The mental health clinician最新文献

{"title":"Transitions of care: Assessment of adherence to long-acting injectable antipsychotic treatment following discharge from inpatient psychiatry.","authors":"Charnae Ross, Katie S Adams, Ericka L Crouse","doi":"10.9740/mhc.2025.02.009","DOIUrl":"https://doi.org/10.9740/mhc.2025.02.009","url":null,"abstract":"<p><p><b>Introduction:</b> Long-acting injectable antipsychotics (LAI-APs) are used in patients with chronic psychiatric disorders as a strategy to manage oral medication nonadherence. Inpatient LAI-AP administration may assist with transition to the outpatient setting. The study objective was to characterize receipt of the next LAI-AP injection as planned in the outpatient setting following administration during inpatient psychiatric hospitalization. <b>Methods:</b> Patients 18 years and older were eligible for inclusion if they received an LAI-AP while inpatient and provided consent to monitor their 90-day follow-up. The primary outcome determined the percentage of patients who received the same LAI-AP administered during their inpatient psychiatric admission at their initial visit post discharge. The secondary outcomes compared appropriate documentation of the LAI-AP follow-up plan, oral overlap, and early psychiatric rehospitalization rates. <b>Results:</b> Fifty-one patients were included. Twenty-nine patients (56.9%) followed up within the outpatient setting after discharge and received their next scheduled LAI-AP as planned. Twenty-two patients (43.1%) did not receive an LAI-AP injection following discharge, 15 of whom did not attend their initial follow-up appointment. Thirty-nine patients (76.5%) were newly initiated on LAI-AP therapy, 19 of whom received their next follow-up injection. <b>Discussion:</b> More than 40% of patients who received an LAI-AP inpatient did not follow up in the outpatient setting despite appropriate discharge planning. Patients more likely to receive follow-up LAI-AP were older, received a maintenance injection while inpatient, and had a scheduled follow-up appointment. Prior to inpatient administration of LAI-AP, multiple factors should be considered, including outpatient adherence, access, feasibility of outpatient continuation, and transition of care plan.</p>","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"15 1","pages":"9-16"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of weight loss surgery on valproic acid levels: A case report.","authors":"Kristin Waters, Grace Cose, Chloe Hurme, Ashley Tewksbury","doi":"10.9740/mhc.2025.02.025","DOIUrl":"https://doi.org/10.9740/mhc.2025.02.025","url":null,"abstract":"<p><p>Weight loss surgery has become more common in the United States because of the increasing rates of obesity. The physiological changes caused by weight loss surgery have the potential for clinically significant changes in the pharmacokinetic parameters of mood stabilizers, including valproic acid (VPA). A patient with a history of Roux-en-Y gastric bypass and bipolar disorder was hospitalized because of mania. The dosing regimen of the VPA was changed multiple times due to unexpectedly low and inconsistent trough levels. Despite a significant increase in the total daily dose, the final trough level obtained was not significantly different than the initial level. The VPA was changed from the delayed-release to the immediate-release formulation to achieve better absorption. However, no trough level was obtained after this change. Weight loss surgeries, such as Roux-en-Y gastric bypass, may continue to impact the pharmacokinetic parameters of VPA for several years after the procedure. This patient was titrated to a dose of 39 mg/kg/day (typical range 20-30 mg/kg/day) with minimal change in level. Pharmacokinetic changes are a concern in the use of mood stabilizers, including VPA, after weight loss surgery. Close monitoring is essential for safe and effective treatment. If strict drug level monitoring is not an option, it may be preferable to consider an alternative mood-stabilizing treatment. Switching to the immediate-release formulation of VPA may also be an option; however, further investigation is required to determine if this makes a clinical difference in the management of bipolar disorder.