Top Ten Tips Palliative Care Clinicians Should Know About the Physical Manifestations of Psychiatric Illness and Treatment

Journal of Palliative Medicine, Journal Year: 2024, Volume and Issue: 27(11), P. 1531 - 1540

Published: May 9, 2024

Addressing the psychiatric aspects of serious illness in palliative care (PC) is crucial to both delivery and outcomes. Psychiatric comorbidities are common among patients with PC needs can significantly impact their total burden symptomatic distress, overall quality life, functional independence, healthcare utilization. Yet, these often deferred mental health consultant teams context busy services limited human resources. To provide comprehensive person-centered care, clinicians must understand interplay between medical conditions presentations within a biopsychosocial framework respond empathically, efficiently, effectively. This article first two-part series developed collaboration group psychiatric-palliative specialists. explores ten physical manifestations treatment facing illnesses. The second will pragmatic tips should know about nonpsychiatric treatment. Combined, two articles support holistic approach that use prioritize integrate emotional well-being throughout continuum illness.

Language: Английский

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Rise of escitalopram and the fall of citalopram

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: May 8, 2023

Citalopram and escitalopram are among the most used medications key treatments for many psychiatric disorders. Previous findings suggest citalopram prescription rates changing because of patent ending as opposed to evidence a clear therapeutic advantage, which is called evergreening. This retrospective study focuses on characterizing chronologic geographic variation in use US Medicaid Medicare patients. We hypothesized that will decrease with concurrent increase escitalopram, consistent evergreening.Citalopram costs per state were obtained from State Drug Utilization Database Provider Payment Data. Annual outside 95% confidence interval considered significantly different average.Overall, decreasing trend an increasing noted both Cost differences between generic brand drugs, forms being cheaper compared brand-name version.Despite limited suggesting have any meaningful or adverse effects, there exists noticeable decline cooccurred prescribing, our hypothesis. Moreover, these general pharmacoepidemiologic trends significant variability. There was disproportionate spending (relative their use) versions medicines forms.

Language: Английский

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Use of the Third-Generation Atypical Antipsychotic Aripiprazole (Zylaxera®) for Treatment of Depressive States in Schizophrenia: Efficacy and Safety Study

Psikhiatriya, Journal Year: 2023, Volume and Issue: 21(3), P. 6 - 19

Published: June 19, 2023

Background : Aripiprazole, among other atypical antipsychotics, is recommended as a drug for maintenance therapy in schizophrenia cases which the patient identified having depressive symptoms. At same time, depression not listed separate indication its antidepressant properties are considered only recommendations treatment of bipolar and augmentation recurrent disorder. There no works characterizing efficacy patients with schizophrenia, well evaluating spectrum action such conditions. Objective study to examine therapeutic safety Aripiprazole (Zylaxera®) moderate severe states schizophrenia. Patients methods 5–20 mg daily dose 6 weeks was studied 72 aged 18 47 years (all women) at least 17 Hamilton Scale scores remitted postchizophrenic schizotypal disorder (F20.01 + F32.1–2; F20.04; F21.3–4 F32.1–2). The HDRS-21, CGI, UKU scales were used psychometric assessment. Results effectiveness Zylaxera® revealed majority patients: rate responders evaluated by HDRS-21 scale (reduction severity disorders 50% or more) 67.2% 71.4% CGI scale. it established that group had certain similarity terms psychopathological structure states. Conclusion has been established, suffering from distinct favorable tolerability profile. maximum within framework use observed predominance negative affectivity.

Language: Английский

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Specialty-type and state-level variation in paroxetine use among older adult patients

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2023, Volume and Issue: unknown

Published: Feb. 16, 2023

Abstract Introduction Paroxetine is an older “selective” serotonin reuptake inhibitor (SSRI) that notable for its lack of selectivity, resulting in a cholinergic adverse-effect profile, especially among adults (65+). Methods prescription rates and costs per state were ascertained from the Medicare Specialty Utilization Payment Data. States’ annual rate, corrected thousand Part D enrollees, outside 95% confidence interval considered significantly different average. Results There was steady decrease paroxetine prescriptions (-34.52%) spending (-16.69%) 2015-2020 but consistent, five-fold state-level difference. From 2015-2020, Kentucky (194.9, 195.3, 182.7, 165.1, 143.3, 132.5) showed higher relative to national average, Hawaii (42.1, 37.9, 34.3, 31.7, 27.7, 26.6) lower rates. North Dakota often frequent elevated prescriber (2016: 170.7, 2018: 143.3), Neuropsychiatry geriatric medicine frequently prescribed largest amount prescriptions, number providers specialty, 2015-2020. Discussion Despite American Geriatrics Society prohibition against use many effective treatment alternatives, still commonly used this population, by neuropsychiatry medicine. These findings provide information on specialty types states where education policy reform would likely have greatest impact improving adherence recommendations.

