Psychotropic Medicine | Nursing Assignment

Running head: NURSING ASSIGNMENT
NURSING ASSIGNMENT
Name of the Student
Name of the university
Author’s note

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Introduction
Psychotropic drugs are being used for the treatment of mental disorders. Two main types
of psychotropic drugs have been introduced for the treatment –some antidepressants and some
antipsychotic drugs. They normally work by inhibiting the dopaminergic neurotransmission.
Psychotropic drugs have been widely used in the treatment of a large number of mental disorders
like Schizophrenia and Schizoaffective disorder, acute mania, major depressive disorders,
delusional disorders and severe agitation, Tourette disorder, dementia and delirium as well as
substance abused psychotic disorder. But antipsychotics have been associated with significant
extrapyramidal side effects. As per the studies nearly one half of the medication errors has been
associated with the writing and the dispensing of the prescriptions which indicates that the
prescribers can work for reducing the errors.
This paper will critically discus about the controversies related to the use of the
Psychotropic medicine in the patients having behavioral disorders. The various controversies like
the use of psychotropic medicine as chemical restraints or their rampant use by the college
students for improving their academic skills. The assignment will also identify the challenging
aspect of the registered nurses administering psychotropic drugs to customer posing risk to
psychotropic medicines.
The controversy of the use of psychotropic medications to control behaviors and manage
symptoms for people who experience mental illness

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While there had been a lot of controversies regarding the application of the physical
restraints for managing behavior in patients. Chemical restraints are often used for controlling
the behavior of patients with mental health illness. Forced administration of psychotropic
medicines against the will of the patient and involuntary confinement of the patient in seclusion
or isolation has been adopted to prevent the free movement of the patients (McLaughlin, Giacco
& Priebe, 2016). Greater reliance on the psychotropic medicines have been found to create
several social as well as ethical concerns. Some of the concerns associated to the risk of
pharmacological interventions, like the paradoxical findings that children who are depressed and
are under antidepressants might have an increased risk of suicidal behavior relative to those
receiving the placebo. Some of the serious adverse effects can be associated with atypical
antipsychotics.
Many of the medicines are epileptogenic. Some might cause prolongation of the OTc
interval, prolonged arterial and ventricular contraction ad some anomalies in the cardiac
contraction. Allergic dermatitis and photosensitivity are the other side effects that can occur due
to the administration of the psychotropic medicines like Chlorpromazine (Chokhawala &
Stevens, 2019). Chlorpromazine has also found to be associated with blue-grey coloration of the
skin and can also cause pigmentation in the lens and the cornea. Some of the psychotropic
medicines can also cause pigmentation in the retina (Procyshyn, Bezchlibnyk-Butler and Jeffries
(2019). Drugs like Clozapine can cause hypersalivation, tachycardia, hypotension, and
anticholinergic side effects. They have also been found to be an important reason of hypertension
(De Fazio et al., 2016). Some of the drugs have been found to be showing some neuroleptic

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malignant symptom, causing increased temperature, confusion, muscular rigidity and an elevated
level of white blood count.
New ethical issues have raised around the use of the psychotropic ( like stimulants) for
enhancing the mental performance of the healthy people.
There is a controversy regarding the use of psychotic medicines for the enhancement of
studies among the college students. Psychotropic drug misuse among the college students is
variable among those studying in colleges are quite unpredictable and variable. A rampant usage
of the drugs like medications, including stimulants, benzodiazepines, and antidepressants are
seen among the college students for a variety of reasons like the enhancement of concentration
and studies.
Misuse of the psychotropic drugs have been found to be common among the college
students. According to a study consisting of 14175 students, from various campuses have
reported that 14.7 % of the students taking psychotropic medicines do so without any proper and
valid prescriptions (bt Mamat et al., 2015). The medicines taken by the college students includes
stimulus, antidepressants and anxiolytics and antidepressants. In has been reported in another
study that more than one third of the responders have reported the misuse of the psychotropic
drugs.
As stated by CARLSONAN and CROSSI (2019), the number of children all over the
world taking these prescription drugs has grown over the years. The current trends in the use of
the psychotropic medications from a large population based studies have shown the use of
psychotropic medicines by the pediatrics and the adolescents. Drugs are being purchased to treat
varieties of mental health conditions like autism or Attention-deficit hypersensitivity disorder.