</p>","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"15 1","pages":"25-29"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461192","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacist administration of long-acting injectable medications for substance use disorders: A scoping review.","authors":"Pamela Hernandez Bustamante, Amanda Charles, Marissa Snider, Samantha Catanzano","doi":"10.9740/mhc.2025.02.017","DOIUrl":"https://doi.org/10.9740/mhc.2025.02.017","url":null,"abstract":"<p><p><b>Introduction:</b> Using long-acting injectable (LAI) medications increases treatment adherence and promotes positive outcomes for patients with substance use disorders (SUD). Despite documented benefits that LAI medications can have over their oral counterparts, they continue to be underused. With the expansion of pharmacists' scope of practice for medication administration services, there is a need to document and evaluate the benefits of pharmacist engagement in LAI administration services for SUD and identify growth opportunities. <b>Methods:</b> A PubMed database search for articles related to a pharmacist's role in LAI administration services for buprenorphine and naltrexone was conducted. Articles published before December 15, 2023, and in English describing or reporting outcomes of pharmacists administering LAI buprenorphine or LAI naltrexone in the United States were included. <b>Results:</b> A total of 56 articles were identified in the search process. After removing duplicate citations and exploring references and similar article recommendations, a total of 5 articles were included in the final analysis. All 5 articles discussed pharmacist administration of LAI naltrexone, and no articles discussed pharmacist administration of LAI buprenorphine. Outcomes for each article varied and included cost analyses, implementation procedures, and identified barriers. <b>Discussion:</b> Current literature on pharmacist-administered LAI services is limited. With many states allowing pharmacist administration of LAI medications, there is a significant opportunity to expand patient access to LAI medications for SUD in the pharmacy setting. Standardized training on LAI administration, development of standard operating procedures, and clarity on reimbursement policies are needed to help accelerate the implementation of pharmacist-administered LAI services.</p>","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"15 1","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461135","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A model for timely dissemination of critical information: Clozapine toxicity during the COVID pandemic.","authors":"Jessica Gannon, K N Roy Chengappa, Robert O Cotes, Jonathan G Leung, Patrick Frailey, Mariel Piechowicz, Elizabeth Kistler, Vernon Nathaniel, Cynthia Eldredge, Jade Alessandro, Kimberly Clinebell, Melanie Yabs, Dale Adair, Joseph Zimmerman","doi":"10.9740/mhc.2025.02.030","DOIUrl":"https://doi.org/10.9740/mhc.2025.02.030","url":null,"abstract":"<p><p>Clozapine is the only medication approved for treatment-resistant schizophrenia. Clozapine toxicity associated with COVID-19 infection could be amplified by concomitant nirmatrelvir/ritonavir. Knowledge gaps among clinicians and patients led to patient safety concerns and the implementation of a quality improvement (QI) project focused on rapid education dissemination. This QI project focused on clinicians, patients, and caregivers. Steps included clinician education at system, regional, and national levels and patient/caregiver education at system and regional levels. Optimization of electronic health record (EHR) tools facilitated efficient clinical workflows, targeted patient education to facilitate shared decision making, and promoted best practices. Education concerning risk for COVID-19, clozapine toxicity, and nirmatrelvir/ritonavir drug interactions was distributed to more than 1400 clinicians via e-mail and conference presentations. Enduring continuing education materials had more than 1200 views. Verbal or written education was rapidly delivered to 231 patients/caregivers and documented via autotext, an EHR tool. Following presentation of this QI project at a schizophrenia conference, more than 95% of attendees, including health care clinicians and patients/caregivers, rated their understanding of COVID-19, clozapine toxicity, and the interaction with nirmatrelvir/ritonavir as \"very high\" or \"high.\" Separately, web-hosted continuing education platforms indicated that more than 75% of clinicians rated their understanding of these 2 issues as \"very high\" or \"high\" upon module completion. By educating patients/caregivers and clinicians about COVID-19 infection and nirmatrelvir-/ritonavir-associated toxicity risks, this project helped ensure safe prescription of clozapine during the COVID-19 pandemic. This project could serve as a rapid risk mitigation dissemination model of patient safety education.</p>","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"15 1","pages":"30-35"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential changes impacting psychiatric pharmacy by 2030.","authors":"Amy Werremeyer, Greg Payne","doi":"10.9740/mhc.2025.02.036","DOIUrl":"https://doi.org/10.9740/mhc.2025.02.036","url":null,"abstract":"","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"15 1","pages":"36-39"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of atypical antipsychotics in individuals with anorexia nervosa.","authors":"Danielle L Stutzman","doi":"10.9740/mhc.2025.02.001","DOIUrl":"https://doi.org/10.9740/mhc.2025.02.001","url":null,"abstract":"","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"15 