NRSG263 Principles of Nursing: Mental Health

Running head: NURSING
NRSG263 Principles of Nursing: Mental Health
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Introduction- In the past decade several advancements has been made in the discovery
and research of psychotropic medication, categorisation of different psychological disorders, and
executive brain functioning, related to consciousness, memory, and emotions. Australia is
challenged by social and financial costs of mental illness and conscious efforts have also been
taken by researchers in order to obtain a consensus for making definite diagnosis of psychiatric
problems (Double & Richards, 2017). Psychotropic medications, also referred to as psychotropic
drugs success were formulated by researchers during a time when not much discovery had been
done regarding neurotransmitters, and there was little or no information available about the
functioning and physiology of these chemical messengers. The mode of action of psychotropic
medications was explored several years after they had been first clinically used, and they are still
under investigation. They are also referred to as dirty drugs, owing to the fact that they create an
impact on a plethora of brain systems. In this essay the controversies related with the
administration of psychotropic medication will be critically discussed, followed by the issues and
challenges that the registered nurses face why administering these medications.
Associated controversies- Psychotropic medications are typically responsible for
bringing about modifications in the functioning of the human brain, and they result in alteration
in perception, consciousness, behaviour, mood, and cognition. Often used for recreational
purpose, apart from medical usage, these drugs are also associated with an enhancement of
performance amongst individuals. There is a growing body of evidence for the fact that
psychotropic medications do more harm to the human body, than bring about any benefits
(Goldberg & Ernst, 2018). Sedatives are a type of psychotropic drugs that predominantly create
an impact on the central nervous system, and affect the neurotransmitter gamma aminobutyric
neurotransmitter (GABA) (Saxena et al., 2020). Commonly administered sedatives are

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temazepam valium, xanax, oxycodone and Phenobarbital. The major controversy associated with
their administration is a dependence on these drugs. Findings from a study conducted in
Australia showed that prolonged administration leads to psychological and physical dependence
of the patients and their sudden cessation often makes the patients manifest withdrawal
symptoms of agitation, restlessness, insomnia, and might even prove fatal (Arunogiri & Lubman,
2016). Taking into consideration the fact that these drugs are also used for recreational purpose,
on using them for a long duration, people typically report adverse symptoms such as, stupor,
anxiety, poor memory and concentration, loss of attention, sleeplessness, drowsiness, stress, and
psychomotor problems (Milhorn, 2018).
Another group of psychotropic drugs are atypical antipsychotics that are also referred to
as second generation antipsychotics, which are neuroleptics or tranquilizers particularly used for
the management of bipolar disorder, autism, major depressive disorder, and schizophrenia. These
medications function by blocking receptors that are located in the dopamine pathways of the
human brain. Atypical antipsychotics have been found to result in onset and progress of tardive
dyskinesia among patients (Loughlin et al., 2018). This refers to a disorder that leads to repetitive
and involuntary body movements that commonly comprise of sticking out of tongue, grimacing
or lip smacking. Research evidences have also associated administration of these drugs with an
increased risk of suffering from cardiovascular complications (Nazarinasab et al.,
2019). Amongst males, atypical antipsychotics have been found to decrease sexual interest,
besides leading to impairment in sexual performance, with the principal difficulties associated
with ejaculation. On the contrary, amongst females they result in abnormalities in the menstrual
cycle and infertility (Downing et al., 2019). Sexual adverse effects that are a direct manifestation

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of some antipsychotics such as, amisulpiride, risperidone and sulpiride, lead to an increase in the
secretion of prolactin (Park et al., 2016).
Psychoactive drugs have also been found to increase the risk of suffering from diabetes
mellitus and hyperglycaemia on their prolonged usage, thus calling for the need of carrying a
warning on the packaging and labelling (Nagata et al., 2018). Medications such as, olanzapine
and clozapine have been allied with decrease in insulin sensitivity, and gain in body weight,
followed by quetiapine and risperidone. Antidepressants are other psychotropic drugs that are
used for the management of major depressive disorder, chronic pain, and anxiety disorder.
However, paradoxical findings from Missouri in the USA elaborate on the fact that the
administration of antidepressant increases the risk of suicidal ideations in several patients,
particular early in children (Geller, 2019). Research evidences have concluded that there exists a
causal correlation between paediatrics suicidality and consumption of antidepressants, with an
augmented risk for aggression among the children (Brent, 2016). It is controversial whether an
increase in the risk of suicide ideations is predominantly due to the antidepressant medication
(paradoxical impact) or due to manifestation of the depression disorder. As claimed by reports
from the USA, tricyclic agents like sertraline and venlafaxine have been found to increase
attempted suicide risks in adolescents, who are severely depressed (Saade et al., 2019).
Mood stabilizers belong to another category of psychotropic medications that are used for
the treatment of mood disorders, predominantly characterized by sustained mood shifts like
schizoactive disorder, or bipolar disorder. Valproate, carbamazepine, and lamotrigine are some
common examples; however, these are also associated with controversies. Prolonged
administration of valproate results in drowsiness, dizziness, weakness, nausea, and vomiting. In
addition, it also leads to encephalopathy, a decrease in blood platelets, and the onset of suicidal