Free Assignment on Psychotropic Medications

Running head: PSYCHOTROPIC MEDICATIONS
Mental healthcare medication and challenges
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Introduction
Psychotropic medication consists of a wide range of drugs that function by altering the levels
of chemicals in the brain or neurotransmitters such as serotonin, dopamine, norepinephrine
and similar chemicals. The psychotropic medications can be classified into five major groups,
namely antidepressants, antipsychotics, stimulants, anti-anxiety drugs and mood stabilizers.
Some of these may also lead to severe ill-effects and are administered only under the
supervision of healthcare providers. Medical experts are increasingly prescribing
psychotropic medications to patients with mental illnesses. This is because these drugs target
the central nervous system of the individual, reduce the behavioral symptoms exhibited by
the patient, improving the prognosis of the treatment and the overall health status of the
person. Despite the useful nature of these medications, evidence display that the adherence of
patients with mental diseases to these medications is considered low. A possible explanation
for low adherence can be the associated side-effects. Some of the most common adverse
effects include weight gain, fatigue, sleep disturbances, appetite modifications and emotional
swings (Ferreira et al., 2017).
Along with the benefits of using psychotropic drugs for controlling the symptoms of mental
diseases, it is accompanied by various side-effects and mismanagement on the part of the
healthcare providers. Often, high doses of a multitude of these drugs are prescribed for
prolonged periods without sufficient follow-up with its efficacy. These reasons, a mixture of
the benefits and associated challenges, have led to the controversy regarding the use of
psychotropic drugs and sedatives to control the signs and symptoms in people with mental
conditions (Goldacre, 2012). This paper critically discusses the controversy regarding the use
of psychotropic drugs to control the behavioral symptoms of people experiencing mental

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disorders and the challenges faced by nursing professionals in the administration of these
drugs to the consumers possessing severe harm to themselves as well as others.
Controversy to the use of psychotropic medications
Prescribed psychotropic medications and sedatives are chief elements in the treatment of
many mental diseases and controlling the symptoms of co-occurring disorders. They are
known to reduce the symptoms and lower the occurrences of relapses of the disease and
keeps the symptoms under control. This is demonstrated by various placebo-controlled trials
as well. For instance, antidepressants like selective serotonin reuptake inhibitors (SSRIs) are
persistent in reducing the symptoms of depression by 60% on average. It is known to result in
total remission in a considerable count of patients. Similar medications have been prepared
and tested for significant mental diseases with mild or moderate disorders. Effective
medication is a crucial element of the treatment plan for people with more severe or long-
term symptoms of mental illness.
Essential psychotropic drugs are the medicines satisfying the mental health care requirements
that are of priority in a population. These drugs are classified with due regard to their
relevance to the public health, evidence of safety and efficacy, and relative cost-effectiveness.
These medications must be available for functional mental health delivery systems in
sufficient quantities all the time in suitable doses, with quality assurance and the requisite
details, and at an affordable cost to the people and the community. These medicines enable
the control and treatment of many symptoms of mental conditions, reduce the term of the
course of several diseases, decrease morbidity and prevent associated relapses (Apps.who.int,
2020). Significant treatment options are present for the psychotropic management of mental
health diseases. Majority of these treatments demonstrate efficacy in critical stages and to
prevent the chances of relapses. However, their effectiveness in long-standing treatment plans

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and in the management of daily mental issues remain unclear. Some drugs including
fluphenazine, chlorpromazine, amitriptyline, haloperidol, and diazepam are considered as
examples of the group of drugs with the most reliable evidence for safety and efficacy
(Masopust et al., 2018).
However, some experts believe that psychotropic medications cause more harm than benefit
and the. Also, the majority of the sedatives and antidepressants are not necessarily required
and can be virtually discontinued without significant trouble. Some also argue that the
advantages and utilities of these drugs are overemphasised and their associated dangers
understated as the results of the randomised controlled trials of these drugs are biased, may
not be properly blinded, the effects of the medications lack evaluation and many adverse
effects may go under reported (the Guardian, 2020). For instance, many studies involve
patients already using a psychiatric medications and these people may undergo abstinence or
suffer from symptoms of withdrawal. Thus, various studies exaggerate the advantages and
effects of psychotropic treatments and sedatives which may increase the adversities of the
placebo group. Besides, various trials funded industrially have reported fewer deaths than the
reality, estimating a probable 15 times higher suicide rate among patients on antidepressants
than stated (Gøtzsche, Young & Crace, 2015).
Another reason for the rising controversy regarding the use of psychotropic medications,
particularly sedatives to control behavioral symptoms is dependency and the subsequent
withdrawal symptoms. Development of Dependency is observed when the patient gets
physically dependent, also known as addiction on the prescribed sedative and cannot function
logically in its absence. Regular doses of the medication lead to dependency which can be
detected when the person cannot stop taking the drug. This may become evident if the patient
takes the medicine beyond the prescribed or safety level of the dose (Miller & Rollnick,
2012). Dependence can also be noted when the patient requires a higher dosage than the