Language: Английский

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Standard of practice in mental health for pharmacy services

Journal of Pharmacy Practice and Research, Journal Year: 2023, Volume and Issue: 53(4), P. 204 - 225

Published: Aug. 1, 2023

Language: Английский

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Mitigating Pediatric Inpatient Aggression: A Quality Improvement Initiative

Hospital Pediatrics, Journal Year: 2022, Volume and Issue: 12(5), P. 499 - 506

Published: April 26, 2022

Patient aggression in the health care workplace has increased significantly, and impact of violence can be profound, including psychological trauma lost productivity. We suspect these safety events are often unreported, leading to missed opportunities design interventions reduce harm. The primary aim interdisciplinary quality improvement team was increase staff reporting utilizing our event system related verbally and/or physically aggressive pediatric patients by 10% over a 12-month period.An addressed existing gaps inpatients with escalating behavior. Interventions included survey knowledge, use guideline for management, updates electronic medical record, patient screening tool, an order set, online education module. outcome measure number reported patients. Compliance risk tool tracked as process measure.The from just <1.0 per 1000 days 3.0 special cause variation observed on statistical control chart. compliance improved during time project, nearing 90%.A variety aimed address inpatient improve foster culture employee safety.

Language: Английский

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From Urinary Retention to Increased Urinary Frequency: A Case Report on Mirtazapine\'s Unusual Side Effect

Indian Journal of Private Psychiatry, Journal Year: 2024, Volume and Issue: 18(1), P. 35 - 36

Published: Jan. 3, 2024

Mirtazapine is a noradrenergic and specific serotonergic antidepressant (NaSSA).It used off-label for the treatment of insomnia, panic disorder, generalized anxiety posttraumatic stress disorder (PTSD), obsessive-compulsive (OCD), headaches, migraines.The common side effects include sedation, increased appetite, weight gain, dry mouth.Changes in urinary function are an uncommon effect, predominantly as retention very rarely increase frequency.Here case depressive episode middle-aged female, where mirtazapine precipitated rapid troublesome micturition frequency.

Language: Английский

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Why so down?

Cambridge University Press eBooks, Journal Year: 2024, Volume and Issue: unknown, P. 199 - 214

Published: April 3, 2024

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Long-term effects of benzodiazepine discontinuation among older adults: potential improvements on depressive symptoms

Aging & Mental Health, Journal Year: 2024, Volume and Issue: 28(12), P. 1625 - 1633

Published: July 2, 2024

To examine how change in benzodiazepine (BZD) use is linked to changes depressive symptoms intensity, worry and sleep quality over 16 months.

Language: Английский

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National patterns of paroxetine use among US Medicare patients from 2015–2020

Frontiers in Psychiatry, Journal Year: 2024, Volume and Issue: 15

Published: July 10, 2024

Introduction Paroxetine is an older “selective” serotonin reuptake inhibitor (SSRI) that notable for its lack of selectivity, resulting in anticholinergic adverse-effect profile, especially among adults (65+). Methods prescription rates and costs per state were ascertained from the Medicare Specialty Utilization Payment Data. States’ annual rate, corrected thousand Part D enrollees, outside a 95% confidence interval considered significantly different average. Results Nationally, there was steady decrease population-corrected paroxetine prescriptions (-34.52%) spending (-29.55%) 2015–2020 but consistent, five-fold state-level difference. From 2015–2020, Kentucky (194.9, 195.3, 182.7, 165.1, 143.3, 132.5) showed higher relative to national average, Hawaii (42.1, 37.9, 34.3, 31.7, 27.7, 26.6) lower rates. North Dakota often frequently elevated prescriber (2016: 170.7, 2018: 143.3), Neuropsychiatry geriatric medicine prescribed most paroxetine, number providers specialty, 2015–2020. Discussion Despite American Geriatrics Society’s prohibition against use many effective treatment alternatives, still commonly used US this population, by neuropsychiatry medicine. These findings provide information on specialty types states where education policy reform would likely have greatest impact improving adherence recommendations.

Language: Английский

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