Psychiatric Medications Essay: Side Effects, Management & Case Studies

According to the National Institute of Mental Health (2022), psychiatric medications can help treat mental disorders and conditions. They are frequently used together with other therapies like brain stimulation and psychotherapies. Medications can have various effects on various individuals, and it may take many attempts to identify the most efficient medication with the minimum side effects. Patients must collaborate with a healthcare practitioner or mental health specialist to create a plan tailored to their necessities and medical conditions.

Side Effects of Psychiatric Medication and Ways to Manage Them

There are numerous possible side effects of psychiatric medications, some of which are reasonably consistent throughout types of drugs. However, psychiatric medications, on the other hand, are effective, safer, and tolerated by patients. They are more straightforward for physicians to recommend because they have more manageable dosage plans, present less risk of overdose, and cause more manageable side effects (Adept, 2019). Therefore, the most common side effects can be managed by patients with the assistance of a mental health specialist.

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Some psychiatric medications have been associated with substantial weight gain. Clinicians are thus tasked with informing patients about the possibility of weight gain caused by these drugs and ensuring they are not at high risk of developing hypertension, heart disease, diabetes, and other medical conditions (National Institute of Mental Health, 2019). Fortunately, this side effect can be handled and even avoided by following weight control techniques such as eating a healthy diet, exercising frequently, and changing one’s lifestyle (Adept, 2019). Clinicians can also assist in managing this side effect by combining nonpharmacologic and pharmacologic strategies. To avoid severe situations of weight gain, early diagnosis is critical.

Sexual dysfunction is a common side effect of some psychiatric drugs, such as antipsychotics and antidepressants. However, it may not appear until months after a patient’s initial treatment. Therefore,  a physician may inquire about one’s sexual history. This side effect may concern a patient, but it can be managed by reducing the drug doses or changing prescription drugs. One must consult a clinician before changing the dosage.

Antidepressants are intended to function by raising neurotransmitters in the brain, like norepinephrine and serotonin. One of the most frequently prescribed antidepressants, SSRIs, helps people feel less depressed. Still, they can occasionally make people emotionally disengaged. . For example, one might struggle to cry when sad or laugh when happy (Adept, 2019). Reduced drug intake or changing to a distinctive type of medication are two strategies for alleviating emotional flattening. Patients who use antidepressants may need to change to a new class since different types can cause various side effects in different patients.

Adept (2019) states that taking psychiatric drugs may cause sleep disturbances such as sedation and chronic insomnia. Although drugs for depression and anxiety are recognized to have indirect and direct sleep advantages, studies indicate that psychiatric medications have adverse sleep effects, such as insomnia and daytime sleepiness. Sleep medications are available, but strategies like sleep hygiene education, relaxation, and cognitive behavioral therapy, be considered. In any situation, patients should talk to their physician about how to manage the effects of medications on their sleep.

Importance of Including Side Effects in Informed Consent

According to Gallagher Healthcare (2018), informed consent in healthcare is a dialogue between a patient and a health practitioner that allows patients to give their physician permission to operate a treatment. Patients have the right to information about their care and the ability to ask questions before undergoing a medical procedure. If an adult patient is not mentally capable of making choices, medical treatment cannot proceed unless they consent to clinical treatment. This enables patients to make informed decisions and increases compliance. Patients vary in their desire for information, but they should be informed about significant side effects and what to do if they occur.

Informed consent implies that patients are provided with adequate information to make an informed decision about their treatment. This enables a doctor to clarify a treatment option’s potential side effects, dangers, and advantages or tells a patient about other treatment options (Gallagher Healthcare, 2018). It ensures patients are given sufficient time, if necessary, to make their choices and, if necessary, consider an alternative opinion. Informed consent can also imply that patients are informed if intervention is preferred and what may occur if they do not receive treatment.

In addition, by guaranteeing clear understanding, informed consent bonds of trust between the patient and the doctor. Additionally, it lessens the risk for both the doctor and the patient. Patients can make better decisions for themselves, and doctors are less likely to be sued if there is clear communication about the dangers and available options. Informed consent must enable patients to make the best decisions for themselves for it to be efficient (Gallagher Healthcare, 2018). This implies that healthcare experts must give patients sufficient information that would allow them to make a decision and, whenever necessary, enough time, so patients do not feel rushed. When requesting consent from a patient, doctors must consider that discomfort, medication, and some health conditions can impair understanding and judgment.

Case Studies

Pristiq is a serotonin and norepinephrine reuptake inhibitor (SNRI) suitable for treating Major Depressive Disorder (MDD) in adults. Patient 1 may experience mood changes, nausea, headache, excessive sweating, blurred vision, dizziness, fatigue, sleep issues, vomiting, dry mouth, anxiety, decreased appetite, tremor, constipation, and sexual dysfunction as the potential side effects from Pristiq (Brewer, 2021). The medication is appropriate for the patient since the recommended starting and therapeutic dose is 50mg, to be taken once daily, with or without food. However, being 67 years old, the patient’s possible reduced renal clearance of Pristiq should be considered before the prescription. The other medication that could be started for patient 1 is Venlafaxine. Venlafaxine is an FDA-approved selective serotonin and norepinephrine reuptake inhibitor (SNRI) for treating both GAD and MDD (WebMD, 2022). The medication’s side effects include constipation, dizziness, drowsiness, nausea, nervousness, headache, decreased appetite, sexual dysfunction, abdominal pain, anxiety, blurred vision, hypertension, tremor, visual disturbance, vomiting, diarrhoea, weight loss, and sleep issues.