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previous ones to experience the same effect. This implies that the body of the individual has
got used to the drug and will require more doses to attain the expected effect (Weaver, 2015).
Experts argue that the dependency is mostly ended with the occurrence of withdrawal
symptoms. It is the manner in which the body responds in the absence of the sedative
medicines and include painful physical as well as mental symptoms. Other widespread
withdrawal symptoms are increased anxiety, irritability and difficulties in sleeping. The most
dangerous symptoms which is the main concern regarding the debate on the use of
psychotropics such as sedatives is seizures in absence of high doses of sedatives that the body
is accustomed to (Santos et al., 2017). In additions, these medicines also face oppositions as
they seem to affect the elderly, pregnant women, breast-feeding females and adolescents. The
dependency of these drugs cause severe risks during these conditions.
However, again these arguments of dependency are counter-argues and explained by the
individuals supporting the use of psychtropics to control and manage the behavioural signs of
mental diseases. They explain that the effects of psychiatric sedatives for mental illnesses
may require several days to a few weeks to occur, and some months for their complete
efficacy to be experienced by the individual. As soon as the mental disease gets stabilized
over a few months, the dosage must be taken for about six to eight months. People
experiencing anxiety and disorders can gradually taper the dose and eventually discontinue
the medication, on the basis of severity of the symptoms of the mental health disorder.
Besides, it is also argued that individuals affected with psychotic disorders and bipolar
disorders can benefit from continuing the prescribed psychotropic medications for a
comparatively much longer duration of time, throughout the time-time as well. However,
some research studies reveal that relapse of symptoms of the mental health disorder repeats
within one year of discontinuation of doses in these kinds of mental diseases.

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Challenges for registered nurses to administer psychotropic medications
The existing mental healthcare system of Australia struggles to provide adequate care in its
services as required. The fundament reasons for this include limited resources, biases
experienced from the public, and the complexities associated with the treatment of several
patients or populations suffering from mental diseases (Sobekwa & Arunachallam, 2015).
Nurses responsible for providing mental healthcare services, also called mental health nurses
or psychiatric nurses, face similar biases and complexities in their role, specifically in the
administration of the psychotropic doses of medications prescribed to the patients. As the
nursing professionals constitute one of the largest category of health care workers responsible
for mental health care consumers in the field of psychiatric services, they are positioned at the
essential juncture in delivering quality care while also making efforts for managing the
challenges arising with this group of patients. While the duties of mental health care nurses is
recieving increasing attention, fewer studies discuss the roles and associated challenges
experienced by registered nurses in mental care at local mental health care settings (Joubert &
Bhagwan, 2018).
Some of the most common and fundamental challenges faced by the majority of the
registered nurses in dealing with patients susceptible to self-harm or harm to others are denial
of mental problems by the patients, exposure to the unpredictable behaviour of the patients,
high levels of violence and aggression among patients and ethical and public controversy in
administering psychotropic drugs. Each of these challenges are described in detail in the
following sections.
Patient denial of mental health disorder: one of the most widespread challenges faced by
registered mental health nurses to administer the required doses of medications to patients
posing severe danger is the denial of the patient in accepting the mental illness. It causes a

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serious barrier to accessing quality care and treatment for recovery. This challenge also
influences the practices of the health care providers, such as nurses themselves and negatively
mediates their working behaviour and environment. As a result of denial, the patient does not
realize the potential harm they may pose to themselves as well as their surroundings (Knaak,
Mantler & Szeto, 2017).
Exposure to the unpredictable behaviour of the patients: Patients with mental diseases exhibit
reduced functional capacity of the brain. As a result, their behaviours are unpredictable and
often cause serious distress to the assigned nurses. They require continuous monitoring of the
mental health nurses and resulting negative experiences reported by the nurses. These
behaviours are specifically adverse in acute care settings. This challenge is one of the reasons
that many nurses do not prefer services in these settings. The behaviours of the patients are
unpredictable as the mental condition of each patient is different (Roughead et al., 2017).
High levels of violence and aggression among patients: The violent nature of patients
suffering from mental illnesses is a major reason for their potential harm to themselves as
well as their surroundings. This is a severe challenge faced by the nurses working in these
departments as the patients often lead to physical injuries (Schablon et al., 2018). Some of
these violent behaviours may result in severe abuses, assaults, and threats to the environment.
The nurses are at the highest risk to these circumstances and face physical and verbal abuse
which often results in distress of the nursing professionals (Rudkjoebing et al., 2020).
Ethical and public controversy in administering psychotropic drugs: apart from the distress
faced from the patients, mental health nurses also experience challenges in administering
psychiatric medications to their patients from their family members and some public health
workers opposing the use of psychotropics. Many family members firmly refuse the doses of