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This has given rise to multiple controversies that ranges from the off-level use and long term
safety to debates from the societal values and the cultural meaning of pharmacological treatment
of the behavioral symptoms of childhood.
Another controversy or myth surrounding the use of psychotropic medicine is that many
claim psychotropic medicine to be addictive. Addictive behaviors can be defined by the intense
urges, loss of control, obsessions, urges and behaviors for satisfying the addiction. Robinson,
(2015) have refuted the fact and have stated that psychotropic medicines might be hypnotics, yet
they cannot be addictive. They do not create any dependencies. People are likely to face some
withdrawal symptoms. However, some of the withdrawal symptoms would include dizziness,
lethargy, headache, lethargy, nausea and sweating, insomnia, disturbed mood and restlessness.
Post-partum mental depression or depression at the time of pregnancy is common, and
there also had been controversy about the use of psychotropic medicines at the time of
pregnancy. Decisions about the use of these medications are affected by understanding the
adverse effects of these medicines causing loss of pregnancy, congenital malformations, neonatal
adaptation syndrome, persistent pulmonary hypertension and the occurrence of long term
neurocognitive disorders (Chisolm & Payne, 2016). Although some of the researches have raised
these concerns, but most of the other studies have refuted the findings and have noted that most
of the neonatal population are actually not risked by this (Robinson, 2015). Again, it has been
claimed that older people taking psychotropic drugs are more susceptible to falls.

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The challenging aspects for registered nurses who administer psychotropic medication to
the consumer
The registered nurses comprises of the large group of health professional who care for the
patients having mental health illness in the psychiatric field of service. This places them in the
crucial position to provide quality care while trying to manage the challenges that arise while
providing care to the psychiatric patients (Evans, Nizette & O’Brien, 2017). The psychiatric
nurses might face problems while administering psychotropic medicines to the clients, due to the
aggressive behavior of the patients, their non-compliance with the medications. The patient
family might have a predetermined notion about the addictive property of the psychotropic
medicines and might refuse to continue with the treatment. One of the other challenging aspect
are the side effects associated with the administration of such medications (Joubert & Bhagwan,
2018). The side effects can have deleterious effects on the health of the patient. Some of patients
with mental illness might deny any form of mental illness and the challenges associated with
exposure to the aggressive behavior of the patient. They are often exposed with the exposed
anger and frustration, which can be due to the side effects of the medicines. It is due to this that
the psychiatric nurses might face with burnout. Joubert and Bhagwan, (2018) have admitted that
in many cases the psychiatric nurses are not trained enough to deal with the mental health
patients as one needs to be extra careful while providing them with psychotropic medicines.
Any nurse using sedative medicines for putting restraints on the patient might give rise to
legal and ethical concerns. As per the Mental health law, both physical and chemical restraints
can only be applied as the last resort. Hence, this can bring about legal issues. Before
psychotropic medicine is being prescribed, the nurses should be able to conduct a thorough

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diagnostic assessment and reviewing of the medical history of the patient, like the past symptoms
and response to the treatment (Moxham et al., 2017). It is necessary to learn about the hopes,
concerns and motivations that is necessary for the development of the therapeutic relationship
with the patient. As mentioned in NMBA standards, RNs should be able to establish, sustain and
conclude a therapeutic relationship in a way which differentiate the barriers between the personal
relationships and the professionals (NMBA, 2017). Psychotropic medicines should only be
applied when they are clearly designated and when there is a strong evidence base. According to
Iseselo and Ambikile, (2017) in many circumstances combined pharmacological and non-
pharmacological interventions have been found to be of great therapeutic help.
Again, it has been already stated above, that the rate of the fall among the elderly mental
health patients under psychotropic medicines are susceptible to falls. Hence, the clinicians might
be cornered if any such incidences of falls can be due to the application of the psychotropic
medicines. Polypharmacy can be one of the risk of fall due to drug use. Use of multiple drugs
with the psychotropic drugs can be harmful and might cause side effects like delirium (Janus et
al., 2017).
Registered nurses needs to be kept updated with the empirical findings on all the
psychotropic treatments and the somatic treatments, along with their adverse effects,
contraindications, indications. Moreover, the clinicians needs to be prepared to recommend a
pertinent and data driven therapies and psychological interventions. It might be indicated as the
first line treatment or as essential adjunctive treatment. This is in compliance with the standard 1
of NMBA, which states that the RNs should think critically, analyze and use the best possible
evidences which includes the research findings for a safe and quality nursing practice (NMBA,
2017). Again, as per the standard 6 of NMBA, nurses should provide a comprehensive and safe

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quality of nursing as per the needs of people. Nurses should only administer the psychotropic
medicines after assessing the physical health of the patients.
Conclusion
In conclusion, it can be stated that the registered nurses are in a position to determine the
actual wellbeing of the mental health patients, by safe medication administration. Before the
administration of the psychotic medicines, it is necessary to inform the patient about the
medicine and seek consent from the patients. It is evident that patients who are mentally ill will
not be able to take proper health decisions on their own, hence registered nurses should advocate
on behalf of the mental health patients respecting the autonomy of the patients. Again, use of the
antidepressants at the time of pregnancy in the mental health patients should be done on the basis
of the risk- benefit analysis that is based on the evidence of the risk of treating or not treating
depression in the would be mothers (Robinson, 2015).

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References
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Carpenter, W. T. (2018). Clinical high risk controversies and challenge for the experts.
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