASCULAR DEMENTİA

This article highlights another problem emerging in connectiın with the aging of population . An increase in the number of elderly people means an increase in the number of elderly patients suffering from psychiatric illness. Studies show that in recent years, 25% of older people take more medication than they need. This also applies to older people suffering from mental illness at home, in hospital or in nursing homes. As psycho-pharmacology is very specific in older people, the development of side effects of psychotropic drugs is also different. One of the most important issues for us is to study the side effects of psychotropic drugs in the elderly population, which complicate treatment and sometimes even lead to death. The article examines which group of psychotropic drugs have the most side effects in elderly patients, the relationship between age and diagnosis and the occurrence of side effects of psychotropic drugs, the duration of side effects, the impact on the course of the disease. Although side effects of psychotropic drugs are observed in the treatment of vascular dementia, in many cases their use is necessary. It is recommended to start with a small dose and gradually increase the dose. Even during the first 4 weeks, it is recommended to keep the dose as low as possible. This will reduce the development of side effects that can lead to treatment failure and lead to a decrease in mortality.

Hypoactive Sexual Desire and Other Sexual Dysfunctions Caused by Psychotropic Drugs and Anticonvulsants

Currently, there are a huge number of drugs. Every year their number increases and their number is in the tens of thousands, which makes it possible to speak of a “pharmaceutical explosion”. In addition to its main therapeutic effect, each of the drugs has side effects, which, in particular, may affect the sexual sphere. This article discusses the literature on the side effects of psychotropic drugs and anticonvulsants, which can lead to hypoactive sexual desire and other sexual dysfunctions. The side effects on sexual functions of tranquilizers, antipsychotics (traditional and newer), antidepressants of various groups (tricyclic antidepressants, selective serotonin reuptake inhibitors, serotonin and norepinephrine reuptake inhibitors, monoamine oxidase inhibitors, as well as newer antidepressants), mood stabilizers and anticonvulsants are considered. The degree of influence of neuroleptics and antidepressants on sexual function is discussed depending on the dose, duration of administration, belonging to one or another chemical class. It is noted that some drugs from these groups can have a stronger negative effect on sexual functions, others have a moderate or weak effect, and still others not only do not have such an effect, but even increase sexual desire and other sexual functions. Therefore, before starting to take one or another drug from these groups, one should evaluate the state of sexual functions and, in case of their violation, prescribe such drugs that have the same therapeutic effect, but when they are used, there is no risk of adverse effects on the sexual sphere. These drugs (for example, antidepressants) should be prescribed as a substitute even in cases where a drug with an antidepressant effect was previously taken, which led to sexual dysfunctions.

Preferred outcome measures in treatments for challenging behaviour in individuals with intellectual disabilities: Results of an inclusive Delphi method.

Interventions for challenging behaviours in individuals with intellectual disabilities benefit from outcome monitoring that takes clients' preferences into account. We determined clients' and representatives' preferred outcome domains and measures to secure their involvement in treatment decisions for challenging behaviours. We used an inclusive Delphi method. A focus group of individuals with mild intellectual disabilities and representatives of those with moderate and severe intellectual disabilities prepared the first round by assisting us in collecting possible outcomes. Panels of individuals with intellectual disabilities and representatives were composed to achieve consensus on instruments for preferred outcome domains. Preferred outcome domains were behaviour, side-effects of psychotropic drugs, quality of life, daily functioning, caregiver burden and family quality of life. Corresponding outcome measures included self-report, interview and proxy-scales, including spoken versions. Including the preferred domains on outcomes of interventions for challenging behaviours is recommended. Research on corresponding outcome measures is necessary.

