What Your Patients Need to Know About Psychiatric Medications

I suspect most physicians struggle as I do to adequately educate our patients about the medications we prescribe for them. Primary care physicians in particular prescribe a wide array of medications and also often refill medications prescribed originally by specialist consultants. Prescription education for patients with psychiatric conditions is especially tough. With their mental illness, how much information are they retaining as we discuss the potential side effects of mood stabilizers, antidepressants, or atypical antipsychotics? What Your Patients Need to Know About Psychiatric Medications is a book written for physicians who prescribe psychiatric medications, but it is also a book written for those patients and their caregivers. The goal is to furnish prescribers understandable yet thorough patient education material about psychiatric medications. The authors accomplish this goal. The book begins with a nice introduction and instructions on how to best utilize the information. These brief chapters are quite helpful. Next is another brief, easy-to-understand section on “Medications in Pregnancy,” including a concise table outlining the risk categories (A through X) of medication use in pregnancy. This 2-page section itself makes a helpful handout for pregnant patients. The bulk of the text is patient-focused, educational descriptions of commonly used psychiatric medications, including antianxiety, insomnia, antidepressant, mood stabilizer, antipsychotic, attention deficit disorder, attention-deficit/hyperactivity disorder, and cognitive enhancing medications. The authors organize the medications by category (anti-anxiety, antidepressant, insomnia, etc.). Each category begins with an overview of all the medication types used to treat a specific condition and a description of how these medications work. For example, the section on antianxiety medications gives a brief, understandable description of various anxiety conditions (e.g., posttraumatic stress disorder, panic disorder, and generalized anxiety disorder) and then a brief description of benzodiazepines, nonbenzodi-azepines, and antidepressants used to treat these disorders. Each category of medication, for example, selective serotonin reuptake inhibitors, also has a general information sheet that is pertinent to the class of medications as a whole. This is followed by information on each specific medication in that class. The medications are listed alphabetically. The generic and trade names are given for each medication. The description of each medication includes available strengths, generic availability, medication class, general information (usually how it works), dosing information (this is very specific regarding time, with or without food, etc.), common side effects, adverse reactions and precautions, use in pregnancy and breastfeeding, possible drug interactions, overdose, and special considerations (for example, what to do if the patient misses a dose). Although written for patient education, I found the information incredibly useful and educational. The common side effects and drug interaction sections will be most beneficial to primary care physicians. Psychiatrists, who prescribe these medications more exclusively, may not find this as personally educational. I think patients, too, will find this information most helpful, yet written in a way that will not scare them out of taking the medication. I also found the organization effective for me as a prescriber and a medical educator. The grouping of medication classes by disease makes it easy to describe to a student or resident how you chose a medication or will change medication class if needed. These handouts will make me feel more confident that I have adequately educated the patient. They reinforce my discussions of how medications work, how to take them, and what side effects to watch for. I especially like the information regarding antidepressants and increased risk of suicide. It is clearly written and understandable. I'm glad to have this topic documented in a written handout. My one concern is that although written for patients, these handouts still require a fairly high reading level. They are not at the USA Today reading level. Physicians will need to review the handouts with patients and explain things that are not understood. I found this especially true with the descriptions of neurotransmitters/mechanism of action. The authors anticipated this difficulty and have a “notes” space at the end of each medication description, which is great for patients to write down questions or physicians to write personal instructions. Also, one thing not included is the average retail price of the medications, which, even in the age of formularies, would have been nice. The book is spiral-bound and 8 × 11 inches in size. What I find most useful is the included CD-ROM. I put that into my office computer and easily print what I want for each patient. I've done it and it is great. Overall, I think the authors accomplished what they set out to do with this book and that it will be most useful for primary care doctors. Obviously, one can also use it for patients with other conditions, such as migraine or fibro-myalgia, in which psychiatric medications are used. I would think psychiatrists would also find this a helpful tool for patient education regarding medications.