An increasing number of U.S. adults are being prescribed combinations of antidepressants and antipsychotic medications, according to a report in the January issue of Archives of General Psychiatry, one of the JAMA/Archives journals.
In some clinical situations, evidence suggests that more than one psychotropic (affecting the brain or mind) medication may be beneficial, according to background information in the article. For instance, a patient with depression who does not respond to one medication alone might require a second antidepressant, or an individual who has depression with psychotic features might respond to a combination of an antidepressant and an antipsychotic. "In routine psychiatric practice, however, patients often receive psychiatric medication combinations that are not well supported by controlled clinical trials," the authors write.
To examine patterns and trends in psychotropic polypharmacy—or the prescription of more than one psychiatric medication—Ramin Mojtabai, M.D., Ph.D., M.P.H., of Bloomberg School of Public Health, Johns Hopkins University, Baltimore, and Mark Olfson, M.D., M.P.H., of Columbia University Medical Center and the New York State Psychiatric Institute, New York, analyzed data collected from a national sample of office-based psychiatry practices. The number of medications prescribed and specific medication combinations were assessed from a total of 13,079 office visits to psychiatrists by adults (18 years or older) between 1996 and 2006.
READ MORE @ EUREKALERT
Showing posts with label psychotropic medications. Show all posts
Showing posts with label psychotropic medications. Show all posts
Tuesday, January 5, 2010
Tuesday, December 29, 2009
Mental health isn't the issue - stigma is
Mark Dayton at his campaign headquarters in downtown Minneapolis.
Many politicians have overcome admissions of addiction or depression, thanks to better understanding of the manageable diseases. Can Dayton, too?
There was a time when the public admission of mental illness could derail a candidate's political career.
That could still happen to Mark Dayton, the Democratic candidate for governor who went public this week with his history of depression. But if so, experts say, it's the stigma -- not the disease itself -- that would sabotage his run for office.
Today, more than a decade into Prozac Nation, there is no reason why someone being treated for mild to moderate depression shouldn't hold a job with enormous responsibility, doctors say. Abraham Lincoln and Winston Churchill both suffered from depression, they say, and that was long before Prozac and even more effective medications that are available now.
READ MOE @ Minneapolis Star Tribune
Monday, August 10, 2009
Certain drugs may increase risk of falling
In elderly men and women, certain medications can increase the risk of falling, new research shows.
Findings from a 4-year study conducted in France suggest the risk of falling is 1.4 times greater among elderly men and women taking a long-acting benzodiazepine, compared with age-matched men and women not using this type of anti-anxiety medication.
Dr. Annick Alperovitch, at INSERM in Paris, and colleagues also found a moderately increased risk of falling among elderly men and women who regularly used mood- and behavior-altering "psychotropic" medications.
Their findings, reported in the journal BMC Geriatrics, identified similar risk among elderly individuals reporting regular use of tranquilizers, muscle relaxants and anti-spasmodics, and some antihistamines that block nerve responses (so-called "anticholinergics").
READ MORE @ REUTERS
Findings from a 4-year study conducted in France suggest the risk of falling is 1.4 times greater among elderly men and women taking a long-acting benzodiazepine, compared with age-matched men and women not using this type of anti-anxiety medication.
Dr. Annick Alperovitch, at INSERM in Paris, and colleagues also found a moderately increased risk of falling among elderly men and women who regularly used mood- and behavior-altering "psychotropic" medications.
Their findings, reported in the journal BMC Geriatrics, identified similar risk among elderly individuals reporting regular use of tranquilizers, muscle relaxants and anti-spasmodics, and some antihistamines that block nerve responses (so-called "anticholinergics").
READ MORE @ REUTERS
Monday, September 29, 2008
U.S. Kids Take More Psychotropic Drugs Than Europeans
American children are three times more likely to be prescribed psychotropic medications for conditions such as ADHD and bipolar disease than European children are, a new study finds.
Differences in regulatory practices and cultural beliefs about the benefit of medication for emotional and behavioral problems may explain this dramatic difference, the U.S. researchers added.
"There is significantly greater use of atypical antipsychotics and SSRI-type antidepressants for child mental health treatment in U.S. than in Western Europe," said lead researcher Julie Zito, from the pharmaceutical health services research department in the School of Pharmacy at the University of Maryland. "Since most of the use is 'off-label' -- without adequate evidence of benefits and risks, close monitoring should be considered when these medications are used."
The report was published in the Sept. 24 online edition of Child and Adolescent Psychiatry and Mental Health.
READ MORE @ FORBES
Differences in regulatory practices and cultural beliefs about the benefit of medication for emotional and behavioral problems may explain this dramatic difference, the U.S. researchers added.
"There is significantly greater use of atypical antipsychotics and SSRI-type antidepressants for child mental health treatment in U.S. than in Western Europe," said lead researcher Julie Zito, from the pharmaceutical health services research department in the School of Pharmacy at the University of Maryland. "Since most of the use is 'off-label' -- without adequate evidence of benefits and risks, close monitoring should be considered when these medications are used."
