Medication management is a crucial issue that greatly influences
the outcomes of treatment for many clients with mental disorders. The following
sections discuss sev-eral categories of drugs used to treat mental disorders (psychotropic drugs): antipsychotics,
antidepressants, mood stabilizers, anxiolytics, and stimulants. Nurses should
understand how these drugs work; their side effects, contraindications, and
interactions; and the nurs-ing interventions required to help clients manage
Several terms used in discussions of drugs and drug therapy are
important for nurses to know. Efficacy
refers to the maximal therapeutic effect that a drug can achieve. Potency de scribes the amount of the
drug needed to achieve that maximum
effect; low-potency drugs require higher dosages to achieve efficacy, whereas
high-potency drugs achieve efficacy at lower dosages. Half-life is the time it takes for half of the drug to be removed
from the bloodstream. Drugs with a shorter half-life may need to be given three
or four times a day, but drugs with a longer half-life may be given once a day.
The time that a drug needs to leave the body completely after it has been
dis-continued is about five times its half-life.
The U.S. Food and Drug Administration (FDA) is responsible for supervising the testing and marketing ofmedications for public safety. These activities include clini-cal drug trials for new drugs and monitoring the effective-ness and side effects of medications. The FDA approves each drug for use in a particular population and for specific diseases. At times, a drug will prove effective for a disease that differs from the one involved in original testing and FDA approval. This is called off-label use. An example is some anticonvulsant drugs (approved to prevent seizures) that are prescribed for their effects in stabilizing the moods of clients with bipolar disorder (off-label use). The FDA also monitors the occurrence and severity of drug side effects. When a drug is found to have serious or life-threatening side effects, even if such side effects are rare, the FDA may issue a black box warning. This means that package inserts must have a highlighted box, separate from the text, which contains a warning about the serious or life-threatening side effects.