Topic
Psychotropic drug
About: Psychotropic drug is a research topic. Over the lifetime, 2309 publications have been published within this topic receiving 54070 citations.
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TL;DR: Primary care practitioners provide a larger percentage of psychotropic drug visits than psychiatrists in every psychotropic class except for those patients prescribed lithium, and psychiatrists typically provided a mental health diagnosis while primary care physicians did not.
Abstract: This study investigates the prescribing of psychotropic medications by primary care physicians and psychiatrists using the National Ambulatory Medical Care Survey database. Results indicate that primary care practitioners provide a larger percentage of psychotropic drug visits than psychiatrists in every psychotropic class except for those patients prescribed lithium. In addition, the two provider groups differed in the relative proportions of the classes of psychotropic drugs prescribed. Primary care physicians prescribed anxiolytics most frequently, while psychiatrists prescribed antidepressants most often. Finally, in all therapeutic classes, when a psychotropic medication was prescribed, psychiatrists typically provided a mental health diagnosis, while primary care physicians did not.
107 citations
TL;DR: Over one in six patients are currently prescribed antipsychotic drugs known to be of little benefit and causing significant harm, with other psychotropics equally commonly used.
Abstract: Objective: to compare psychotropic prescribing in older people with dementia and the general elderly population. Design and setting: retrospective population database study in 315 General Practices. Subjects: there were 271,365 patients aged ≥65, of which 10,058 (3.7%) recorded as having dementia. Methods: epidemiology of psychotropic prescribing in older people with and without dementia; multilevel modelling of patient and practice characteristics associated with antipsychotic prescribing. Results: people with dementia were currently prescribed an antipsychotic drug (17.7%), an antidepressant (28.7%) and a hypnotic/anxiolytic (16.7%). Compared to the general elderly population, antipsychotic prescribing was 17.4 [95% confidence interval (CI) 16.4–18.4], antidepressant prescribing 2.7 (95% CI 2.6–1.8) and hypnotic/anxiolytics 2.2 (95% 2.1–2.3) times more likely in people with dementia. Most antipsychotic prescribing in people with dementia was prolonged (>16 weeks). Patients living in more deprived areas and registered with larger and more remote practices were more likely to be prescribed prolonged antipsychotics. Conclusions: over one in six patients are currently prescribed antipsychotic drugs known to be of little benefit and causing significant harm, with other psychotropics equally commonly used. Changing this will require investment in services to support alternative management strategies for people with behavioural and psychological disturbance associated with dementia.
106 citations
TL;DR: The association between organisational downsizing and increased use of psychotropic drugs suggests that this managerial strategy may pose mental health risks among employees.
Abstract: Objective: Organisational downsizing is common in modern work life, but its effect on employees’ mental health is not known. The authors examined whether working in downsizing organisations predicts use of psychotropic drugs among employees who remain in employment. Design, setting and participants: Prospective cohort study of municipal employees in Finland. 4783 employees worked in downsized units but kept their jobs after downsizing in 1993, 4271 employees lost their jobs during the downsizing, and 17 599 employees did not experience downsizing. The outcome was psychotropic drug prescriptions (antidepressants, anxiolytics and hypnotics) during 1994–2000 extracted from nationwide registers and linked to the data by means of each participant’s personal identification number. Main results: After adjustment for predownsizing characteristics, employees who were exposed to downsizing but kept their jobs were at a higher risk of being prescribed psychotropic drugs (rate ratio 1.49, 95% CI 1.10 to 2.02 in men and 1.12, 95% CI 1.00 to 1.27 in women) than those not exposed to downsizing. The association of downsizing was strongest with hypnotics among the men and with anxiolytics among the women. An increased rate of psychotropic prescriptions after downsizing was also seen in male workers who lost their job (rate ratio 1.64, 95% CI 1.19 to 2.25). Conclusions: The association between organisational downsizing and increased use of psychotropic drugs suggests that this managerial strategy may pose mental health risks among employees.
106 citations
TL;DR: The clinician must weigh the relative risks of various treatment options and take into account individual patient wishes to lead to thoughtful treatment choices, which with close clinical follow-up can minimize the risk for maternal morbidity.
105 citations
Book•
01 Jan 2005
TL;DR: This book presents the latest clinical guidelines for psychiatrists who prescribe electroconvulsive therapy and practitioners who administer it, and clarifies the place of ECT in contemporary practice and reviews the evidence for its efficacy.
Abstract: This book presents the latest clinical guidelines for psychiatrists who prescribe electroconvulsive therapy (ECT) and practitioners who administer it. It clarifies the place of ECT in contemporary practice and reviews the evidence for its efficacy. Recommendations about practical administration are included, which are intended to maximise the effectiveness of the treatment and minimise any possible adverse effects. The evidence relating to psychotropic drug therapy during and after ECT is presented and analysed, and a chapter is devoted to legal issues and consent to treatment. Suggested protocols and other useful resources are included as appendices.
104 citations