Tag: medication
Power of medications and prescribing scenarios
In this post I will spend some time understanding the power of medications, then extract some fundamental principles from the GMC’s guidance on prescribing (April 2021). I then analyse two real-world scenarios in prescribing that I have experienced and reference each against the GMC’s guidance. The power of medications Medicines are powerful ‘chemicals’. How? A few milligrams – thousandths of a gram – can have powerful effects on the body’s organs. 20 mg of citalopram is 7 ten thousandths ofRead More …
Fundamentals of psychiatric diagnosis
Back in the 1990s, diagnostic criteria existed for sure. We had ICD-9 as our main diagnostic manual. My recollections from around that time was that the criteria were hardly ever referenced. How it worked was, the consultant psychiatrist would declare diagnosis or differential diagnoses without actually stating which criteria were met from available evidence. As a junior trainee, I had no say in the matter. In one adolescent psychiatry service around 1993, the consultant psychiatrist and a consultant psychologist stated,Read More …
Sitting in the lap of Big Pharma
Following a recent BBC documentary on antidepressants(2023), I was set on a path of deeper inquiry about psychotropic medications and the relationship of Big Pharma to psychiatrists as a group. Then my colleague S.D. got me reading: The Empire of Pain: The Secret History of the Sackler Dynasty. I was driven to do some digging about Big Pharma’s ‘offences’ in general and then sieved the list down to psychotropic medications. Note our disclaimers. This information is gathered from the publicRead More …
Polypharmacy
Polypharmacy is the use of multiple medications by a patient, particularly when too many forms of medication are used by a patient, when more medications are prescribed than are clinically warranted, or when all of an individual’s medications are not clinically necessary. While there is no set number of medications that defines polypharmacy, the term is often used when a person uses five or more medications concurrently. However, polypharmacy can be present for someone on three medications, depending on theRead More …
Medication reviews
In the last 3 years I’ve received many requests for medication reviews. Interestingly most of those requests came from nurses; not pharmacists, not social workers and not other doctors. Underlying the requests were generally some concern that patients were not improving. Not a single request was about medication toxicity, or polypharmacy. Nurses tended to hint at the patient requiring higher doses or more medications. That body of experience led me to investigate the concept of medication reviews. The term meansRead More …