Psychotropic drug

About: Psychotropic drug is a research topic. Over the lifetime, 2309 publications have been published within this topic receiving 54070 citations.

Surgical effects of focus resection for patients with intractable epilepsy.

Abstract: Postoperative seizure-free outcome, psychiatric condition, intellectual function, and employment status were reviewed to demonstrate the usefulness of focus resection in 71 patients who underwent resective epilepsy surgery between 2000 and 2010 for the treatment of medication-resistant epilepsy. The psychiatric problems were assumed to be present only if the patient received psychotropic drug therapy. Seizure-free outcome was obtained in 53 (75%) patients. The patients were followed up for 2.0-12.0 years (mean 7.2 years) after surgery. Temporal lobe epilepsy (TLE), late seizure onset, short seizure duration, and magnetic resonance imaging lesions were all significantly associated with cessation of seizures. Psychotropic drug therapy was performed in 3 (4.2%) patients before surgery and in 12 (17.0%) patients at 2 years or later after surgery. TLE and preoperative psychotropic drugs were significantly associated with postoperative psychiatric problems. Among the 71 patients, 65 underwent full Wechsler Adult Intelligence Scale-Revised (WAIS-R) examinations both before and after surgery. The mean WAIS-R score was 82.5 ± 18.7 points for total intelligence quotient (IQ) preoperatively and 89.6 ± 20.3 points for total IQ postoperatively. Before surgery, 19 (27%) patients were engaged in full-time employment. After surgery, 2 patients lost and 9 patients newly entered full-time employment, so a total of 26 (37%) patients were engaged in full-time employment after surgery. Resective epilepsy surgery resulted in overall improvements in seizure control, intellectual functions, and employment status. However, patients with TLE had some risk of postoperative psychiatric disorder.

Optimising psychotropic medication use

Abstract: Purpose This commentary accompanies Clare et al.’s study investigating psychotropic drug prescribing for adults with intellectual disability who were referred to specialist community learning disability teams in the east of England. The purpose of this paper is to explore some of the background to psychotropic drug prescribing for people with intellectual disability, review important contextual factors that influence prescribing decisions, and consider how we might make the best use of psychotropic drugs in this group. Design/methodology/approach Narrative summary and opinion, supported by reference to recent research literature. Findings Psychotropic drug use for people with intellectual disability raises complex issues, not least because of the lack of research evidence that exists on the topic. Psychotropic drugs can be an important part of treatment for people with mental illness but further research is needed to support prescribing for challenging behaviour. Medication optimisation is a framework within which individual preferences and values are considered alongside the evidence base and clinical judgement in order to inform safe, effective, and collaborative management decisions. Practical implications Prescribing decisions should be individualised and reviewed regularly, incorporating evidence from patients and carers. Improving the use of psychotropic medication requires concerted action, adequate social support, and the provision of alternative, non-pharmacological interventions that are acceptable and effective. Originality/value This paper reviews some of the current concerns about the use of psychotropic drugs and opens up new avenues of discussion.

The effect of a novel dietary intervention on weight loss in psychotropic drug-induced obesity.

Abstract: Weight gain associated with the use of psychotropic drugs may be related to their blockade of serotonin receptors which mediate satiety. Obese individuals whose weight gain followed psychotropic drug use, or control nondrug-treated obese subjects, were treated with a 12-week weight loss program that included a carbohydrate-rich, protein-poor beverage thought to increase brain serotonin.The 38 psychotropic drug treated females lost slightly more weight than their 60 nondrug-treated controls, ie, 13.4-/+1.8 pounds versus 12.1-/+1.1 pounds. The eight drug-treated males lost 26-/+4.1 pounds and their 12 nondrug-treated controls lost 22.2-/+3.2 pounds. Weight loss was significant in all groups (all P<.001). A treatment program that included a high carbohydrate dietary supplement caused as much weight loss among patients on psychotropic drugs as among control obese patients, without blocking the drugs' therapeutic effects.

Micturition difficulty and urinary retention associated with aripiprazole and citalopram treatment in a male adolescent with Asperger syndrome.

