FINALS 2 - PSYCHOPHARMACOLOGY

Psychopharmacology

is a field, which analyses the impact of different drugs on the mental health of patients

Psychopharmacology

it considers how different compounds alter people’s behavior by changing the way that the person thinks or feels

Psychopharmacology

Some of the conditions that these medicines are used to treat include depression, psychosis, and anxiety

Psychopharmacologist

an expert on which drug might have the best impact on a patient with a particular mental health condition

Psychopharmacologist

they understand how the medicine works and what the expected clinical outcomes are

CNS

Psychopharmacologist also likely to have a grasp of neuroscience as the medicines used have impacts on the functioning of the _____

1970s

Psychiatry has experienced a rapid metamorphosis since the _____ in its methods of treatments

• biological stance

• psychiatrists

The move from a largely psychoanalytic orientation toward a more _____ ____ radically changes

• Not only its basic approaches to patients but also the professional identities of ______

1980s & 1990s

When the most transformation were not easy for most older psychiatrists

1980s and 1990s

At first, keeping up with ever-expanding information on biological theories, new laboratory tests, computerization, new medications and new additional uses for old medications was in itself a full-time occupation

• one that often allowed little time or energy for integrating current information into daily practice

biological and psychopharmacological information

Moreover, the proliferation of _____________________ occurred so rapidly that the task of integrating biological and psychotherapeutic approaches became ever more difficult

two or more decades

However, the transition has now passed, and over the past ___________ a cadre of psychiatrists, well versed in psychopharmacology, has been trained

Biological & Psychopharmacological Approaches

for many academics and practitioners, this have become the essence of psychiatry

Biological & Psychopharmacological Approaches

whereas for many years other insisted that these drugs merely masked underlying diseases, worked against resolution, interfered with therapy, and so forth

psychotherapy and psychopharmacology

During the transition, most practitioners developed more balanced, practical approaches, combing elements of both _________ & ________

• academic psychiatry

• practical blending

In an odd way, ________, with its sometimes hypertrophied and polarized approaches, lagged behind

• Clinical practice where a _________ is needed

do not change the underlying disease process (they do not fix the root cause of the illness)

One reason for needing a blended approach is that although psychotropic drugs exert profound and beneficial effects on cognition, mood, and behavior, they WHAT?

• reducing symptoms

• promoting the capacity of the individual to adapt to the exigencies of his or her life

As a rule, beneficial outcomes can be achieved only by simultaneously ________ & ______

Psychopharmacological Approaches

For practitioners who did not have extensive experience, the transition for a more pharmacological practice (prescribing drugs) was not without difficulties.

• A favorable clinical outcome after prescribing a psychotropic drug does reinforce confidence in _______________

Practice Guidelines

Since the early 1990s, ____________ have been developed by professional societies as well as academic leaders.

• can be helpful, since they are generally based on evidence in the literature.

out of date

Unfortunately, there are limitations imposed by overreliance on these guidelines:

• First, guidelines may quickly become _______ with the reporting of evidence or new indications or new treatments

patients with more atypical or comorbid conditions

Second, available evidence in the published literature may be for agents that are not the most effective for treating ___________________

lack of response to the initial therapy

Third, evidence often breaks down when the practitioner encounters a ____________________ leaving him or her to fall back once again on clinical experience or judgment

recommendations

Fourth, ________ can often be based on the consensus opinions of experts

• These opinions are helpful but are not necessarily accurate

• non specialist practitioners

• experienced treaters

Last, guidelines may be most helpful for _______ and less helpful for more ________ of patients with refractory conditions

Refractory conditions

are diseases or disorders that don’t respond well to typical treatments or standard interventions.

• These are often rare, complex, or involve a high level of individual variability

Informed Consent

has become an increasingly important issue in medicine

informing patients of the benefits versus the risks

Standard medical practice has long called for __________ versus the ____ of various surgical and medical procedures

• patient’s capacity either to understand fully the benefits and risks of the medication prescribed

• OR to interpret the provided information in a reflective and beneficial way

For one, psychiatrists must wrestle with the problem of evaluating: (2)

Psychotic patients

patients that has pressing issues within formed consent because legal guardianship may be required at times to effect adequate informed consent.

Psychotic patients

these patients represent a minority of the average practitioner’s patient population

Paranoid but competent patients

present practical problems that are best overcome by creating a solid working relationship

Paranoid but competent patients

such patients are less commonly encountered than highly anxious, obsessive, or agitated patients

Phobic approach to medication

what highly anxious, obsessive, or agitated patients are prone to

insurmountable obstacle

The practitioner at first glance may view informed consent in such cases as an ___________________

respecting the severity of the patient’s illness

the Practitioner’s role is not just about providing information but also recognizing and _________________

• autonomy

• recognizing that the patient’s condition is so severe that it may cloud their ability to consent freely

While the patient may not fully appreciate the risks and benefits of treatment, it’s essential for the practitioner to respect the patient's ______ while ______________

Some courts say a doctor could get in trouble if they don’t tell the patient about every side effect. But in real life, most doctors don’t do this because it takes too much time and might scare the patient too much.

(MEMORIZE)

Should the physician inform the patient of every side effects listed in the PDR or merely highlight the most common ones?

Open dialogue

this is what physicians need to do with all patients regarding the benefits and side effects of medication, even patients who are self-taught