The report was published in the Sept. 24 online edition of Child and Adolescent Psychiatry and Mental Health.
READ MORE @ FORBES
Friday, August 8, 2008
Psychiatrists Prescribing More Drugs, But Not Psychotherapy
A declining number of office-based psychiatrists appear to be providing psychotherapy to their patients, according to a report in the August issue of Archives of General Psychiatry.
Psychotherapy has been part of the practice of psychiatry for generations. "Yet, despite the traditional prominence of psychotherapy in psychiatric practice and training, there are indications of a recent decline in the provision of psychotherapy by US psychiatrists -- a trend attributed to reimbursement policies favouring brief medication management visits rather than psychotherapy and the introduction of newer psychotropic medications with fewer adverse effects," the authors wrote.
Ramin Mojtabai, MD, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and Mark Olfson, MD, Columbia University Medical Center and New York State Psychiatric Institute, New York, New York, analysed trends in psychotherapy provision using data from national surveys of office-based psychiatrist visits from 1996 through 2005.
READ MORE @ DOCTOR'S GUIDE
Psychotherapy has been part of the practice of psychiatry for generations. "Yet, despite the traditional prominence of psychotherapy in psychiatric practice and training, there are indications of a recent decline in the provision of psychotherapy by US psychiatrists -- a trend attributed to reimbursement policies favouring brief medication management visits rather than psychotherapy and the introduction of newer psychotropic medications with fewer adverse effects," the authors wrote.
Ramin Mojtabai, MD, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, and Mark Olfson, MD, Columbia University Medical Center and New York State Psychiatric Institute, New York, New York, analysed trends in psychotherapy provision using data from national surveys of office-based psychiatrist visits from 1996 through 2005.
READ MORE @ DOCTOR'S GUIDE
Tuesday, August 5, 2008
Medication increasingly replaces psychotherapy, study finds
Fewer patients are undergoing in-depth treatment as antidepressants and other drugs are more widely used. The shift is attributed partly to insurance reimbursement policies.
Wider use of antidepressants and other prescription medications has reduced the role of psychotherapy, once the defining characteristic of psychiatric care, according to an analysis published today.
The percentage of patients who received psychotherapy fell to 28.9% in 2004-05 from 44.4% in 1996-97, the report in Archives of General Psychiatry said.
Researchers attributed the shift to insurance reimbursement policies that favor short medication visits compared with longer psychotherapy sessions, and to the introduction of a new generation of psychotropic medications with fewer side effects.
Although not a surprise to many psychiatrists, the findings were expected to intensify a debate over the increased medicalization of psychiatric care, which in part reflects an emphasis on the biology of mental illness, as opposed to the processes of the mind.
Psychotherapy is an interpersonal intervention that may involve such things as behavior modification and group discussion. It is recommended -- with or without medication -- for major depression, post-traumatic stress disorder, bipolar disorder and other psychiatric illnesses.
READ MORE @ LOS ANGELES TIMES
Wider use of antidepressants and other prescription medications has reduced the role of psychotherapy, once the defining characteristic of psychiatric care, according to an analysis published today.
The percentage of patients who received psychotherapy fell to 28.9% in 2004-05 from 44.4% in 1996-97, the report in Archives of General Psychiatry said.
Researchers attributed the shift to insurance reimbursement policies that favor short medication visits compared with longer psychotherapy sessions, and to the introduction of a new generation of psychotropic medications with fewer side effects.
Although not a surprise to many psychiatrists, the findings were expected to intensify a debate over the increased medicalization of psychiatric care, which in part reflects an emphasis on the biology of mental illness, as opposed to the processes of the mind.
Psychotherapy is an interpersonal intervention that may involve such things as behavior modification and group discussion. It is recommended -- with or without medication -- for major depression, post-traumatic stress disorder, bipolar disorder and other psychiatric illnesses.
READ MORE @ LOS ANGELES TIMES
Tuesday, June 10, 2008
With Precautions, Psychiatrists Need Not Shun off-Label Prescribing
Fear of lawsuits should not stop psychiatrists from prescribing medications for off-label indications as long as they make patient-centered decisions based on evidence and talk to patients about risks and benefits.
By focusing on patient care and providing appropriate informed consent, consultation-liaison psychiatrists can protect themselves from liability lawsuits regarding the use of antipsychotics and other medications for indications not approved by the Food and Drug Administratio (FDA). So said experts who led a workshop for consultation-liaison (C-L) psychiatrists at APA's 2008 annual meeting in Washington, D.C., in May.
Off-label use includes prescribing medications not only for unapproved indications, but also for unapproved dosages and patient populations, some of which may be subject to specific warnings by the FDA, said Ramaswamy Viswanathan, M.D. He is the director of the C-L Psychiatry Department at the State University of New York Downstate Medical Center in Brooklyn, N.Y. Intravenous infusion of haloperidol and the use of antipsychotics to treat dementia-related agitation are only two notable examples.