Characterisation of medication side effects in patients with mostly resistant depression in a real-world setting

Objectives This study aimed to identify factors associated with side effects of psychotropic drugs in a real-world setting enriched with treatment-resistant depression (TRD) patients. Methods A total of 1410 depressed patients were treated in a naturalistic setting. Side effects were measured with the Udvalg for Kliniske Undersogelser Side Effect Rating Scale (UKU); the total score and UKU subscales were considered. Clinical-demographic variables were tested for association with side effects in univariate and then multivariate analyses. Results Total, psychic and neurological side effects were associated with depressive symptom severity, while autonomic side effects were higher in those with somatic comorbidities and other side effects were lower in patients receiving trazodone. In multivariate analyses, depressive symptom severity was associated with psychic and total side effects, while generalised anxiety disorder (GAD) with neurological side effects and somatic comorbidities remained associated with autonomic side effects. Trazodone was associated with lower side effects and with augmentation treatments. Augmentation therapies showed opposite effects depending on response status, i.e. increased or decreased the risk of side effects in responders and non-responders/resistant patients, respectively. Conclusions Psychic side effects may be difficult to distinguish from depressive symptoms and factors associated with different types of side effects are heterogeneous and likely interacting.

Collaboration between Psychiatrists and Other Allied Medical Specialists for the Treatment of Delusional Disorders.

Background: There is increasing evidence that individuals with psychosis are at increased risk for cardiovascular disease, diabetes, metabolic syndrome, and several other medical comorbidities. In delusional disorder (DD), this is particularly so because of the relatively late onset age. Aims: The aim of this narrative review is to synthesize the literature on the necessity for medical collaboration between psychiatrists and other specialists. Methods: A non-systematic narrative review was carried out of papers addressing referrals and cooperation among specialists in the care of DD patients. Results: Psychiatrists, the primary care providers for DD patients, depend on neurology to assess cognitive defects and rule out organic sources of delusions. Neurologists rely on psychiatry to help with patient adherence to treatment and the management of psychotropic drug side effects. Psychiatrists require ophthalmology/otolaryngology to treat sensory deficits that often precede delusions; reciprocally, psychiatric consults can help in instances of functional sensory impairment. Close collaboration with dermatologists is essential for treating delusional parasitosis and dysmorphophobia to ensure timely referrals to psychiatry. Conclusions: This review offers many other examples from the literature of the extent of overlap among medical specialties in the evaluation and effective treatment of DD. Optimal patient care requires close collaboration among specialties.

Investigating causes of increased morbidity and mortality within psychiatric patients - Somatic comorbidities of inpatients in a german psychiatric community hospital

IntroductionThe co-occurrence of mental illness and somatic comorbidities is a major cause of increased morbidity and mortality within psychiatric patients, compared to the general population. This may be caused by an unhealthy lifestyle, side effects of psychotropic drugs and systematic barriers in healthcare provision. The underlying mechanisms remain under-investigated.ObjectivesWe systematically investigated relevant barriers and risk factors to the utilization of primary care among severe mentally ill outpatients.MethodsIn a cross-sectional analysis, the psychiatric as well as somatic diagnoses of inpatients of a German psychiatric community hospital were identified. Furthermore, somatic and psychiatric medication, blood values (HBA1C) and sociodemographic data of the patients were analyzed. The frequencies of the somatic diagnoses were presented according to psychiatric diagnoses. By a Chi-Square goodness-of-Fit Test the distribution of somatic diagnoses and drug classes were verified according to the total cohort as well as for each psychiatric diagnosis and in respect to sex.ResultsOur results provide an overview of common comorbidities with regard to the psychiatric diagnosis. The medication, in relation to the recorded somatic comorbidities, as well as the blood values, allow a conclusion to be drawn about the extent and success of the treatment.ConclusionsFor the first time, real-life data on the somatic diagnoses and treatment of patients with a severe mental illness in a German hospital is presented. Our results will be used to create low-threshold interventions for the most relevant somatic comorbidities and to improve primary care of psychiatric patients through linking the care systems.DisclosureNo significant relationships.

