Unit 3-1: Principles of Prescribing for Mental Health Disorders

Question 1

The decision to treat with medications is based on several parameters, including:

Answer 1

1. Familiarity with the client
2. Historical mental health patterns: previous episodes, previous treatments, and medications
3. Family history
4. Level of distress
5. Level of dysfunction
6. Comorbidities
7. Risk of treatment versus risk of not treating with medications
8. Illness trajectory
9. Client’s beliefs, concerns, and thoughts about pharmacological treatment

Question 2

What is the impact of marketing psychotropic medications on mental health perceptions?

Answer 2

It promotes oversimplified views, framing medications as quick fixes for complex issues, prioritizing profit over patient care.

Question 3

How does the dominance of single-culture perspectives affect mental health diagnosis and treatment?

Answer 3

It leads to a one-size-fits-all approach, overlooking cultural variations in mental health experiences, which can result in misdiagnosis.

Question 4

What percentage of individuals with one depressive episode will experience another?

Answer 4

60%

Question 5

What does a history of recurrent depressive episodes suggest about future treatment?

Answer 5

Previously successful therapies may be re-initiated, and medication is likely to be helpful if it was effective before.

Question 6

Why might some individuals require long-term medication for mental health conditions?

Answer 6

Recurrence may indicate chronicity, especially for conditions like Bipolar Disorder and Schizophrenia.

Question 7

How does family history influence the risk of developing mental health issues?

Answer 7

A strong family history increases risk, prompting earlier consideration for medication.

Question 8

Q: Is a high level of distress always an indication for medication?

Answer 8

A: No, acute distress may fade over time, while low-level distress (like dysthymia) can significantly impact functioning.

Question 9

What two parameters are typically considered in mental health diagnoses?

Answer 9

Diagnostic patterns indicating abnormality and the degree of dysfunction in everyday life.

Question 10

Why is it important to consider comorbidities when prescribing psychotropic medications?

Answer 10

Chronic physical diseases can have mental health implications, and vice versa; holistic assessment is crucial.

Question 11

What factors should be assessed when weighing the risks of medication treatment?

Answer 11

Patient’s ability to engage in counseling, risk of misuse, likelihood of improvement without medication, and illness trajectory.

Question 12

What might influence a patient’s beliefs about pharmacological treatment?

Answer 12

Misconceptions about addiction, side effects, personality changes, and stigma associated with mental health.

Question 13

What common myths about mental health medications should be addressed?

Answer 13

Concerns about lifelong dependency, personality changes, addiction, and negative perceptions related to treatment.

Question 14

What is the therapeutic objective of prescribing treatment?

Answer 14

Generally, for mental illnesses we want to improve function and minimize bothersome or distressing symptoms in regards to behaviour, thoughts, or somatizations.

Question 15

What is the best drug to achieve the therapeutic objective?

Answer 15

We choose drugs to target the primary symptom(s), be they hallucinations, headaches, insomnia, agitation, low mood, or ruminations. Most drugs have similar effects shared by other drugs in the same class but certain drugs within a class can have strengths in regards to targeting specific symptoms. We also want to choose a drug that is safe (does no harm) and that will be well tolerated.

Question 16

What is the best drug for each client? How do you decide?

Answer 16

Based on the individual’s situation, history, genetics, comorbidities, and all the other criteria we have explored thus far, we will be able to refine our choice to something safe, effective, and with a risk profile appropriate to this unique patient.

Question 17

What determines treatment for mental health conditions?

Answer 17

Treatment is determined by the diagnosis, which helps choose a class of medication.

Question 18

What class of drug might be chosen for a woman diagnosed with generalized anxiety disorder and mild-moderate depression?

Answer 18

An anxiolytic with antidepressant properties.

Question 19

How is the choice within a medication class determined?

Answer 19

It is based on the individual’s situation and prominent symptoms.

Question 20

What symptom might lead to a refined choice of medication class for a patient with anxiety and depression?

Answer 20

Rumination, which is common in depression and can reinforce anxiety.

Question 21

Why might an SSRI be chosen for a patient with both anxiety and depression?

Answer 21

SSRIs can relieve both anxiety and depression symptoms.

Question 22

Which specific SSRI might be chosen for a client who ruminates?

Answer 22

Fluvoxamine (Luvox), as it can effectively decrease rumination.

Question 23

What are the four main classes of psychotropic medications?

Answer 23

1. Anti-anxiety
2. Antidepressants
3. Mood stabilizers
4. Anti-psychotics

Question 24

what is rumination?

Answer 24

the process of continuously thinking about the same thoughts, often those that are distressing or negative. It involves repeatedly reflecting on problems, past events, or feelings rather than moving forward or finding solutions. In the context of mental health, rumination is commonly associated with conditions like depression and anxiety, where individuals may dwell on their worries or perceived failures, which can exacerbate their emotional distress and interfere with their ability to cope effectively