For patient 2, the patient could experience decreased appetite, anxiety, dry mouth, insomnia, nausea, diarrhoea, headache, racing heart, dizziness, mood changes, and stomach ache as Adderall XR’s potential side effects. However, the prescription is inappropriate for the patient since the recommended starting dose for a 9-year-old is 10mg to be taken once daily (Ulrich, 2021). Adderall XR should also be taken in the morning, not at noon, since taking the medication later in the day may result in sleep disturbances. The other medication that could be started is Strattera (Entringer, 2022). Its side effects include constipation, decreased appetite, insomnia, dermatitis, sexual dysfunction, dizziness, and urinary hesitancy.

For patient 3, Abilify Maintena’s potential side effects include fainting, restlessness, seizures, trouble swallowing, fever, tenderness, persistent sore throat, muscle stiffness,  increased thirst, high blood sugar, uncontrolled movements, increased urination, severe tiredness, sweating, severe confusion, irregular heartbeat, change in the amount of urine, rash, dark urine, itching, swelling of the face, tongue or throat, severe dizziness, and trouble breathing (RxList, 2020). The prescription is appropriate since both starting and maintenance doses are 400mg monthly. However, the medication should not be started since the patient had the last injection a week earlier, yet the next one should be administered after 26 days. The alternative medication would be Lithobid (Multum, 2022). The medication’s potential side effects include tremors, dizziness, trouble walking, drowsiness, dry mouth, nausea, loss of appetite, increased thirst or urination, vomiting, rash, and blurred vision.

In the case of Patient 4, paroxetine may have potential side effects such as nausea, sleep issues, weakness, dizziness, anxiousness, sexual dysfunction, sweating, shaking, decreased appetite, dry mouth, constipation, infection, and yawning (Drugs.com, 2021). However, the starting dose should be 20mg to be taken orally, once daily, in the morning. As for quetiapine, the potential side effects include sleep issues, headache, nausea, irritability, and diarrhoea. The dosage is appropriate as it should be taken once daily during bedtime. The two medications can also be taken together. An alternative medication could be Prazosin (IBM Micromedex, 2022). The medication’s side effects include dizziness, fast, irregular, increased pulse, and sleepiness.

Lastly, patient 5 may experience issues with coordination, blurred vision, sexual dysfunction, frequent urination, painful joints or muscles, increased saliva production, respiratory issues, and unsteadiness as clonazepam’s potential side effects (Cieri-Hutcherson, 2022). The medication is appropriate since the recommended starting dose is 0.5mg, which can be taken orally once to thrice daily. The alternative medication, in this case, is Brisdelle 7.5mg hs (Cieri-Hutcherson, 2022). However, its side effects may include headache, fatigue, nausea and vomiting.

References

Adept. (2019, July 23). Ways to manage the side effects of psychotropic medications. Meridian Psychiatric Partners, LLC. Retrieved November 23, 2022, from https://meridianpsychiatricpartners.com/ways-to-manage-the-side-effects-of-psychotropic-medications/#:~:text=This%20side%20effect%2C%20fortunately%2C%20can,of%20pharmacologic%20and%20nonpharmacologic%20interventions.

Brewer, A. P. (2021, September 19). Pristiq side effects: What you should know. https://www.medicalnewstoday.com/articles/drugs-pristiq-side-effects

Cieri-Hutcherson, N. (2022, June 28). Can You Take Antidepressants for Menopause Symptoms? How SSRIs May Reduce Hot Flashes. GoodRx Health. https://www.goodrx.com/conditions/menopause/antidepressants-for-menopause

Drugs.com. (2021). Drug Interactions between paroxetine and Seroquel. https://www.drugs.com/drug-interactions/paroxetine-with-seroquel-1800-0-1979-1274.html

Entringer, S. (2022, May 24). Strattera. Drugs.com. https://www.drugs.com/strattera.html

Gallagher Healthcare. ((2018, November 10). The Importance of Patient Informed Consent. Gallagher Healthcare. Retrieved November 23, 2022, from https://www.gallaghermalpractice.com/blog/post/the-importance-of-patient-informed-consent/

IBM Micromedex. (2022, November 3). Prazosin (Oral Route). Mayo Clinic. https://www.mayoclinic.org/drugs-supplements/prazosin-oral-route/side-effects/drg-20065617

Multum, C. (2022, February 8). Lithobid. Drugs.com. https://www.drugs.com/mtm/lithobid.html

National Institute of Mental Health. (2022, June). Mental health medications. National Institute of Mental Health. Retrieved November 23, 2022, from https://www.nimh.nih.gov/health/topics/mental-health-medications

RxList. (2020, September 15). Abilify Maintena. https://www.rxlist.com/abilify-maintena-drug.htm

Schumacher, C. (2021, December 27). Clonazepam for Anxiety and Depression: Side Effects. Vista Pines Health. https://vistapineshealth.com/services/anxiety-disorder/clonazepam/

Ulrich, A. (2021, September 8). Adderall Dosage: Common Adderall dosages for Adderall and Adderall XR. GoodRx Health. http://blocked.goodrx.com/conditions/adhd/whats-the-difference-between-adderall-and-adderall-xr

WebMD. (2022). Venlafaxine Oral: Uses, Side Effects, Interactions, Pictures, Warnings & Dosing – WebMD. https://www.webmd.com/drugs/2/drug-4870-5047/venlafaxine-oral/venlafaxine-oral/details