READ MORE @ PSYCHIATRIC NEWS
By focusing on patient care and providing appropriate informed consent, consultation-liaison psychiatrists can protect themselves from liability lawsuits regarding the use of antipsychotics and other medications for indications not approved by the Food and Drug Administratio (FDA). So said experts who led a workshop for consultation-liaison (C-L) psychiatrists at APA's 2008 annual meeting in Washington, D.C., in May.
Off-label use includes prescribing medications not only for unapproved indications, but also for unapproved dosages and patient populations, some of which may be subject to specific warnings by the FDA, said Ramaswamy Viswanathan, M.D. He is the director of the C-L Psychiatry Department at the State University of New York Downstate Medical Center in Brooklyn, N.Y. Intravenous infusion of haloperidol and the use of antipsychotics to treat dementia-related agitation are only two notable examples.
READ MORE @ PSYCHIATRIC NEWS
Tuesday, November 13, 2007
Pharmacological Management of Major Depressive Disorder
About 121 million people worldwide suffer from depression. Major depression is one of the main causes of disability adjusted life years (DALY) as measured by the global burden of disease.1 The lifetime risk of major depression is about 15% for men and about 30% for women.2 Numerous types of depression exist, such as melancholic, atypical, psychotic, postpartum, bipolar, resistant, and mixed depression.3 The most commonly encountered types of depression and specific recommendations for their pharmacologic management are discussed below.
Many medications are used for the management of major depression. These include tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), second generation atypical antidepressants (eg, bupropion, mirtazapine), psychostimulants (eg, methylphenidate), mood stabilizers (eg, lithium), and augmentation drugs (eg, triiodothyronine). Antidepressants work through a variety of mechanisms, a topic beyond the scope of this newsletter, but generally influence the function of neurotrasmitters such as norepinephrine, serotonin, or dopamine by exerting an impact on the interaction of these neurotransmitters with their receptors.
READ MORE @ ABKHAZIA
Many medications are used for the management of major depression. These include tricyclic antidepressants (TCAs), monoamine oxidase inhibitors (MAOIs), selective serotonin reuptake inhibitors (SSRIs), selective norepinephrine reuptake inhibitors (SNRIs), second generation atypical antidepressants (eg, bupropion, mirtazapine), psychostimulants (eg, methylphenidate), mood stabilizers (eg, lithium), and augmentation drugs (eg, triiodothyronine). Antidepressants work through a variety of mechanisms, a topic beyond the scope of this newsletter, but generally influence the function of neurotrasmitters such as norepinephrine, serotonin, or dopamine by exerting an impact on the interaction of these neurotransmitters with their receptors.
READ MORE @ ABKHAZIA
Saturday, November 3, 2007
Concomitant Psychotropic Medications Overprescribed in Foster-Care Youth: Presented at AACAP
Nearly 20% of youths in foster care receiving psychotropic medications received two or more such drugs in the same drug class, in a study presented here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP).
Professionally developed monitoring guidelines would help to validate any necessary prescriptions for multiple psychotropic medications, noted lead author Julie M. Zito, PhD, MS, Associate Professor in Pharmacy and Psychiatry, Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland, United States.
Dr. Zito and colleagues selected a random sample (n = 472) from a total of 32,135 Medicaid foster-care enrolees in Texas in 2004. All subjects were 19 years of age or younger (64% over the age of 10; 5% were age 4 years and under) and all received at least one psychotropic drug in the study year (2004).
The psychotropic drugs were classified under 8 drug descriptions: anticonvulsants; alpha agonists; antianxiolytics; antidepressants (selective serotonin reuptake inhibitors, tricyclic antidepressants, other); antipsychotics (atypical and conventional); ADHD drugs (amphetamines, methylphenidate, atomoxetine); lithium; and miscellaneous.
READ MORE @ DOCTOR'S GUIDE
Professionally developed monitoring guidelines would help to validate any necessary prescriptions for multiple psychotropic medications, noted lead author Julie M. Zito, PhD, MS, Associate Professor in Pharmacy and Psychiatry, Department of Pharmaceutical Health Services Research, School of Pharmacy, University of Maryland, Baltimore, Maryland, United States.
Dr. Zito and colleagues selected a random sample (n = 472) from a total of 32,135 Medicaid foster-care enrolees in Texas in 2004. All subjects were 19 years of age or younger (64% over the age of 10; 5% were age 4 years and under) and all received at least one psychotropic drug in the study year (2004).
The psychotropic drugs were classified under 8 drug descriptions: anticonvulsants; alpha agonists; antianxiolytics; antidepressants (selective serotonin reuptake inhibitors, tricyclic antidepressants, other); antipsychotics (atypical and conventional); ADHD drugs (amphetamines, methylphenidate, atomoxetine); lithium; and miscellaneous.
READ MORE @ DOCTOR'S GUIDE
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