Rating scores are often used in mental health and neurology to give objective values when assessing symptoms or changes in cognitive function. Additionally, some rating scores are utilized to assess the severity of medication side effects or risks associated with these agents.
The QT interval is defined as the amount of time it takes the ventricles of the heart to repolarize after activation. This number can vary based on an individual’s heart rate and is often corrected to the QTc interval. A prolonged QTc interval is a risk factor for developing torsades de pointes (TdP), a relatively rare and potentially life-threatening polymorphic ventricular tachycardia.
Antiepileptics and/or mood stabilizers are the cornerstones of bipolar disorder management. They each contain a unique set of monitoring parameters, including therapeutic drug monitoring. Patient-specific factors, such as mood state, organ function, and pregnancy status, may help guide clinicians on selecting the appropriate mood stabilizer.
The prevalence of psychiatric disorders has been well documented in individuals with renal disease. Although not robust, data exists to guide medication choices and dosing strategies in patients with renal insufficiency, including those on dialysis.
Management of pain in patients with comorbid substance use disorders can be challenging. Providers may be hesitant to use opioid analgesics in patients with a history of medication misuse or those currently receiving substance use disorder treatment. However, these patients may still experience pain and should have their pain adequately treated.
Electroconvulsive therapy (ECT) is a psychiatric treatment for severe mental illness (emphasis on bipolar disorder, depression, suicidality, and catatonia) that involves passing small electric currents through the brain to induce a brief seizure or convulsion. This is often saved for patients who have not responded or have had insufficient response to medications.
AAPP members have developed tools and toolkits for the benefit of fellow psychiatric pharmacists and to further the knowledge of other pharmacists and health care professionals. You are encouraged to share these to educate others and highlight the value of psychiatric pharmacists. For practice-related resources, explore the Employer Resource Center.
The urine drug screen (UDS) can be an important tool in evaluating patients for appropriateness of chronic pharmacotherapy, identifying sources of delirium and altered mental status, and monitoring for substance use. However, interpretation of results is not always straightforward and requires careful consideration.
American Academy of Neurology (AAN) Aducanumab Use in Symptomatic Alzheimer Disease Evidence In Focus (2023) American Psychiatric Association (APA)
The sponsors of the Pharmacy and Medically Underserved Areas Enhancement Act (S. 2800), Senators Chuck Grassley (R-IA) and Ben Ray Lujan (D-NM), issued an RFI to gain feedback on how pharmacists can meet the pressing challenges of chronic care among seniors particularly in rural and underserved areas.
Neurodevelopmental disorders are impairments of the growth and development of the brain or central nervous system that affect behavior, cognition, or motor skills. These conditions tend to begin in childhood and persist into adulthood or may remain undiagnosed long-term. American Academy of Child and Adolescent Psychiatry
Many patients and providers can be hesitant to utilize medications during pregnancy due to concerns of harm to the fetus. However, medications in pregnancy cannot always be avoided, especially in patients where the benefit outweighs the risks. Exacerbations of mental health conditions can increase risks for both mother and fetus. For each medication and each individual pregnancy, the risks and benefits must be carefully weighed.