An Audit on Patient Safety and Prescribing in Patients With a Learning Disability, Autism, or Both at a Scottish GP Practice

AimsThe aim was to investigate the proportion of patients with a previous diagnosis of learning disability or autism who later successfully underwent an annual review of their prescribed anti-psychotic or anti-depressant. This audit was prompted after Public Health England announced that a significant number of adults with a learning disability, autism or both take a prescribed antipsychotic, an antidepressant or both without appropriate clinical indications (psychosis or affective/anxiety disorder).MethodsThe sample included 23 patients from the practice who had received a diagnosis of learning disabilities, autism, or both by 12th October 2020. Of these, 12 patients had a record of at least 5 prescriptions of an anti-psychotic in the last 12 months and 20 patients had a record of at least 5 prescriptions of an anti-depressant within the last 12 months. The notes for these patients were reviewed in May 2021 in an effort to ascertain whether a medication review had been completed for these patients since May 2020. The review process included a phone call between the patient and the prescribing doctor to determine whether there any side effects were being experienced and to assess the need for the continuation of the prescription. The resulting data were recorded and analysed on Microsoft Excel.ResultsOut of the 12 patients who had been prescribed an anti-psychotic, 10 had received a medication review within the last 12 months. From the 20 patients who had been prescribed an anti-depressant, 19 had undergone a review of their medication within the last 12 months.ConclusionReview of anti-psychotics and anti-depressants prescribed to patients with a diagnosis of learning disability, autism, or both was overall positive with the majority of these patients receiving a medication review within 12 months. As a further recommendation, another audit can be done to explore whether these patients had an annual blood test done as increased cholesterol is a known side-effect of psychotropic drugs.

A Review of Ocular Complications Associated with Medications Used for Anxiety, Depression, and Stress.

This review of commonly prescribed psychotropic drugs aims to update the clinician on possible ophthalmic side effects that may include dry eye, diplopia, mydriasis, and cataracts. This review summarizes our current knowledge of known ocular side effects of psychotropic drugs based on reviews, case reports, case-control studies, a case series, and cross-sectional observational studies reported in the recent literature. The review covers disorders related to depression, anxiety, and stress which are commonly encountered within society and can have debilitating impacts on an individual’s quality of life that may require chronic therapeutic management. The main medications used in the treatment and management of these conditions typically target receptors, metabolic enzymes, or transport pumps that alter the pre- and/or post-synaptic levels of neurotransmitters such as serotonin, norepinephrine, dopamine, gamma-aminobutyric acid, and opioids to improve mood and/or relieve pain and anxiety. Novel non-therapeutic options are undergoing clinical trials, and some patients may seek alternative therapies or have associated substance abuse issues to alleviate their symptoms. This review summarizes some of the clinical signs of depression and the main therapeutic options and their reported ocular side effects which may be pertinent today given the rise in use of psychotropic medications used to manage depression, anxiety, and stress.

Uso de Antidepressivos em Adolescentes: uma Revisão Sistemática da Literatura

In recent years, the number of young people diagnosed with depression has grown, and consequently there has been an increase in the consumption of psychotropic drugs, with the need to monitor the patient's needs, together with applied pharmacotherapy, aimed at improving the patient's health. Therefore, this research aims to carry out a systematic review on the use of antidepressants in adolescents. A survey of studies published in scientific databases was carried out, including Google Scholar, the Virtual Health Library and the Scientific Electronic Library Online, following the PRISMA method. After applying the inclusion and exclusion criteria, 6 studies were selected to compose the review. The results were presented according to the symptoms associated with depression; therapy and treatment with psychotropic drugs; the side effects of psychotropic drugs; and the role of the pharmacist in the therapeutic management of adolescents with depression. It is concluded that pharmacological therapy should be based on the symptoms presented by each client, therefore, in the different studies described, there was a discrepancy between the drugs prescribed for the treatment of patients, after all, the disorder occurs in different ways depending on each individual., as they result from the influence of external and internal factors.

Communication at the End of Life.

