How Quickly Multiple Medication Use Can Start: A Medication for Every Complaint on the First Visit Compromising the Ability to Determine Cause and Effect.

IF 1.3 4区 医学 Q3 PSYCHIATRY Journal of Psychiatric Practice Pub Date : 2025-01-01 DOI:10.1097/PRA.0000000000000835
Sheldon H Preskorn, Amy Terry
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Abstract

This article presents a case demonstrating that multiple medication use can begin on the first outpatient visit if the prescriber makes multiple psychiatric diagnoses and then feels the need to treat each diagnosis with a different central nervous system active medication labeled for each indication. This approach poses potential problems. First, a single drug or perhaps 2 drugs, in this case, may have been sufficient as initial and perhaps final treatment. Second, the prescriber cannot tell which drug(s) is/are producing either a beneficial or an adverse effect. This approach may stem from prescribers thinking that if they have made a diagnosis then they need to treat it with a drug labeled for or clinically used to treat that indication rather than taking a more conservative approach. However, such an approach adversely affects the ability to determine cause-and-effect relationships and hence adversely affects the ability to determine the best way to revise the treatment going forward.

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多种药物的使用可以多快开始:在第一次就诊时对每个投诉进行药物治疗,损害了确定因果关系的能力。
这篇文章提出了一个案例,表明如果医生做出多种精神诊断,然后觉得有必要针对每种适应症使用不同的中枢神经系统活性药物治疗,那么在第一次门诊就诊时就可以开始使用多种药物。这种方法带来了潜在的问题。首先,在这种情况下,一种或两种药物可能已经足够作为初始和最终治疗。第二,开处方的人不知道哪种药物是有益的还是有害的。这种方法可能源于开处方者的想法,即如果他们做出了诊断,那么他们就需要用标签上标明或临床用于治疗该适应症的药物来治疗,而不是采取更保守的方法。然而,这种方法对确定因果关系的能力产生了不利影响,因此对确定改进治疗的最佳方法产生了不利影响。
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来源期刊
CiteScore
2.30
自引率
10.50%
发文量
159
审稿时长
>12 weeks
期刊介绍: Journal of Psychiatric Practice® seizes the day with its emphasis on the three Rs — readability, reliability, and relevance. Featuring an eye-catching style, the journal combines clinically applicable reviews, case studies, and articles on treatment advances with practical and informative tips for treating patients. Mental health professionals will want access to this review journal — for sharpening their clinical skills, discovering the best in treatment, and navigating this rapidly changing field. Journal of Psychiatric Practice combines clinically applicable reviews, case studies, and articles on treatment advances with informative "how to" tips for surviving in a managed care environment.
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