Psycho-Babble Medication Thread 1051219

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Using AAP's when + for what conditions?

Posted by Phillipa on September 23, 2013, at 20:21:09

Medscape Medical News > Psychiatry

What Not to Prescribe: APA List Aims to Make Patients Safer

Caroline Cassels
Sep 20, 2013

The American Psychiatric Association (APA) has released a list of specific uses of common antipsychotic medications that are potentially unnecessary and sometimes harmful.

"As clinicians, we know we can improve the care we deliver by engaging our patients in conversation about their care. The recommendations from APA released today provide valuable information to help patients and physicians start important conversations about treatment options and make informed choices about their healthcare," APA president Jeffrey Lieberman, MD, said in a statement.

The APA's list is part of an initiative from the American Board of Internal Medicine (ABIM) Foundation called Choosing Wisely, which has brought together leading specialty societies to develop 30 new evidence-based lists of tests and procedures that may be overused in their specific field.

"When the Choosing Wisely campaign was launched in 2012, we were at the threshold of a national dialogue on waste and overuse in our healthcare system," Richard J. Baron, MD, president and CEO of the ABIM Foundation, said in a statement.

"Thanks to the leadership of physician groups and consumer partners, the campaign has inspired conversations about what care is truly necessary in doctors' offices, communities, hospitals, and health systems across the country," Dr. Baron added.

The APA's list includes 5 recommendations:

Don't prescribe antipsychotic medications to patients for any indication without appropriate initial evaluation and appropriate ongoing monitoring

Don't routinely prescribe 2 or more antipsychotic medications concurrently

Don't use antipsychotics as first choice to treat behavioral and psychological symptoms of dementia

Don't routinely prescribe antipsychotic medications as a first-line intervention for insomnia in adults

Don't routinely prescribe antipsychotic medications as a first-line intervention for children and adolescents for any diagnosis other than psychotic disorders

The purpose of the list, said Dr. Lieberman, "is not to preclude the use of antipsychotic medications for these indications and populations but to suggest that other treatment options should be considered first, and patients should be engaged in discussion of the rationale for use and the potential benefits and risks."

"The American Psychiatric Association has shown tremendous leadership by releasing its list of common uses of medication that aren't always necessary," said Dr. Baron. "The content of this list and all of the others developed through the Choosing Wisely effort are helping physicians and patients across the country engage in conversations about what care they need and what we can do to reduce waste and overuse in our healthcare system and improve overall health."

To date, more than 80 national and state medical specialty societies, regional health collaboratives, and consumer partners have joined the Choosing Wisely effort promoting conversations about appropriate care. During the next year, more than 30 other specialty society partners will release Choosing Wisely lists. Some of the participating organizations include the following:

Information from Industry

American College of Surgeons

American Academy of Orthopaedic Surgeons

Society of General Internal Medicine

American Academy of Family Physicians

American College of Emergency Physicians

American Association of Clinical Endocrinology/The Endocrine Society

American Society of Hematology

American Geriatrics Society

American Academy of Allergy, Asthma, and Immunology

To view the complete APA list and additional details about the recommendations and evidence supporting them, visit www.psychiatry.org/choosingwisely. Also, see more on the Choosing Wisely national effort.

Re: Using AAP's when + for what conditions?

Posted by Christ_empowered on September 24, 2013, at 17:51:32

In reply to Using AAP's when + for what conditions?, posted by Phillipa on September 23, 2013, at 20:21:09

There's so many issues with psych drugs. Women are drugged up more often and more heavily than men...poor people are often on higher doses of more noxious meds than middle- and upper-class people...minorities are often drugged up more than white people...foster kids are often drugged to the gills (true of anybody in an institution of any sort, really)..

I think AAPs are prescribed heavily because they're perceived as safe, they're non-addictive, there's usually 0 street value, and they don't make you feel good. At all. Anything that might lift the mood or make you feel good is usually reserved for middle- and upper-class people, whites more than minorities (that said, I've heard that sketch docs in sketch neighborhoods have been known to be...generous :-)

There's still plenty of money to be made off the atypicals as tranquilizers for...everything. The US, in particular, is a heavily medicated society. Personally, I blame the economy and our hyper-individualistic culture, plus remaining racism, misogyny, and our refusal to examine our culture (this goes with our hyper-individualistic culture). Also, SSI now functions as a psychiatry-controlled form of welfare, in the age of "welfare reform."

Just some random thoughts...

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