Prescribing and Overprescribing

2017 ◽  
Author(s):  
Joel Paris
Keyword(s):  
Side Effects ◽  
Mental Disorders ◽  
Atypical Antipsychotics ◽  
Common Mental Disorders ◽  
Medical Science ◽  
Drug Combinations ◽  
Pharmacological Treatments ◽  
Treatment Resistant ◽  
Severe Mental Disorders ◽  
Prescription Rates

The development of effective pharmacological treatments for severe mental disorders between the 1950s and 1970s was one of the great triumphs of medical science. However, progress since then has been slow. Most drugs in current use are variants of those previously on the market, albeit with less worrisome side effects. Yet prescription rates have skyrocketed. Moreover, atypical antipsychotics, despite their side effects and warnings from watchdog organizations, are currently being widely used for sedation. Psychiatrists are prescribing these drugs for many, if not most, of their patients. All have a proper use—one cannot treat psychosis without antipsychotics. However, the situation in common mental disorders is different. Although antidepressants are essential in melancholic depressions, they are much less effective in mild to moderate cases. Moreover, protocols that advise drug combinations for “treatment-resistant” cases are not well based in evidence.

Receptor mechanisms of antipsychotic drug atypicality

1998 ◽  
Vol 13 (S1) ◽  
pp. 5s-8s
Author(s):  
GP Reynolds
Keyword(s):  
Side Effects ◽  
Animal Models ◽  
Negative Symptoms ◽  
Atypical Antipsychotics ◽  
Mechanisms Of Action ◽  
Antipsychotic Treatment ◽  
Extrapyramidal Side Effects ◽  
Treatment Resistant ◽  
Pharmacological Profile ◽  
New Compounds

SummaryRecent advances in antipsychotic treatment of schizophrenia have offered several new compounds which avoid many of the limitations of the classical antipsychotics. These so-called ‘atypical’ antipsychotics have fewer extrapyramidal side effects, greater efficacy against negative symptoms and greater efficacy in otherwise treatment-resistant patients. However, the mechanism of action of these atypical antipsychotics is still unclear. The several receptors currently implicated in the pharmacological profile of these atypical antipsychotics include subtypes of those for dopamine, serotonin, noradrenaline, and acetylcholine among others. The current hypotheses for possible mechanisms of action of atypical antipsychotics are discussed along with the experimental correlates of antipsychotic efficacy in animal models.

scholarly journals Barriers to using clozapine in treatment-resistant schizophrenia: systematic review

2018 ◽  
Vol 43 (1) ◽  
pp. 8-16 ◽  
Author(s):  
Saeed Farooq ◽  
Abid Choudry ◽  
Dan Cohen ◽  
Farooq Naeem ◽  
Muhammad Ayub
Keyword(s):  
Side Effects ◽  
Review Of The Literature ◽  
Prescribing Practices ◽  
Treatment Resistant ◽  
Search Terms ◽  
Inadequate Knowledge ◽  
Mandatory Requirement ◽  
Significant Barrier ◽  
Prescription Rates ◽  
Training Programmes

Aims and methodTo systematically review the literature on barriers to the use of clozapine and identify any interventions for optimizing clozapine use in treatment-resistant schizophrenia. Journal databases were searched from 1972 to March 2018. The following search terms were used: treatment-resistant schizophrenia, clozapine, barriers, use, prescription rates, implementation, clozaril and prescribing practices. Following a review of the literature, 15 papers were included in the review.ResultsThe major barriers that were identified included mandatory blood testing, fear of serious side-effects and lack of adherence by the patients, difficulty in identifying suitable patients, service fragmentation, and inadequate training in or exposure to using clozapine.Clinical implicationsIn view of consistent evidence across the studies on inadequate knowledge and skills as a significant barrier, we suggest that a certification requiring competence in initiating and managing side-effects of clozapine becomes a mandatory requirement in training programmes.Declarations of interestNone.

scholarly journals Maternal mental health and nutritional status of six-month-old infants

2016 ◽  
Vol 50 (0) ◽  
Author(s):  
Bruna Kulik Hassan ◽  
Guilherme Loureiro Werneck ◽  
Maria Helena Hasselmann
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Nutritional Status ◽  
Common Mental Disorders ◽  
Maternal Mental Health ◽  
World Health ◽  
Southeastern Brazil ◽  
Severe Mental Disorders ◽  
Z Scores ◽  
Weight For Age

