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Drug Therapy01:28

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The advent of drug therapy has profoundly shaped modern mental health care, providing targeted treatments for a range of psychological disorders. Psychotherapeutic drugs, classified into antianxiety, antidepressant, and antipsychotic medications, address symptoms across anxiety disorders, mood disorders, and schizophrenia. While these medications have transformed patient outcomes, they require careful management due to their potential side effects and limitations.
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Antidepressant drugs are a class of medications primarily used for treating various mood disorders, including major depression, anxiety disorders, and other related conditions. These medicines work by modulating the neurotransmitter balance within the brain, alleviating depressive symptoms. Antidepressants can be broadly categorized into several groups according to their mechanism of action and chemical structure: Selective Serotonin Reuptake Inhibitors (SSRIs), Serotonin-Norepinephrine...
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Drug dependence, abuse, and addiction are complex phenomena that can precipitate various abnormal states. Physical dependence refers to a state of pharmacological adaptation to a drug. This adaptation often results in tolerance—a reduced response to the drug after repeated administrations. When the drug use is abruptly stopped, withdrawal symptoms occur due to the body's need to readjust from the pharmacologically induced imbalance. However, tolerance and withdrawal symptoms do not...
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Psychosis: Goals of Pharmacotherapy01:26

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Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
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Antidepressant Drugs: MAOIs and Other Agents01:23

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Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
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Engaging Patients in Discussions About Medication Deprescribing.

Jacquelyn Pendergast1, Jolie B Wormwood2,3, Kelly Stolzmann2

  • 1Center for Health Optimization and Implementation Research, VA Boston Healthcare System and VA Bedford Healthcare System, Boston and Bedford, MA, USA. Jacquelyn.Pendergast@va.gov.

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|January 29, 2025
PubMed
Summary
This summary is machine-generated.

Patient-directed educational brochures increase deprescribing discussions with primary care providers (PCPs). Engaging with brochures and prior PCP contact significantly boosts these conversations, promoting shared decision-making.

Keywords:
deprescribingpatient educationpatient engagementpolypharmacyshared-decision making

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Area of Science:

  • Gerontology
  • Health Literacy
  • Patient Engagement

Background:

  • Deprescribing, the intentional reduction or discontinuation of medications, aims to minimize inappropriate use and medication-related harm.
  • Patient involvement in deprescribing conversations can enhance the likelihood of medication changes and support shared decision-making.

Purpose of the Study:

  • To evaluate the effect of patient-focused educational materials on patient engagement and initiation of deprescribing discussions with primary care providers (PCPs).

Main Methods:

  • A study involved mailing medication-specific brochures to patients two weeks before their PCP appointments.
  • Surveys were sent post-appointment to assess patient-reported deprescribing discussions and brochure engagement.
  • Multivariable logistic regression analyzed factors associated with deprescribing discussions.

Main Results:

  • Patient characteristics like higher education and adequate health literacy were linked to increased deprescribing discussions.
  • Active engagement with brochure activities, pre-appointment PCP contact, and discussing the brochure with others also significantly increased discussion likelihood.
  • Conversely, Black patients were less likely to report deprescribing discussions compared to White patients.

Conclusions:

  • Patient engagement with educational materials and individual characteristics significantly influence deprescribing discussions.
  • Patient-centered brochures can empower patients, integrating their perspectives into deprescribing decisions.
  • Future research should focus on implementation strategies to improve deprescribing reach, especially for patients with lower health literacy.