Mastering Mental Health Management

MANAGEMENT OF THE PATIENT WITH A MENTAL ILLNESS Dr. Jacqueline Martin

• The approach to management is holistic. • It involves the biopsychosocial approach. • Biological treatments include physical treatments. • Psycho treatments include psychological treatments. • Social treatments involve all other interactions such as family, community, workplace, school, and recreational activities. The Physical Treatments • Antipsychotics • Antidepressants • Electroconvulsive Therapy • Mood stabilizers • Minor tranquilizers The Psychological Treatments • Supportive therapies • Psychotherapies (variety of) • Psychoanalysis Social Treatments • Rehabilitation • Community care Physical Treatments • Should be seen as only a part of the management, not the whole. • Must complement the psychological and social aspects of management. • Patients may be managed in the hospital (admitted), out-patient (clinics), or in the community. Antipsychotics • These drugs are noted to reduce delusions, hallucinations, and to have a sedating/calming effect. • Two types of antipsychotics are typicals and atypicals. Typicals Atypicals *Older type * newer type Typical Antipsychotics • Phenothiazines e.g. Chlorpromazine • Butyrophenones e.g. haloperidol • Thioxanthines e.g. clopixol • Diphenylbutylpiperidines e.g. pimozide • Substituted benzamides e.g. Amilsulpride Atypical Antipsychotics • Clozapine(Clozaril) • Olanzapine (Zyprexa) • Quetiapine (Seroquel) • Risperidone (Risperdol) • Zisprasidone (Geodon) • Aripripazole (Abilify) Mechanism of Action • Typical antipsychotics may block serotonin, dopamine, adrenergic, histaminergic, and cholinergic receptors. • Atypical antipsychotics also block serotonin receptors. • Some atypicals block dopamine receptors in the limbic system only. Mode of Administration • Orally (tablets, drops) • Sublingually (quicklets) • Intramuscularly • Intravenously • Long-acting preparations e.g. oil-based – modecate, haldol decano; H2O-based – Risperdal consta Side Effects The most important are the extrapyramidal movement side effects and NMS. • Acute dystonias – (torticollis, increases muscle tone/spasm) • Parkinsonism – shuffling gait, difficulty initiating movement, masked facies • Akathesia – a subjective feeling of restlessness • Tremors – trembling at rest or during activity • Tardive dyskinesia – abnormal movements of face/mouth/chorea form movements of body/limbs – may be irreversible in 50% of patients. • The EPS side effects may be minimized by the use of anticholinergic agents, which may also cause side effects. Other side effects include: • Weight gain • Sexual abnormalities/impotence • Side effects from the anticholinergics include dry mouth, blurred vision/confusion, const

Test your knowledge on the management of patients with mental illness with this informative quiz! Learn about the holistic approach to management and the various biological, psychological, and social treatments available. Explore the different types of antipsychotics and their mechanisms of action, as well as the potential side effects of these medications. Improve your understanding of this important topic and enhance your professional skills as a healthcare provider.