Article: Multiple Medication In Psychiatry (10/1/05)

in
Multiple Medication Use in General Practice and Psychiatry: So What? By Ahsan Y. Khan, M.D., and Sheldon H. Preskorn, M.D., Psychiatric Times URL: http://www.psychiatrictimes.com/article/showArticle.jhtml;jsessionid=VD4W1KUS31SRQQSNDLOSKHSCJUNN2JVN?articleId=172901304
Psychiatric Times October 2005 Vol. XXII Issue 12
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Conclusion. (click on the link above to read the full article)
Patients with psychiatric illnesses may be at higher risk for the development of certain medical problems because of the physiologic derangements of their psychiatric conditions, or as a result of the somatic treatment used to help them, hence at risk for drug-drug reactions from taking several medications concurrently. Psychopharmacological treatment of psychiatric disorders can be successfully and safely accomplished in the medically ill taking multiple medications when the psychiatrist is cognizant of potential difficulties stemming from both their different medical illnesses and the medications the patient is taking for the treatments of those illnesses by following the principles outlined in (Table 3). Each patient should be assessed for potential disease-related pharmacokinetic and pharmacodynamic changes altering drug distribution, metabolism and clearance, as well as possible drug interactions and vulnerability to the side effects.
As the use of multiple drugs increases and drug expenditures rise, trade-offs between the cost and benefits of medications are becoming major clinical and policy issues. As a result of all of these variables, there is a growing and urgent need for further research to evaluate the potential risks associated with polypharmacy, such as developing drug classifications or groupings based on pharmacodynamic and pharmacokinetic characteristics. Research can identify the most prevalent drug regimens and evaluate their potential to interact. There is a clear need to implement online drug screening or computerized drug alert systems. Expert consensus guidelines regarding specific combinations can be developed.