1. Use of Medication

2. Test review Stages of change Substance-related disorders: –know the difference between use and induced disorders –be able to describe abuse and dependence Medications: –Important terms –Stepwise treatment –Your role re: meds –Reasons why clients discontinue meds

3. Important terms Pharmacotherapy-treatment with medication Psychotropics-drugs that affect mental functioning Neuroleptics-antipsychotic meds Psychoactive-drugs with acute effects on mood, thought, behavior

4. General issues For some disorders, medication is a core part of treatment. Meds treat the symptoms, they don’t cure the disorder. Psychotropics don’t typically cause physiological dependence. Meds are approved for specific disorders. They are often used “off-label.” Stepwise treatment is preferred.

5. Stepwise Treatment 1.Nonpharmacological approaches first 2.Medications with low abuse potential 3.Varied treatment approaches are complementary, not competitive…this and that, as opposed to this or that.

6. Your role Document clearly and consicely Describe sx, side effects, difficulties cx is experiencing. Give information, not recommendations Talk with cx about their meds –Educate –Ask about how it is helpful –Consistency –Reasons why they missed meds

7. Why do clients dc medication? 1.Side effects are unpleasant 2.Sx diminish or go away 3.Sx are familiar and possible pleasant 4.Life is too disorganized to keep track 5.Preference for nonprescribed drugs 6.Limited or no improvement 7.Rebellion, aka autonomous

8. Antidepressants Tricyclics Monoamine Oxidase Inhibitors (MAOIs) SSRIs or SRIs SNRIs-effexor, cymbalta

9. Special considerations- antidepressants Gradual increase in blood level=gradual reduction of sx. Sometimes a reduction of side effects. Discontinuation syndrome with 6 weeks or more use & abrupt discontinuation. Serotonin syndrome-restless, extreme nervousness, tremor, confusion

10. Antimanics Lithium Anticonvulsants-tegretol, depakote, etc. Special considerations Blood tests are required to monitor lithium level Therapeutic dose is close to toxic dose

11. Antipsychotics Traditional Atypical or novel Special considerations Gradual increase in effect Medication for side effects Tardive dyskinesia Blood tests required for some

12. Anxiolytics Benzodiazepines “Other”-buspirone SSRIs-luvox (ocd), paxel (gad), zoloft (ptsd) Special considerations Benzos are addictive Benzos can be taken “prn” and have immediate effect. “Other” includes buspirone, which builds up in system over time.

13. Stimulants Ritalin Adderall Special considerations Stimulants may be abused Non stimulants (SNRIs) are sometimes used for ADHD

14. Too many meds?