psychotropic agent

Epidemiology

• most commonly prescribed drugs are
  • sertraline (Zoloft)
  • citalopram (Celexa)
  • fluoxetine (Prozac)
  • alprazolam (Xanax)
  • zolpidem (Ambien)
• 17% of adults filled at least one psychotropic drug prescription in 2013
  • highest among whites, 21%, lowest among Asians, 5%
  • women were more likely than men (21% vs 12%)
  • use was more common among older adults, 25% of those age 60-85 years

Pharmacology

• crosses the blood-brain barrier
• acts primarily on the central nervous system
• results in alterations in perception, mood, consciousness, cognition, & behavior

Includes:

any drug that affects brain activity associated with mental processes & behavior

• alcoholic beverage
• stimulants
  • coffee, tea, tobacco, coca, amphetamine, phenethylamine, cocoa, guarana, mate, ephedra, khat
• depressants
  • sedative/hypnotic, narcotics
• antipsychotics, antidepressants, anxiolytics
• hallucinogens
  • psilocybin, LSD, Salvia divinorum, nitrous oxide
• marijuana
• mood stabilizers, anticonvulsants, muscle relaxants, anticholinergics, antihistamines, NMDA receptor antagonist

Management

• use psychotropic drugs must be accompanied by gradual dose reductions, & behavioral intervention, unless contraindicated, in an effort to discontinue
  • gradual dose reductions may not be appropriate for specific, chronic, progressive or terminal conditions such as chronic depression, Parkinson's disease psychosis or recurrent seizures
• PRN orders for psychotropic medications
  • excluding antipsychotics: limited to 14 days, but may be extended
    • must have documented rationale for extension in the medical record, including a specific duration
  • PRN orders for antiosychotics limited to 14 days without exception.
    • patient must be evaluated first.

More general terms

• pharmaceutical agent

More specific terms

• analeptic (CNS stimulant)
• antidepressant
• antipsychotic agent
• appetite stimulant
• atomoxetine (Strattera)
• attention-deficit hyperactivity disorder (ADHD) medication
• cannabinoid (spice, K2, AMB-FUBINACA)
• hallucinogen; psychodysleptic
• mood stabilizer
• sedative/hypnotic (tranquilizer)