ABSTRACT OBJECTIVE To analyze if maternal mental health is associated with infant nutritional status at six month of age. METHODS A cross-sectional study with 228 six-month-old infants who used primary health care units of the city of Rio de Janeiro, Southeastern Brazil. Mean weight-for-length and mean weight-for-age were expressed in z-scores considering the 2006 World Health Organization reference curves. Maternal mental health was measured by the 12-item General Health Questionnaire. The following cutoff points were used: ≥ 3 for common mental disorders, ≥ 5 for more severe mental disorders, and ≥ 9 for depression. The statistical analysis employed adjusted linear regression models. RESULTS The prevalence of common mental disorders, more severe mental disorders and depression was 39.9%, 23.7%, and 8.3%, respectively. Children of women with more severe mental disorders had, on average, a weight-for-length 0.37 z-scores lower than children of women without this health harm (p = 0.026). We also observed that the weight-for-length indicator of children of depressed mothers was, on average, 0.67 z-scores lower than that of children of nondepressed women (p = 0.010). Maternal depression was associated with lower mean values of weight-for-age z-scores (p = 0.041). CONCLUSIONS Maternal mental health is positively related to the inadequacy of the nutritional status of infants at six months.

scholarly journals Anxiety Disorders: Recent Global Approach to Neuro-pathogenesis, Drug Treatment, Cognitive Behavioral Therapy, and Their Implications

2021 ◽  
Vol 20 (3) ◽  
pp. 487-503
Author(s):  
Abdullahi Rabiu Abubakar ◽  
Ibrahim Haruna Sani ◽  
Sani Malami ◽  
Abudllahi Hamza Yaro ◽  
Iffat Jahan ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Anxiety Disorders ◽  
Common Mental Disorders ◽  
Behavioral Therapy ◽  
Muscle Tension ◽  
Medical Science ◽  
Stressful Situation ◽  
Blurred Vision ◽  
Annual Prevalence ◽  
Intense Fear

Anxiety is a group of mental disorders characterized by the sudden feeling of intense fear, panic, shortness of breath, chest pain, restlessness, GIT problems, insomnia, fatigue, muscle tension, sweating, loss of memory, blurred vision, and impaired learning. It occurs typically in response to a stressful situation that may become pathological when it is no longer controlled or occurs in the absence of real threat. This review aimed to appraise the literature on the prevalence, classification, neuro-pathogenesis, diagnoses, and treatment of anxiety disorders (AD). The search was made using PubMed, Embase, MEDLINE, and PsycINFO databases. Anxiety disorders are the most common mental disorders affecting humans, especially among developing nations. In general, the lifetime prevalence of AD is about 14%, with an annual prevalence of 31%. Unfortunately, AD, in general, is underdiagnosed and undertreated globally. Bangladesh Journal of Medical Science Vol.20(3) 2021 p.487-503

Transcriptional biomarkers of response to pharmacological treatments in severe mental disorders: A systematic review

2022 ◽  
Vol 55 ◽  
pp. 112-157
Author(s):  
Claudia Pisanu ◽  
Giovanni Severino ◽  
Ilario De Toma ◽  
Mara Dierssen ◽  
Paolo Fusar-Poli ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Disorders ◽  
Pharmacological Treatments ◽  
Severe Mental Disorders ◽  
Transcriptional Biomarkers

scholarly journals Common mental disorders in nursing students of the professionalizing cycle

2020 ◽  
Vol 73 (1) ◽  
Author(s):  
Elias Barbosa de Oliveira ◽  
Regina Célia Gollner Zeitoune ◽  
Cristiane Helena Gallasch ◽  
Eugenio Fuentez Pérez Júnior ◽  
Alexandre Vicente da Silva ◽  
...  
Keyword(s):  
Nursing Students ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Cross Sectional Study ◽  
Public University ◽  
Self Report ◽  
Severe Mental Disorders ◽  
Cross Sectional ◽  
High Prevalence ◽  
Alcohol And Other Drugs

ABSTRACT Objectives: to verify the suspicion of common mental disorders in nursing students of the professionalizing cycle and the association with sociodemographic features. Method: cross-sectional study with a sample of 85 students from a public university in the state of Rio de Janeiro (RJ) who responded to the Self-Report Questionnaire-20 and sociodemographic questions. Results: the suspicion prevalence of common mental disorders (CMD) in the sample was 55.3% and it was identified the association with the consumption of alcohol. Of the most frequent SRQ-20 complaints, 95.3% reported “feeling nervous, tense or worried”, 72.9% “having difficulty making decisions”, 60% “sleeping poorly” and 37.6% “having lost interest by things “. Conclusion: high prevalence of CMD in the sample and the association with the consumption of alcohol requires preventive and therapeutic actions among the students that minimize the possibility of severe mental disorders related to the consumption of alcohol and other drugs.

The WHO World Mental Health (WMH) Surveys

2009 ◽  
Vol 06 (01) ◽  
pp. 5-9 ◽  
Author(s):  
S. Aguilar-Gaxiola ◽  
J. Alonso ◽  
S. Chatterji ◽  
S. Lee ◽  
T. B. Üstün ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Treatment Effectiveness ◽  
Age Of Onset ◽  
Common Mental Disorders ◽  
Mental Health Policy ◽  
Unmet Need ◽  
Cost Effective ◽  
World Mental Health ◽  
Prevalence Estimates

SummaryThe paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, burden, and unmet need for treatment of common mental disorders. Results show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Adult mental disorders are found in the WMH data to be associated with high levels of role impairment. Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective from both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several such interventions.

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