Click here to download

Mental health strategies for dealing with psychiatric medications? Research and practices
Journal Title: RIVISTA SPERIMENTALE DI FRENIATRIA 
Author/s:  Barbara D'Avanzo, Alberto Parabiaghi 
Year:  2016 Issue: Language: Italian 
Pages:  14 Pg. 9-22 FullText PDF:  224 KB
DOI:  10.3280/RSF2016-002002
(DOI is like a bar code for intellectual property: to have more infomation:  clicca qui   and here 


The authors examine different approaches in studying the effects of psychiatric drugs on patients and the use of medications by mental health services. Nowadays, in Italy, the current and diffuse administration of psychiatric drugs goes now together, in the field of research, with rising doubts about the effectiveness of psychiatric medications, and about the relationship between drugs’ mechanisms of action and psychiatric disorder’s etiologic mechanisms. The option of less medication and of a more personalized use of psychiatric drugs is now a topic of research, that meets the need for a more cognisant use of drugs by psychiatrist and patient. Psychosocial interventions for improving self-management and drug non-adherence are seldom offered by mental health services. Users thus self organise themselves to improve medication non-adherence. Despite growing empirical evidence on the doubts about the effects of psychiatric drugs, medications remain critical for treating severe mental illnesses, for a number of reasons, including drug effectiveness on major aspects of psychiatric disorders. Academic teaching focuses on the competence in associating drugs with symptoms, and might not include the expertise in designing complex and integrated treatment plans, an essential competence mental health professionals should acquire. The authors finally suggest that researchers and mental health professionals should take account of psychiatric users’ requests and also of the doubts about traditional psychiatric tools.
Keywords: Research, use of psychiatric drugs, mental health services

