scholarly journals Managing patients on atypical antipsychotics in primary care

Prescriber ◽  
2021 ◽  
Vol 32 (11-12) ◽  
pp. 18-23
Author(s):  
Alan Woodall
2010 ◽  
Vol 34 (9) ◽  
pp. 390-395 ◽  
Author(s):  
Rohit Gumber ◽  
Mizrab Abbas ◽  
Manjunath Minajagi

Aims and methodNational clinical guidance states that patients on antipsychotics should have their metabolic profile regularly monitored. The aim of this study was to assess whether we are effectively monitoring metabolic profiles and to improve the detection, communication and intervention of metabolic abnormalities among patients on atypical antipsychotics. We describe a full audit cycle.ResultsThe audit resulted in a 24% increase in the number of patients on atypical antipsychotics being referred to the metabolic clinic. The number of abnormal results communicated to primary care showed a significant improvement of 25% (P <0.001), and ultimately the number of patients who received intervention improved by 17% (P = 0.001).Clinical implicationsAudit feedback has been effective in changing clinical practice. The audit demonstrated the potential value of a metabolic clinic and shared care between primary and secondary practitioners for this group of high-risk patients.


Author(s):  
Deirdre Caffrey ◽  
Gillian L Sowden

Objective Many patients with bipolar disorder are treated exclusively in primary care settings, and the use of atypical antipsychotics as primary treatment for bipolar depression is increasing. Extrapyramidal symptoms (EPS) are common side effects of antipsychotic medications, and clinicians should actively monitor for these symptoms when prescribing antipsychotic medications. Accurate diagnosis of EPS is especially important as the symptoms can be highly distressing, and in some cases, life threatening. Our aim is to familiarize primary care providers and other clinicians prescribing antipsychotic medications with EPS and to aid in its rapid diagnosis and treatment. Method We describe a case of lurasidone induced dystonia with prominent laryngospasm and oculogyric crisis which was missed for many years in the primary care setting, largely due to misdiagnosis of symptoms as being related to anxiety and panic attacks. Results In addition to summarizing this illustrative case, we present the most common forms of EPS and summarize the primary therapies for each type of EPS. Conclusions With increased management of bipolar disorder in the primary care setting and increased use of atypical antipsychotics as the primary therapy for bipolar disorder, it is essential that all practitioners are prepared to actively monitor for EPS, followed by its rapid diagnosis and treatment.


2019 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Sarah Wakefield ◽  
Manish Aligeti ◽  
Vivekananda Rachamallu ◽  
Regina Baronia ◽  
Ram Aynampudi ◽  
...  

2003 ◽  
Vol 05 (01) ◽  
pp. 6-14 ◽  
Author(s):  
Gary S. Kabinoff ◽  
Patrick A. Toalson ◽  
Kristine Masur Healey

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.


ASHA Leader ◽  
2016 ◽  
Vol 21 (6) ◽  
pp. 18-19
Author(s):  
Barbara E. Weinstein

Addiction ◽  
1997 ◽  
Vol 92 (12) ◽  
pp. 1705-1716 ◽  
Author(s):  
Sandra K. Burge ◽  
Nancy Amodei ◽  
Bernice Elkin ◽  
Selina Catala ◽  
Sylvia Rodriguez Andrew ◽  
...  

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