- Joined
- Feb 8, 2004
- Messages
- 8,026
- Reaction score
- 4,167
Here are some of mine.
Lamotrigine: I explained to the patient the risks of the medication including the need to take as prescribed, possible rash, and Stevens-Johnson Syndrome. The patient was informed that if they experience a rash to call me immediately and that if the medication is not taken consistently it cannot simply be resumed at the prior dosage and to call me to see if it can be restarted.
Benzodiazepines: The risks and benefits of benzodiazepines were discussed with the patient including that this medication class is addictive, mixing with alcohol and/or opioids could be dangerous, their use should be limited (with few exceptions), and with continued use their benefits are less and less because the body will develop a tolerance and possible dependence on them. The possible risks discussed included dementia, poor memory, and worsened sleep quality. Pt was recommended to learn more about the medication from reliable sources such as medlineplus.gov, or the FDA.
Controlled Substances:
You were prescribed a controlled substance and their use requires several responsibilities including not to mix it with alcohol, not to drive on the medication or use heavy machinery unless you are confident it is not affecting your ability to do so, if you want a professional level evaluation to see if you can drive on the substance you need to be evaluated by a local department of motor vehicles office while under the influence of that medication, and that it is your responsibility to monitor yourself with these medications because I cannot follow you 24/7. If you lose a controlled substance there is a high likelihood I will not allow a refill prescription and even if I did your pharmacy might refuse it to be filled. If you are arrested or otherwise in question of having violated the law, I may have to stop prescribing you a controlled substance until I am reasonably certain the controlled substance was not connected with the crime in question. You must carry medications within their prescription bottle while out in the public. You cannot share these medications with other people. Keep any medications, but especially controlled substances, in a safe place where others will not be able to access them. You should make efforts consistently to use the same pharmacy to pick up controlled substances. Going to multiple doctors for several controlled substances and going to several different pharmacies to pick them up can sometimes be interpreted as "doctor-shopping."
Guns:
Due to the patient living in a setting with a firearm, I told the patient that firearms should be kept in accordance to federal, state, and local laws, guns should be kept locked, and ammunition should be kept in a separate location to reduce risk of accidental use or suicide, and that I could not monitor their safety once they leave my office. Further several medications including all psychotropic medications could cause suicidal ideation (although very rare) as a side effect and access to a firearm while suicidal is extremely dangerous. Therefore trying any psychiatric medication while in possession of a firearm should be handled accordingly by the patient because I will not be able to be with the patient to monitor them while trying a new medication. It is the patient's responsibility to incur the risk of trying a new psychiatric medication while in possession of a firearm and take the necessary and reasonable measures such as consideration of placing the firearm out of their access when trying a new medication until the doctor and patient are reasonably certain of the effect that medication has on that specific person.
Lamotrigine: I explained to the patient the risks of the medication including the need to take as prescribed, possible rash, and Stevens-Johnson Syndrome. The patient was informed that if they experience a rash to call me immediately and that if the medication is not taken consistently it cannot simply be resumed at the prior dosage and to call me to see if it can be restarted.
Benzodiazepines: The risks and benefits of benzodiazepines were discussed with the patient including that this medication class is addictive, mixing with alcohol and/or opioids could be dangerous, their use should be limited (with few exceptions), and with continued use their benefits are less and less because the body will develop a tolerance and possible dependence on them. The possible risks discussed included dementia, poor memory, and worsened sleep quality. Pt was recommended to learn more about the medication from reliable sources such as medlineplus.gov, or the FDA.
Controlled Substances:
You were prescribed a controlled substance and their use requires several responsibilities including not to mix it with alcohol, not to drive on the medication or use heavy machinery unless you are confident it is not affecting your ability to do so, if you want a professional level evaluation to see if you can drive on the substance you need to be evaluated by a local department of motor vehicles office while under the influence of that medication, and that it is your responsibility to monitor yourself with these medications because I cannot follow you 24/7. If you lose a controlled substance there is a high likelihood I will not allow a refill prescription and even if I did your pharmacy might refuse it to be filled. If you are arrested or otherwise in question of having violated the law, I may have to stop prescribing you a controlled substance until I am reasonably certain the controlled substance was not connected with the crime in question. You must carry medications within their prescription bottle while out in the public. You cannot share these medications with other people. Keep any medications, but especially controlled substances, in a safe place where others will not be able to access them. You should make efforts consistently to use the same pharmacy to pick up controlled substances. Going to multiple doctors for several controlled substances and going to several different pharmacies to pick them up can sometimes be interpreted as "doctor-shopping."
Guns:
Due to the patient living in a setting with a firearm, I told the patient that firearms should be kept in accordance to federal, state, and local laws, guns should be kept locked, and ammunition should be kept in a separate location to reduce risk of accidental use or suicide, and that I could not monitor their safety once they leave my office. Further several medications including all psychotropic medications could cause suicidal ideation (although very rare) as a side effect and access to a firearm while suicidal is extremely dangerous. Therefore trying any psychiatric medication while in possession of a firearm should be handled accordingly by the patient because I will not be able to be with the patient to monitor them while trying a new medication. It is the patient's responsibility to incur the risk of trying a new psychiatric medication while in possession of a firearm and take the necessary and reasonable measures such as consideration of placing the firearm out of their access when trying a new medication until the doctor and patient are reasonably certain of the effect that medication has on that specific person.
