4.4.3 Monitoring

4.4.3 Monitoring

Monitoring

Drug monitoring in psychiatry refers to the process of regularly monitoring the effects and side effects of medications prescribed to patients with psychiatric disorders.

Efficacy:

Drug efficacy in psychiatry refers to the ability of a specific medication to produce a desired therapeutic effect in a patient with a psychiatric disorder. In other words, it is a measure of how well a medication works in treating a particular condition.

Drug efficacy can vary based on factors such as the type and severity of the disorder, the individual’s specific symptoms, their medical history, and other medications they are taking. The determination of drug efficacy is usually made through clinical trials and ongoing monitoring of patients taking the medication (Kirsh, 2008).

Tolerability:

Tolerability in psychiatry refers to the ability of a patient to tolerate the side effects of medication without experiencing significant distress or disruption to their daily life. Tolerability is a crucial consideration in the treatment of psychiatric disorders, as certain medications can cause unpleasant side effects that may interfere with a patient’s ability to adhere to the treatment plan.

The level of tolerability can vary between individuals and may be influenced by factors such as the type and severity of the disorder, the individual’s medical history, and other medications they are taking. When a medication is not well-tolerated, it can lead to decreased adherence to the treatment plan, and in some cases, may even worsen the patient’s condition.

Regular drug monitoring is essential in assessing the tolerability of medication and in making any necessary adjustments to the treatment plan to minimize side effects and ensure the best possible outcomes for the patient (Alexander, 2000).

Knowledge of Commonly Utilised Standardised Schedules

There are several commonly utilized standardized schedules in psychiatry that are used to assess a patient’s symptoms and monitor the effectiveness of treatment. Some of the most commonly used include:

  1. The MINI International Neuropsychiatric Interview (MINI): a structured diagnostic interview used to assess symptoms and make diagnoses for various psychiatric conditions.
  2. The Hamilton Rating Scale for Depression (HAM-D): a widely used assessment tool for evaluating the severity of depression in patients.
  3. The Young Mania Rating Scale (YMRS): a standardized assessment tool used to evaluate the severity of symptoms in patients with mania or bipolar disorder.
  4. The Clinical Global Impression Scale (CGI): a rating scale used to assess the overall severity of a patient’s illness, as well as their improvement or worsening over time.
  5. The PANSS (Positive and Negative Syndrome Scale): a standardized rating scale used to assess the symptoms of patients with schizophrenia.

References:

(1) Alexander GC, Gallagher SA, Mascola A, et al. Antidepressant side effects: a review of the literature. J Clin Psychiatry. 2000;61 Suppl 2:22-32.

(2) Kirsh B, Berk M. Antidepressant efficacy of new-generation antidepressants: a meta-analysis of 1897 participants in 14 randomized controlled trials. J Affect Disord. 2008 Jul;107(1-3):13-23. doi: 10.1016/j.jad.2007.10.001.