Principles That Guide Pharmacologic Treatment

Principles That Guide Pharmacologic Treatment

The following are several principles that guide the use of medications to treat psychiatric disorders:

·        A medication is selected based on its effect on the cli-ent’s target symptoms such as delusional thinking, panic attacks, or hallucinations. The medication’s effec-tiveness is evaluated largely by its ability to diminish or eliminate the target symptoms.

·        Many psychotropic drugs must be given in adequate dos-ages for some time before their full effect is realized. For example, tricyclic antidepressants can require 4 to 6 weeks before the client experiences optimal therapeutic benefit.

·        The dosage of medication often is adjusted to the low-est effective dosage for the client. Sometimes a client may need higher dosages to stabilize his or her target symptoms, whereas lower dosages can be used to sus-tain those effects over time.

·        As a rule, older adults require lower dosages of medica-tions than do younger clients to experience therapeutic effects. It also may take longer for a drug to achieve its full therapeutic effect in older adults.

·    Psychotropic medications often are decreased gradually (tapering) rather than abruptly. This is because of potential problems with rebound (temporary return of symptoms), recurrence of the original symptoms, or withdrawal (new symptoms resulting from discontinu-ation of the drug).

·    Follow-up care is essential to ensure compliance with the medication regimen, to make needed adjustments in dosage, and to manage side effects.

·        Compliance with the medication regimen often is en-hanced when the regimen is as simple as possible in terms of both the number of medications prescribed and the number of daily doses