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Why you have a key role in monitoring antidepressant use

For mental health nurses, reconciling safety, effectiveness, tolerability and patient choice when it comes to medicines is an integral skill and a complex one. The prescription of psychotropic medications remains high and antidepressants are now one of the most prescribed drug groups nationally.  Nurses have a clear role in medicines management, but this can be challenging in terms of managing risk, as well as promoting choice and recovery.

Antidepressants are one of the most prescribed drugs and the management and monitoring of such psychotropic medications is a challenge for mental health nurses

Applying the principles of recovery to the management of psychotropic medications such as antidepressants can generate passionate debate. Illustration shows unhappy faces on the outside of a circle of antidepressants which has an inner circle of smiling faces.
Applying the principles of recovery to the management of psychotropic medications such as antidepressants can generate passionate debate Picture: iStock

Mental health nursing has evolved to adopt and promote principles of person-centeredness and recovery.

With this evolution, nursing has become a biopsychosocial endeavour, taking a holistic view of individual experiences to address, not just symptoms, but social circumstances and, more broadly, quality of life.

‘For mental health nurses, reconciling safety, effectiveness, tolerability and patient choice when it comes to medicines is an integral skill, and an increasingly complex one’

Despite this, pharmacological treatment remains a first-line intervention for many diagnoses. A focus on adherence over choice often remains a primary focus, and significant side effects are an acknowledged but accepted risk.  

Applying the principles of recovery to the management of psychotropic medications can generate passionate debate.

Community Mental Health Framework advocates for non-pharmacological choices

In what is often a binary discourse, there can be a perceived notion that patients and clinicians are either ‘pro’ or ‘anti’ medication. The reality of practice is much more nuanced. For mental health nurses, reconciling safety, effectiveness, tolerability and patient choice when it comes to medicines is an integral skill, and an increasingly complex one.

The Community Mental Health Framework for Adults and Older Adults is being implemented across England, and advocates for a range of non-pharmacological approaches to common mental health issues, especially in primary care.

Despite this, prescription of psychotropic medications remains high and the use of antidepressants is particularly prolific. The most recent quarterly figures for England have confirmed a 1.5% increase in antidepressant prescribing just between April and June of this year, with 23 million antidepressant items being prescribed to an estimated 6.9 million patients.

Antidepressants are now one of the most prescribed drug groups nationally. 

Mental health nurses have a clear role in medicines management, but this can be challenging in a complex clinical landscape of widespread prescribing.

My CPD article Monitoring the use of antidepressants: the role of mental health nurses aims to support you in refreshing your antidepressant knowledge and considering your role in terms of managing risk, as well as promoting choice and recovery.


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