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PSYCHIATRIC MEDICATION MANAGEMENT

Medications are a mainstay of treatment for mental health problems. These include but are not limited to antidepressants, anxiolytics, antipsychotics, and mood stabilizers.

There is no one-size-fits-all approach when it comes to using psychiatric or psychotropic medications in different patients. Mental health professionals know that psychiatric medications’ efficacy varies from patient to patient. Drugs that work for one person may not work for the other or stop working after some time.

That said, if taken as prescribed, psychiatric medicines improve your symptoms, prevent relapses (recurrences) and hospital stays, and improve your quality of life. In mental health care, medication treatment is combined with other forms of treatment, especially psychotherapy.

Challenges During Medication Management of Psychiatric Illnesses

One of the biggest challenges faced during medication management of psychiatric illnesses is compliance or medication adherence.

A staggering 49% of patients with mental health problems do not take their medicines as prescribed by their providers.

Poor compliance with psychiatric medications can have serious repercussions, including but not limited to:

  • Relapse of the illness
  • Poor outcomes and overall quality of life
  • Excess hospitalizations and wastage of limited health care resources
  • Reduced responsiveness to subsequent treatment

Causes of Poor Medication Compliance in Psychiatry 

Numerous variables can play a role in drug non-compliance, such as:

  • The diagnosis of the patient

Though medication compliance is an issue regardless of the type of illness, bipolar disorder and schizophrenia appear to pose the most significant challenges to the prescribing clinician. People with these disorders often deny that they are sick and need treatment. Anosognosia — a fancy term for the lack of insight into the presence of an illness — is the most likely culprit behind poor compliance.

Patients with a major depressive disorder are also at risk of medication non-adherence. The most probable underlying cause is the concern for potential adverse effects or negative experiences with the first trial medication.

  • Unbearable side effects

We understand that it may be hard for a patient to follow a treatment that produces discomfort.

Common adverse effects of psychotropic medications include drowsiness, weight gain, brain fog, reduced libido (sex drive), involuntary movements, and diabetes.

While most side effects subside with continued medication use, it may take a while to overcome this barrier. Consequently, you may not take your medications as prescribed (take less than the prescribed dose) or quit taking them suddenly.

Compliance also may be impacted when a patient is not warned upfront of the potential side effects of a drug.

  • The number and frequency of medications

Psychiatry polypharmacy uses multiple medications to manage a patient’s condition. It is a common challenge faced by community psychiatrists and presents greater risks due to drug interactions or increased risk of side effects. It is no surprise how a complex drug regimen can negatively impact medication compliance. If a medication must be taken more than once daily, the chances of missed doses increase, resulting in suboptimal effects.

How is Medication Non-Compliance Addressed?

Now that we know what triggers medication non-compliance, we can implement patient-specific strategies to address the non-compliance issue.

1. Practicing Shared Decision-Making (SDM) 

SDM is a process whereby clinicians and patients work together to decide. It is highly recommended in mental health care.

To get the most out of psychotropic medications, we help patients make an informed choice by discussing the available options and the potential benefits and risks of treating an illness. At Orange County, patients are encouraged to research the medication options independently and then discuss the pros and cons with our providers.

Patients who are actively involved in managing their care have better outcomes. Being proactive in their care paves the way for higher‐quality decision-making and improved medication adherence, optimizing outcomes. For instance, because of SDM, a patient with a major depressive disorder may be willing to tolerate an antidepressant’s side effects after receiving assurance that the medication will provide relief in the long run.

2. Educating How and When Medications Work

Educating patients about what medications can do to help improve their symptoms can significantly optimize medication compliance.

At Orange County, we also set realistic, meaningful goals about medication treatment. For instance, it’s essential to inform patients receiving a new antidepressant that the medicine will take about 3 to 4 weeks (6 weeks at most) to work.

At the same time, it’s essential to know that medication therapy is not the only treatment for mental health conditions and that medications work best when combined with other therapies. Why? That’s because when patients wrongly assume that medication will improve all their symptoms, they might often stop taking them when this doesn’t happen.

Thus, we recommend individual psychotherapy and support groups to our patients in addition to pharmacological (medication) treatment.

3. Simplifying the Medication Regimen

At Orange County, our group of experts will work with you to simplify a drug regimen if it’s too complex by finding the best available alternatives. Simplifying the regimen boosts the odds of medication compliance.

We also provide options to switch to a different drug or dosage if you cannot tolerate the side effects of a particular class of psychotropic medication. At Orange County, we also educate our patients upfront on what measures they can take in the event of an adverse effect.

4. Figuring out your Concerns about Medication

It stands to reason that patients’ perspectives on medication will impact their willingness to take it. Therefore, we strive to determine any predetermined fears or beliefs about a specific drug.

One way to assess your attitude, experience, and beliefs about psychiatric medications, in particular antipsychotics, is via using the Drug Attitude Inventory-10 (DAI-10). The DAI-10 is a 10-item self-report that serves as a predictor of medication adherence in psychiatric ailments. The total score ranges from −10 to 10. The higher the score, the greater the level of positive mindset toward psychiatric medications.

Seek Help

If you or your loved ones have been battling anxiety, depression, or similar conditions, we’re here for you. Reach out to our experienced psychiatrist in Orange County today. We will help create an optimal treatment plan that will help you attain wellness in the long run.