1","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143461400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Involuntary medication treatment of schizophrenia in the inpatient setting.","authors":"Courtney A Iuppa","doi":"10.9740/mhc.2024.12.321","DOIUrl":"10.9740/mhc.2024.12.321","url":null,"abstract":"<p><p>Two Supreme Court cases in the United States describe the use of involuntary medication in individuals with mental illnesses. In addition to these legal requirements, clinicians must also incorporate ethics into treating these individuals, including the principles of autonomy and beneficence. Current guidelines do not provide specific recommendations for choosing an antipsychotic for a patient with schizophrenia who is being treated involuntarily. However, it is recommended that clinicians use general guidelines for the treatment of schizophrenia as a basis for narrowing down appropriate therapy, which may involve the use of long-acting injectable antipsychotics. Clinical considerations that should be accounted for include past medication trials, potential adverse effects, whether tolerability has been demonstrated, route of administration, dosing interval, requirement for oral overlap, comorbid conditions, patient preference, and access to the medication.</p>","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"14 6","pages":"321-327"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616963/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical pearls for the management of duloxetine patients with medical comorbidities.","authors":"Megan O'Connell, Amy VandenBerg","doi":"10.9740/mhc.2024.12.313","DOIUrl":"10.9740/mhc.2024.12.313","url":null,"abstract":"<p><p>The effective use of duloxetine can be complicated by acute kidney injury, acute and/or chronic hepatic dysfunction, dysphagia, enteral nutrition, and common pharmacokinetic interactions. This article aimed to review the pharmacological properties of duloxetine pertinent to its use and to discuss the management of duloxetine in patients with common acute and chronic medical comorbidities. Management strategies based on clinical data and expert opinion are reviewed in 3 patient cases.</p>","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"14 6","pages":"313-320"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical experience and treatment considerations with vesicular monoamine transport 2 inhibitors.","authors":"Kayla Johnson","doi":"10.9740/mhc.2024.12.304","DOIUrl":"10.9740/mhc.2024.12.304","url":null,"abstract":"<p><p>Vesicular monoamine transporter 2 inhibitors (VMAT2i) are currently Food and Drug Administration-approved for the treatment of Huntington disease chorea and tardive dyskinesia. Additionally, they are often used for other hyperkinetic movement disorders in clinical practice. Due to a lack of head-to-head clinical trials, management of VMAT2i in the clinical setting may be unclear and rely on the clinical experience of the practitioner. Due to the limited distribution model, which typically requires VMAT2i to be dispensed by specialty pharmacies, access and initiation of treatment may present as barriers. Patient cases allow for the exploration of switching between VMAT2i, alternative routes of administration, utilization in pediatric and off-label conditions, and how to successfully initiate and monitor a patient on VMAT2i therapy.</p>","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"14 6","pages":"304-312"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exacerbation of neuropsychiatric symptoms in an adult male with influenza A virus treated with oseltamivir.","authors":"Masa Scott, Emily Faltin, Kathleen Londick","doi":"10.9740/mhc.2024.12.339","DOIUrl":"10.9740/mhc.2024.12.339","url":null,"abstract":"<p><p>Oseltamivir (Tamiflu) package labeling has a warning for neuropsychiatric adverse events (NPAE), most commonly in children and adolescents, especially males. There are several case reports of NPAE in adults treated with oseltamivir, but few document patients with preexisting neuropsychiatric conditions without additional contributing factors. This case report describes a 22-year-old male with a history of bipolar disorder, depression, and attention-deficit/hyperactivity disorder who had been stable on his medication regimen before experiencing sudden worsening of symptoms after the initiation of oseltamivir. The case adds to previous literature by strengthening the correlation between oseltamivir and a sudden increase in neuropsychiatric symptoms. Providers should be aware that oseltamivir may exacerbate symptoms of previously stable patients. Depending on the severity of neuropsychiatric effects, discontinuation of oseltamivir and symptom treatment with pharmacotherapy may be warranted.</p>","PeriodicalId":101313,"journal":{"name":"The mental health clinician","volume":"14 6","pages":"339-342"},"PeriodicalIF":0.0,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11616964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}