Dr. Siddiqui's Online Psychiatry Clinic

Do psychiatrists only treat by medication?

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No. Not necessarily. But, by the very nature and severity of the cases like psychoses, bipolar disorders , severe depression, they are called to manage., drugs do form a very important part of their management plans. Psychiatrists deal with the psychological as well as interpersonal nature of difficulties by psychotherapy, counselling, suggest appropriate changes in lifestyles by different types of talk therapies.

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Do I need medication?

 

That depends on your symptoms, their severity, the diagnosis, duration and impact on your overall level of functioning. 

Medication can help reduce the symptoms or help you cope with them better.Generally people use a combination of medication and other treatments, such as a talking treatment, to manage their condition

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Do psychiatrists treat only serious cases?

No. Psychiatrists evaluate and treat individuals with a wide range of difficulties.They also seal with the psychological aspects of social and medical conditions.

 

How long will I have to continue with the medicines?

 

This depends on your diagnosis and how severely the condition affects you.​ For some conditions (such as depression, or an episode of psychosis) you might only be expected take the medication for a specific period of time. If you have repeated episodes of mental ill health ( bipolar disorder or schizophrenia), your doctor might advise you to stay on your medication for several years, or indefinitely.

 

Who can prescribe psychiatric medication?

You can be prescribed psychiatric medication by: A Psychiatrist or a GP

 

What if someone refuses medicine?

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It could be because of anxiety, lack of information or a previous bad experience with medications. It may also be part of the underlying illness of a suspicions patient.

 

Will Medicines for sleep cause addiction?

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Pills for inducing sleep or restoring normal sleep are only given after a thorough history and mental state examination. They are prescribed for a limited time and no automatic refills are given.If used and tapered as advised by the treating doctor there will be no cause to worry. However if used in excess and for prolonged periods they can lead to dependence.

 

Are medications for lifetime?

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That depends on the diagnoses, duration of illness, degree of impairment.Anxieties, phobias, obsessive disorders and most depressions as well as stress induced emotional and behavioral disorders and first time acute psychotic episodes are very much responsive to short duration lasting weeks to months.Severe long standing disorders with poor compliance and lack of support systems as in cases of schizophrenia, bipolar disorder may need prolonged or continuous treatment to enable a reasonable level of functioning in the patient like self care, control of violent behavior.

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What are Long Acting Injections? What is their benefit?

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In patients who are non adherent to regular oral medicines, there is an existing burden on the care giver to give the medications daily twice or thrice or the patient is living alone.It ensures better compliance.From once in two weeks to once in three months preparations are available.They are also recommended on basis of research for first episode patients of psychoses for improving better outcomes.

 

Why many patients give up on their medications?

 

Intolerable side effects, too much sedation if on high doses , weight gain on certain medicines, inability to enjoy the unrestricted manic episodes once on medicines. Lack of information. Stigma associated with the diagnosis.

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How to manage a missed dose or extra dose?

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Try not to miss doses intentionally as the benefit of using the medicines regularly is decreased. Some short acting medicines may even cause withdrawal symptoms.If it is near the time of a missed dose you can take it But if it is near the time of the second dose avoid it. Do not double the dose.If you have taken double or more inform your doctor as soon as possible or immediately get in contact with health care service providers.Usually a double dose is unlikely to be harmful. Do not use a double dose unless advised by your doctor.

 

Can I break or crush the bigger pills to make it easy to swallow?

 

Not all pills, tablets, capsules are not supposed to be broken, crushed or powdered unless your doctor has advised so.

Some tablets, pills and capsules don't work properly or may be harmful if they're crushed or opened.They may need to be swallowed whole because:they're designed to release medicine slowly into your body over time and crushing them could cause an overdose your stomach acid could stop them working without their special coating they could be harmful to the lining of your stomach without their special coating they may taste unpleasant without their special coating you could get side effects from inhaling powder from crushed medicines If in doubt check with your doctor or pharmacist to avoid harm. Your doctor can prescribe alternatives in liquid form or a water soluble tablet.

 

Any special precautions in storing the medicines?

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Yes. In fact they must be stored away from reach of young and the elderly. The young may take them out of curiosity and not inform for fear of punishment whilst the elderly out of forgetfulness overdose themselves.

Keep safe in locked drawers and in separate pill boxes.Keep away from heat, moisture, humidity and light like any other medicines.

 

Any other suggestions?

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Yes. A few.

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• Medicines used under proper diagnosis and instructions give the maximum benefits.

• If they are started in low doses and slowly raised the side effects are minimal

• Do not take OTC without checking for interactions.

• Any new additions for other conditions will need a check for possible drug -drug interaction.

• Remember to inform your doctor.

• Keep a record of medications you use in your phone or e-mail.

• f you do not notice any benefit after 8-10 days check with your doctor. He may adjust the dose. If four weeks and still no benefit , your medicines need to be stopped and another alternative suggested.

• Remember! We, with all our advances have still a long way to go when tailor made medicines will be available.

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