End-of-life patients experience physical, mental, social, and existential distress. While medical personnel provide medication and care to alleviate patients' distress, listening to and interacting with patients remains essential for understanding their psychological condition. The most important tool, though difficult to implement in practice, is end-of-life discussion (EOLD). EOLD has been shown to have positive effects on end-of-life treatment choices, achievement of patients' life goals, improvements in the quality of life of patients and their families, and the prevention of depression and complicated grief among bereaved family members. EOLD is not often undertaken in clinical practice, however, due to hesitancy among medical personnel and patients for various reasons. In order to conduct an EOLD, the patient's judgment, psychiatric illnesses such as delirium and depression, and psychological issues such as the side effects of psychotropic drugs, denial, and collusion must be evaluated. Open and honest conversation, treatment goal setting, the doctor's familiarity with the patient's background, and attentiveness when providing information are important elements for any dialogue. Meaning-centered psychotherapy was developed to alleviate the existential distress of cancer patients, and its application may promote EOLD. The future development of meaning-centered psychotherapy in practice and in research is expected to further promote EOLD.

Urinary side effects of psychotropic drugs: A systematic review and metanalysis

To evaluate the effects of psychotropic drugs on bladder function. A systematic review was carried out by searching PubMed and Embase databases for randomized controlled trials enrolling patients treated with psychotropic drugs with available information on treatment-related urinary disorders. A total of 52 studies was selected. In antidepressant therapy, bladder voiding symptoms, rather than storage symptoms, were more frequently observed. Pooled analysis demonstrated a higher odds ratio (OR) of voiding disorders in comparison with placebo (OR: 3.30; confidence interval [CI]: 1.90-5.72; 7856 participants; p < 0.001). Odds for voiding dysfunction was higher for tricyclic antidepressants and for Serotonin and Norepinephrine Reuptake Inhibitors (SNRIs) when compared to Selective Serotonin Reuptake Inhibitors (SSRIs). Treatment with antipsychotics was associated with heterogeneous urinary disorders including emptying and storage disorders. OR for incontinence in patients with dementia taking antipsychotics was higher than placebo (OR: 4.09; CI: 1.71-9.79, p = 0.002) with no difference between different atypical antipsychotics. Rate of voiding disorders was not different between conventional and atypical antipsychotics (OR: 1.64; CI: 0.79-3.39, p = 0.19), although quetiapine showed higher odds to cause voiding dysfunction than other atypical antipsychotics (OR: 2.14; CI: 1.41-3.26; p > 0.001). In patients taking tricyclic antidepressants or SNRIs, bladder voiding disorders, could be the side effects of therapy rather than symptoms of a urological disease. Patients treated with these drugs should be actively monitored for the appearance of urinary symptoms. Antipsychotic treatment is associated with various urinary side effects requiring a tailored approach.

Depression and dry eye: a narrative review.

Dry eye disease (DED) is a multifactorial disease affecting tear quality and/or production and eye surface and is one of the most common eye disorders found in clinical practice. The association between psychiatric disorders and dry eye has been the subject of several studies since patients with this syndrome present a tendency toward a depressive mood. This narrative review aims to demonstrate the relationship between depression and DED, which is due to the side effects of psychotropic drugs or the tendency of the low pain threshold of the depressive patient. The work was produced from the analysis of 13 articles published during the last decade on this subject and demonstrated that the depressive state is linked to the appearance or worsening of DED resulting from chronic eye pain. Also, the treatment of depression with selective inhibitors of serotonin receptors causes inflammatory cytokine secretion with subsequent inflammation and apoptosis of cells on the ocular surface. The need for new studies on optimization of psychiatric treatment in patients with ophthalmic diseases, such as DED, was verified, aiming at the relief of symptoms and the reduction of psychological and eye damage caused by them.