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sedatives and other psychiatric medicines to the patients (Borsje et al., 2018). The nurses are
required to explain the significance to these individuals and persuade them for the drugs.
Conclusion
In conclusion, clinicians prescribe psychotropic drugs to control the behavioural symptoms of
their patients and manage mental health disorders effectively. These medications lower the
functional activity of the brain and inhibit the actions of the person. In contrast, these drugs
receive significant opposition regarding their usage and the associated adverse effects which
lead to a controversy regarding the efficacy and safety of these psychotropic and sedative
drugs. The proportion of patients with mental disabilities that have been successfully treated
with adequate doses of psychotropic drugs far exceeds those with reported mental diseases.
Antipsychotic medications are frequently prescribed to the patients even in the absence of
serious mental health disorders to those reported of challenging behaviours. studies suggest
that modifications are required in the prescription of psychotropics to these patients.
However, greater evidence is required regarding the efficacy and safety of these medications
in a broader patient population, particularly the after-effects of discontinuing the drugs and
the challenges presented to the nursing professionals in mental health care services in
delivering care to the mentally ill patients.

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References
Apps.who.int. (2020). Retrieved 25 March 2020, from
https://apps.who.int/iris/bitstream/handle/10665/44095/9789241547697_eng.pdf;jsess
ionid=308AB8924DFB8448B2231FB667875BEC?sequence=1
Borsje, P., Lucassen, P. L., Wetzels, R. B., Pot, A. M., & Koopmans, R. T. (2018).
Neuropsychiatric symptoms and psychotropic drug use in patients with dementia in
general practices. Family practice, 35(1), 22-28.
Ferreira, A. C. Z., Brusamarello, T., Capistrano, F. C., Marin, M. J. S., & Maftum, M. A.
(2017). The experience of mental disorder patients using psychotropic medication
under the perspective of complex thinking. Texto Contexto Enferm, 26(3), e1000016.
Goldacre, B. (2012). Bad pharma: how medicine is broken, and how we can fix it.
HarperCollins UK.
Gøtzsche, P. C., Young, A. H., & Crace, J. (2015). Does long term use of psychiatric drugs
cause more harm than good?. Bmj, 350, h2435.
Joubert, P. D., & Bhagwan, R. (2018). An empirical study of the challenging roles of
psychiatric nurses at in-patient psychiatric facilities and its implications for nursing
education. International journal of Africa nursing sciences, 9, 49-56.
Knaak, S., Mantler, E., & Szeto, A. (2017, March). Mental illness-related stigma in
healthcare: Barriers to access and care and evidence-based solutions. In Healthcare
management forum (Vol. 30, No. 2, pp. 111-116). Sage CA: Los Angeles, CA: SAGE
Publications.

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Masopust, J., Protopopová, D., Vališ, M., Pavelek, Z., & Klímová, B. (2018). Treatment of
behavioral and psychological symptoms of dementias with psychopharmaceuticals: a
review. Neuropsychiatric disease and treatment, 14, 1211.
Miller, W. R., & Rollnick, S. (2012). Motivational interviewing: Helping people change
(applications of motivational interviewing). New York: Guilford.
Roughead, L., Procter, N., Westaway, K., Sluggett, J., & Alderman, C. (2017). Medication
safety in mental health. ACSQHC: Sydney, NSW, Australia.
Rudkjoebing, L. A., Bungum, A. B., Flachs, E. M., Eller, N. H., Borritz, M., Aust, B., ... &
Bonde, J. P. (2020). Work-related exposure to violence or threats and risk of mental
disorders and symptoms: a systematic review and meta-analysis. Scandinavian
journal of work, environment and health.
Santos, C., Olmedo, R. E., & Kim, J. (2017). Sedative-hypnotic drug withdrawal syndrome:
recognition and treatment [digest]. Emergency medicine practice, 19(3 Suppl Points
& Pearls), S1-S2.
Schablon, A., Wendeler, D., Kozak, A., Nienhaus, A., & Steinke, S. (2018). Prevalence and
consequences of aggression and violence towards nursing and care staff in Germany
—A survey. International journal of environmental research and public health, 15(6),
1274.
Sobekwa, Z. C., & Arunachallam, S. (2015). Experiences of nurses caring for mental health
care users in an acute admission unit at a psychiatric hospital in the Western Cape
Province. Curationis, 38(2), 1-9.

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the Guardian. (2020). Psychiatric drugs do more harm than good, says expert. Retrieved 25
March 2020, from https://www.theguardian.com/society/2015/may/12/psychiatric-
drugs-more-harm-than-good-expert.
Weaver, M. F. (2015). Focus: Addiction: Prescription Sedative Misuse and Abuse. The Yale
journal of biology and medicine, 88(3), 247.