National Alliance on Mental Illness
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Psychiatrists Pose Five Questions About Antipsychotic Medications
By Bob Carolla, NAMI Communications Director
The American Psychiatric Association (APA) has released a list of five uses of antipsychotic medications that are “common, but potentially unnecessary and sometimes harmful,” as part of a broader Choosing Wisely campaign by over 30 specialties in the medical profession.
The APA encourages people taking antipsychotic medications or their caregivers to discuss treatment options with their psychiatrists to confirm whether medications being prescribed are really necessary. The APA’s list of Five Things Physicians and Patients Should Question includes:
NAMI Medical Director, Ken Duckworth, M.D., warns that no one should change, adjust or discontinue a prescribed medication without consulting their doctor. At that same time, he goes further in outlining issues that should be discussed:
The APA recommendations are intended to “start important conversations about treatment options and make informed choices,” said Jeffrey Lieberman, M.D. APA President. "This is not to preclude the use of antipsychotic medications for these indications and populations, but to suggest that other treatment options should be considered first and patients should be engaged in discussion of the rationale for use and the potential benefits and risks."
“Antipsychotic medications have tremendous benefits and improve the quality of life for many people with serious mental illness; however, they carry risks including potentially harmful side effects. Unnecessary use or overuse of antipsychotics can contribute to chronic health problems, such as metabolic, neuromuscular, or cardiovascular problems, in people with serious mental illness,” said Joel Yager, M.D., Chair of the APA Council on Quality Care.
“Because of these risks, APA has recommended that antipsychotics should not be used routinely, and should never be used without considerable thought, good clinical reasoning, and discussion with patients as to why under particular circumstances such a course would be preferable to alternative options.”
The Choosing Wisely campaign is sponsored by the ABIM Foundation and is dedicated to “helping physicians and patients engage in conversations to reduce overuse of tests and procedures and support physician efforts to help patients make smart and effective care choices.”