These meds are expensive and used liberally in the nursing home. I cannot tell they make any difference in the patients they are used in.
We recently had an inservice where this was discussed, and information was given that these psychotropic meds can aggravate an already compromised mental status and make things worse. The nurse educator added I wish we could get some of these doctors to pay attention to this.
The general consensus around the nursing home (and a psychology professor I just talked to) is that psychotropic meds are quackery. I am interested in becoming a PMHNP but I also have serious doubts about the benefits of most of these medications.
I work in pedi psych and I have seen these meds make a difference in patients experiencing acute episodes. With Zyprexa we tend to use the Zydis form because it acts rapidly. I have also seen Risperdal help with severe depression when SSRIs alone are not enough. I have never really seen Remeron do anything at all. There are major con's to using these drugs in the elderly. For starters, the risk for EPS in the elderly is greatly increased. Risperdal and especially Zyprexa can cause weight gain and increase the risk of heart attack and stroke. Antipsychotics can also cause Long QT syndrome. I believe the elderly are grossly overmedicated with these meds, for sure.
The general consensus around the nursing home (and a psychology professor I just talked to) is that psychotropic meds are quackery. I am interested in becoming a PMHNP but I also have serious doubts about the benefits of most of these medications.
I would appreciate any further insight.
Psychology professors do not usually prescribe, although with additional training some are getting rights to do so. Continue with your plans to be a PMHNP. Psychopharm is very challenging. For example, in my class we had a small book of 100 or so pages of all the psychiatric drugs. Then, we had a text of almost 1,000 pages of how they work!
FYI: Even though dementia is incurable, there are six categories of dementia that are amenable to pharmacotherapeutic intervention. They are prevention of neurodegeneration, intellectual decline, behavioral disorders, sleep disorders, common medical complications, and abrupt worsening of dementia.
The general consensus around the nursing home (and a psychology professor I just talked to) is that psychotropic meds are quackery. I am interested in becoming a PMHNP but I also have serious doubts about the benefits of most of these medications.
Bring the quackery on. When I first started Nursing, I worked in a Nursing home. We would admit patient after patient and these people were completely out of control. Then the psychotropic regime was started and these "crazies" turned out to be fun, kind and calm (not sedated) people.
I could not believe the difference these mediations made!
NeoPediRN
945 Posts
I work in pedi psych and I have seen these meds make a difference in patients experiencing acute episodes. With Zyprexa we tend to use the Zydis form because it acts rapidly. I have also seen Risperdal help with severe depression when SSRIs alone are not enough. I have never really seen Remeron do anything at all. There are major con's to using these drugs in the elderly. For starters, the risk for EPS in the elderly is greatly increased. Risperdal and especially Zyprexa can cause weight gain and increase the risk of heart attack and stroke. Antipsychotics can also cause Long QT syndrome. I believe the elderly are grossly overmedicated with these meds, for sure.