A refreshing perpective from a mental health medicine prescriber


I went to a seminar called ‘Mental Health Medications’ a few weeks ago and I thought it would be a good thing to summarize some of the ways the presenter tries to help her patients with medicine. Her name is Fran Miller RN, MSN, BC and I think she lives in Indiana.  I thought she was great and perhaps it will be helpful to readers to know that their are credible professionals out there that approach patients and medicine the way she does.

She always takes the time to explain to patients the theories of how medicines work and interact with other substances like alcohol which compete for your liver’s function.  She was careful to emphasize that these are theories and not ‘facts’, which is very rare to hear. She helps them understand the symptoms of their illness, the role of medicine in treatment, risks and benefits of medicines, risks of relapse, importance of healthy lifestyles, setting realistic goals to increase healthy lifestyles.

 These are the kind of things she says to patients :

     “We have to come up with a long term plan.”

        ” We are going to go low (initial dose) and slow (dose increase). Low and slow.” She always keeps in mind that adding another medicine also involves adding another set of side effects and risk.

         “You don’t have to put up with side effects.”  Imagine that! With meds that have a risk of weight gain, she weighs the patient every appointment. If they gain more than 10 pounds, she’ll change meds.

 She tells patients, ” You shouldn’t feel your medication , just be able to look back and notice a change.”  So many patients I see make this mistake of trying to ‘feel’ their meds. At best, if they are feeling something right away, they are side effects and placebo.

  Relapse rate  x5  if medication is discontinued without presecriber supervision. High rate of relapse within 5 years. Takes longer for patient to bounce back. Medication may not work as well. May need higher doses and/or additions of other meds. Many times, after relapse, patients do not return to previous level of functioning. Very demoralizing.

 “I keep searching. I never give up. I consult and refer as often as necessary.”

She pays a lot of attention to hormonal issues, which she feels is seriously neglected in psychiatry. ie. estrogen is essential for serotonin.

 She waits for patients to express this feeling,one way or another,

  ” I want to take this medicine.”

I think she rocks!

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