By KEVIN SPURGAITIS
HAMILTON, Bermuda — Recent mental health advances have alleviated side effects associated with patients’ treatment. But research shows newer drugs are still far from being a “cure-all.”
The latest anti-psychotic and anti-depressant medications are not associated with the type of side effects patients usually endure during therapy, according to Dr. Dale Harrison, chief psychiatrist at St. Brendan’s Hospital. New medication for depression and psychosis has undergone trials to drastically reduce patient’s discomfort.
“In Bermuda, we are quite fortunate to have good access to wide varieties of medication. We use both traditional and newer medicine to treat patients,” said Dr. Harrison.
Although proven effective in controlling painful symptoms of mental illnesses, almost all psychiatric medicine produces unwanted side effects.The American Psychiatric Association (APS) states patients prescribed traditional anti-psychotic drugs such as haloperidol, thioridazine and chlorpromazine, are likely to experience drowsiness, blurred vision and dry mouth as well difficulty in urinating. In severe cases, between one and eight per cent of patients develop extrapyramidal (EPS) symptoms: involuntary muscle movements including spasms in the face and neck, as well as tremours in the hands.
Though treatable with counter-acting medication, the ordeal sometimes results in a patient’s refusal of therapy. And this non-compliance, more often than not, leads to a relapse in their illness, research reveals. However, St. Brendan’s has started to stock “atypical” (second generation) medication, such as quetiapine and clozapine. Both new drugs are effective in preventing hallucinations and delusions and less likely to cause EPS side effects, according to a review by the Medical Letter on Drugs and Therapeutics. The non-profit publication evaluates therapeutic and adverse effects of medication periodically put out by pharmaceutical companies.
For the most, the latest medicine is tolerated by more patients, but clinical trials showed users of quetiapine still suffered from chronic fatigue, dry mouth and even weight gain. Clozapine may also prevent the production of white blood cells needed to protect the body from infections. As a result, clozapine can become quite expensive for hospitals, because it requires constant blood screening of its users. Psychiatrists at St. Brendan’s have limited the medication in small dosages at this time.
Nonetheless, the mentally ill still fare far better under prescribed drugs than patients with physical conditions. The APS reports the treatment of disorders such as depression, panic disorder and schizophrenia, is more successful than those of other medical conditions like heart disease, which experiences a recovery rate of under 50 per cent.
“The types of medication used in this day and age to treat mental health illness are far less debilitating than before,” said Glenn Caisey, St. Brendan’s mental health program manager.
Mr. Caisey stressed medical evaluations and laboratory tests still need to be conducted by hospital staff, before any new psychiatric medication is prescribed. A psychiatrist or a patient’s case manager must then closely monitor a patient’s receptiveness to treatment, and their tolerance of its side effects.The monitoring of the effects of medication “goes hand and glove” with the person being treated, according to Mr. Caisey. He said if a person has an undesirable reaction to medicine, the hospital will intervene by reducing a patient’s dosage or changing the medication altogether.
“No one is going to give someone an amount of medication that will be detrimental to that person’s well being.”
Still, Dr. Harrison maintained the benefits of new and improved treatment outweigh the risks.
“The hospital’s pharmacy will continue to be updated as advances in anti-psychotic and anti-depressant medications are made.”
Originally published in the Bermuda Sun, November 2000