Abstract: [Author Affiliation]Ozhan Yalcin. Bakirkoy Mental Health, Neurology and Neurosurgery Research and Trainee Hospital, Child and Adolescent Psychiatry Clinic, Istanbul, Turkey.Address correspondence to: Ozhan Yalcin, MD, Bakirkoy Mental Health, Neurology and Neurosurgery Research and Trainee Hospital, Child and Adolescent Psychiatry Clinic, Istanbul, Turkey, E-mail: cpozhan@gmail.comTo The Editor:Urinary problems such as urinary incontinance (clozapine, risperidone) and urinary retention (olanzapine, chlorpromazine) have been reported with both typical and atypical antipsychotics, which could be very problematic, especially for older patients (Saddichha and Kumar 2009). Urinary symptoms caused by antipsychotics are hypothesized to be extrapyramidal side effects (EPS) or a result of the medications' anticholinergic effects or related to their action on the peripheral adrenergic system. As α1-adrenergic receptors are widely distributed over the smooth muscle of the trigone and detrusor muscles of the bladder, it is claimed that central dopamino-seratonergic effects along with peripheral α1-adrenergic blockade may act synergistically to cause urinary incontinance and retention (Saddichha and Kumar 2009). Other psychiatric drugs, especially tricyclic antidepresants (Hermesh et al. 1987), reboxetine (Borade et al. 2005), atomoxetine (Desarkar and Sinha 2006), and even selective serotonin reuptake inhibitors (SSRIs) may cause urinary retention (Uher et al. 2009; Garakani 2010).Case ReportA 15-year-old male adolescent patient was referred to our outpatient clinic with the complaints of tics, obsessive compulsive symptoms, and social incompetence. He was in the ninth grade. Both of his parents were high school graduates. He had a 10-year-old brother. He had been diagnosed with Asperger syndrome at the age of 11 at a university child and adolescent psychiatry clinic. He had been referred to the university clinic with the complaints of social incompetence, socially introverted behavior, monotonous and nonprosodic speech style, anxiety, perfectionism, restricted patterns of interest, and obsessive compulsive symptoms. At the psychiatric examination his nonprosodic and monotonous speech pattern was very prominent, and also he had poor and short eye contact. His memorizing was very good but he had difficullties with mathematics. He had socially phobic attitudes and obsessive compulsive symptoms (cleaning, fear of contamination and touching, continously asking the same questions, being doubtful about hurting people, perfectionism, uncertainty). Also he had had coughing (vocal tic) and multiple motor tics for 1 year. He was diagnosed with Asperger syndrome, obsessive compulsive disorder (OCD), and Tourette syndrome. His parents were informed about his psychiatric condition and citalopram 10 mg/day and aripiprazole 2.5 mg/day were initiated. Low doses were instructed to be used, bcause of his possible vulnerability to psychotropic drug side effects, as he had autism spectrum disorder. The citalopram dose was increased to 20 mg/day on the 10th day of the medical treatment. Three weeks later his OCD findings were 50-60% better, according to him and his parents. The citalopram dose was increased to 30 mg/day on the 3rd week. Three weeks later, his OCD findings and social incompetency were much better, but his tics were only slightly better; therefore, his aripiprazole dose was increased to 5 mg/day. With that dose titration, micturition difficuly and urinary retention developed. He had been admitted to the emergency room for these findings, and his urinary examination and laboratory and radiological findings had not identified any abnormality. The patient's mother thought that the increased dosage of aripiprazole might be responsible for this urinary side effect. When she had administered the dosage of 2.5 mg/day of aripiprazole, there had been no symptoms of micturition difficulty. After the dose was decreased to 2. …

Organic Treatment of the Elderly

Abstract: Although clinical gerontology is a relatively new area of specialization, psychologists who practice in this field are committed to treatment goals which are similar to other areas of clinical psychology. Therapeutic goals, in a very general and ideal sense, are: to minimize the patient’s suffering, to improve behavior, to lessen interpersonal friction, and to assist the patient in taking pleasurable interest in his or her environment. To achieve these goals a combination of methods may be necessary. One method which is often used is psychopharmacology, the treatment of the emotionally disturbed with psychotropic medications. Even though psychologists do not prescribe medications, it is important for them to know what the various medications are, how they are used, what precautions should be taken in giving medications, and how medications affect behavior.