  1. [1] Barbato A. È al tramonto l’età d’oro degli psicofarmaci: verso un uso critico al di là del trionfalismo. Rivista Sperimentale di Freniatria 2015; CXXXIX: 100-12.
  2. [2] Osservatorio Nazionale sull’impiego dei Medicinali. L’uso dei farmaci in Italia. Rapporto Nazionale Gennaio-Settembre 2014. Roma: Agenzia Italiana del Farmaco; 2015.
  3. [3] Parabiaghi A, Franchi C, Tettamanti M, Barbato A, D’Avanzo B, Fortino I, et al. Antidepressants utilization among elderly in Lombardy from 2000 to 2007: dispensing trends and appropriateness. European Journal of Clinical of Pharmacology 2011; 67:1077-83.
  4. [4] Moncrieff J Antipsychotic Maintenance Treatment: Time to Rethink? Plos Medicine 2015; 12: e1001861.
  5. [5] Moncrieff J, Cohen D, Porter S. The psychoactive effects of psychiatric medication: the elephant in the room. Journal of Psychoactive Drugs 2013; 45:409-15.
  6. [6] Kirsch I. Antidepressants and placebo effect. Zeitschrift für Psychologie 2014; 222: 128-134.
  7. [7] Turner EH, Matthews AM, Linardatos E, Tell RA, Rosenthal R. Selective publication of antidepressant trials and its influence on apparent efficacy. New England Journal of Medicine 2008; 358: 252-260.
  8. [8] Whittington CJ, Kendall T, Fonagy P, Cottrell D, Cotgrove A, Boddington E. Selective serotonin reuptake inhibitors in childhood depression: systematic review of published versus unpublished data. Lancet 2004; 363: 1341.
  9. [9] Fournier JC, DeRubeis RJ, Hollon SD, Dimidjian S, Amsterdam JD, Shelton RC, et al. Antidepressant drug effects and depression severity: a patient-level meta-analysis. JAMA 2010; 303: 47-53.
  10. [10] Doshi P, Dickersin K, Healey D, Vedula SS. Restoring invisible and abandoned trials: a call for people to publish the findings. British Medical Journal 2013; 346: f2865.
  11. [11] Wunderink L, Nieboer RM, Wiersma D, Sytema S, Nienhuis FJ. Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: Long-term follow-up of a 2-year randomized clinical trial. JAMA Psychiatry 2013, 70:913-920. [12] Alvarez-Jimenez M, O’Donoghue B, Thompson A, Gleeson JF, Bendall S, Gonzalez-Blanch C, et al. Beyond Clinical Remission in First Episode Psychosis: Thoughts on Antipsychotic Maintenance vs. Guided Discontinuation in the Functional Recovery Era. CNS drugs 2016; 1-12.
  12. [13] Coldham EL, Addington J, Addington D. Medication adherence of individuals with a first episode of psychosis. Acta Psychiatrica Scandinavica 2002; 106: 286-90.
  13. [14] Thompson A, Singh S, Birchwood M. Views of early psychosis clinicians on discontinuation of antipsychotic medication following symptom remission in first episode psychosis. Early Intervention in Psychiatry 2015, epub, 10.1111/eip.12244DOI: 10.1111/eip.12244
  14. [15] Álvarez-Jiménez M, Hetrick SE, González-Blanch C, Gleeson JF, McGorry PD. Non-pharmacological management of antipsychotic-induced weight gain: systematic review and meta-analysis of randomised controlled trials. British Journal of Psychiatry 2008; 193: 101–7.
  15. [16] Saha S, Chant D, McGrath J. A systematic review of mortality in schizophrenia: is the differential mortality gap worsening over time? Archives of General Psychiatry 2007; 64: 1123-31.
  16. [17] Lakka HM, Laaksonen DE, Lakka TA, Niskanen LK, Kumpusalo E, Tuomilehto J, Salonen JT. The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA 2002; 288: 2709-16.
  17. [18] Curtis J, Henry C, Watkins A, Newall H, Samaras K, Ward PB. Metabolic abnormalities in an early psychosis service: a retrospective, naturalistic crosssectional study. Early Intervention in Psychiatry 2011; 5: 108-14.
  18. [19] Kreyenbuhl J, Buchanan RW, Dickerson FB, Dixon LB, Schizophrenia Patient Outcomes Research Team (PORT). The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2009. Schizophrenia Bulletin 2010; 36: 94-103.
  19. [20] Lieberman JA, Stroup TS, McEvoy JP, et al. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. New England Journal of Medicine 2005; 353: 1209-23.
  20. [21] Jones PB, Barnes TR, Davies L, et al. Randomized controlled trial of the effect on quality of life of second- vs first-generation antipsychotic drugs in schizophrenia: CostUtility of the Latest Antipsychotic Drugs in Schizophrenia Study (CUtLASS 1). Archives of General Psychiatry 2006; 63: 1079–1087.
  21. [22] Parabiaghi A, Tettamanti M, D’Avanzo B, Barbato A, GISAS Study Group. Metabolic syndrome and drug discontinuation in schizophrenia: a randomized trial comparing aripiprazole olanzapine and haloperidol. Acta Psychiatrica Scandinavica 2016; 133: 63-75.
  22. [23] Cheng F, Jones PB. Drug treatments for schizophrenia: pragmatism in trial design shows lack of progress in drug design. Epidemiology and Psychiatric Sciences 2013; 22: 223-33.
  23. [24] Ghio L, Natta W, Barbato A, Marcenaro M, Gotelli S, Jones PB, Parabiaghi A. Schizophrenia trial participation: perceived inclusion barriers and beliefs about antipsychotics. Pharmacopsychiatry 2011; 44: 123-128.
  24. [25] Coleman R. Guarire dal male mentale. Roma: Manifestolibri; 2001.
  25. [26] Deegan PE, Drake RE. Shared decision making and medication management in the recovery process. Psychiatric Services 2006; 57:1636-9.
  26. [27] Barbato A, Vallarino M, Rapisarda F, Lora A, Parabiaghi A, D’Avanzo B, et al. Do people with bipolar disorders have access to psychosocial treatments? A survey in Italy. International Journal of Social Psychiatry 2016; E-pub
  27. [28] Masciarri D, Natali D, Palazzari F. I farmaci da dentro. Presentato al Congresso Europeo della World Association for Psychosocial Rehabilitation 2015; Torino.
  28. [29] Progetto Contraria-Mente. Sospendere gli psicofarmaci. Manuale per la riduzione del danno. New York e Northampton: Icarus Project e Freedom Center; 2010.
  29. [30] Barbato A. La terapia farmacologica a lungo termine favorisce la guarigione dalle psicosi? In: Maone A, D’Avanzo B, ed. Recovery. Nuovi paradigmi per la salute mentale. Milano: Raffaello Cortina; 2015.
  30. [31] Bramesfeld A, Wedegärtner F, Elgeti H, Bisson S. How does mental health care perform in respect to service users’ expectations? Evaluating in patient and outpatient care in Germany with the WHO responsiveness concept. BMC Health Services Research 2007; 7:99-110.

Barbara D'Avanzo, Alberto Parabiaghi, Mental health strategies for dealing with psychiatric medications? Research and practices in "RIVISTA SPERIMENTALE DI FRENIATRIA" 2/2016, pp. 9-22, DOI:10.3280/RSF2016-002002

   

FrancoAngeli is a member of Publishers International Linking Association a not for profit orgasnization wich runs the CrossRef service, enabing links to and from online scholarly content