Побочное действие психотропных препаратов на орган зрения

Any antipsychotics provoke more or less ocular complications. Some of them are relatively harmless (i.e., dark eyelids, conjunctival and corneal pigmentation, mydriasis, nystagmus, dry eye etc.). These adverse effects are resolved spontaneously after treatment discontinuation, drug switching, or prescribing additional therapy. However, the intake of both typical and atypical neuroleptics, lithium salts, some anticonvulsants (e.g., topiramate) is associated with high risks of vision loss. Moreover, in some patients these medications may result in blindness. The use of psychotropic drugs (e.g., tricyclic antidepressants or serotonin reuptake inhibitors) in patients with higher risk of acute angle closure is of particular concern. The association between phenothiazines and anticonvulsants and retinopathy, chlorpromazine and cataract, anticonvulsants and poor color vision and reduced contrast sensitivity is also important. Psychiatrists and ophthalmologists should consider potential ocular side effects in patients receiving psychotropic drugs. Knowing management algorithm for these conditions is also important. The number of recent publications on this issue is limited. Therefore, articles older than 10 years are sometimes used. Keywords: eye, visual organ, adverse effects, psychotropic drugs, neuroleptics, tricyclic antidepressants, selective serotonin reuptake inhibitors, glaucoma, retinopathy, cataract. For citation: Petukhova A.A., Panov A.A., Malygin Ya.V., Kazanfarova M.A. Side effects of psychotropic drugs on eye. Russian Journal of Clinical Ophthalmology. 2021;21(1):29–33. DOI: 10.32364/2311-7729-2021-21-1-29-33.

Health professionals’ experience of nursing home residents’ consumption of alcohol and use of psychotropic drugs

Background:Nursing home (NH) residents are in most cases in older ages and use prescription drugs. As alcohol interacts with many commonly prescribed drugs, NH residents may be more vulnerable to the effects of alcohol.Aim:To investigate the experiences of health professionals in Norwegian NHs when it comes to residents' alcohol consumption and use of psychotropic drugs, and the facilitation of such use in the NH.Method:Focus-groups and individual interviews with NH health professionals were performed in 2017 and 2018. The data were analysed using content analysis.Findings:Two main themes emerged: (1) the balancing of alcohol consumption, and (2) the use of psychotropic drugs. Each of these themes involved reasoning, which revealed that the informants in general had little attention regarding alcohol consumption among residents, and few institutions had policies regarding serving and consumption of alcohol. The informants reported an increased attention regarding use of psychotropic drugs and a tendency towards less use of psychotropic drugs among the residents than before, but few informants reported use of standardised observations tools of symptoms related to prescribing and discontinuation of drugs.Conclusion:Alcohol policies or procedures related to alcohol consumption were uncommon at the NH that the interviewees of this study represented, and the professionals regarded infrequent serving and consumption of alcohol among the residents as a part of everyday life. In cases when residents frequently consumed alcohol, the professionals used dialogue to underpin the adherent risks and they also tried to control the consumption of the resident in different ways. The interviewees were aware of various side-effects of psychotropic drugs; they were also aware of their effects in combination with alcohol.

Monitoring The Side Effects Of Psychotropic Drugs Prescribed In Tertiary Care Hospital

Monitoring The Side Effects Of Psychotropic Drugs Prescribed In Tertiary Care Hospital

Psikotropik ilaçlar ve hiponatremi ilişkisi: bir derleme

Hiponatremi, psikotropik ilaçların kullanımını takiben en sık bildirilen elektrolit bozukluğudur. Psikiyatrik bozuklukların tedavisinde kullanılan antidepresan, antipsikotik ve duygudurum düzenleyicilerinin hiponatremi riski taşıdığı iyi bilinmektedir. Herhangi bir risk faktörü olmadan da hiponatremi oluşturmakla birlikte psikotropik ilaçların bu yan etkisiyle ilişkili olan bazı risk faktörleri bulunmaktadır: İleri yaş, eşzamanlı psikiyatrik olmayan ilaç kullanımı ve tıbbi komorbiditelerin varlığı. Bir psikotropik ilaç yan etkisi olarak hiponatremi, konfüzyon ve ajitasyondan ölüme kadar giden çeşitli sonuçlar doğurabilir. Psikotropik ilaçlara bağlı hiponatremi bir övolemik hiponatremi nedeni olan uygunsuz antidiüretik hormon salınımı sendromu ile ilişkilendirilmektedir. Klinisyenler psikotropik ilaca bağlı hiponatreminin yanında psikojenik polidipsi olasılığını ve ilaç etkileşimlerini dikkate almalıdır. Potansiyel olarak ölümcül olabilen psikotropik ilaçlara bağlı hiponatreminin erken tanısı ve tedavisi önemlidir.

Elderly patients under the side effects of psychotropic drugs

Elderly patients under the side effects of psychotropic drugs