Is there a way to combine pharmacy and psychology? I love psychology and was always interested on studying the effect of psychotropic drugs on people, when it is effective, overused, abused etc.
Can pharmacists work with psychologists or psychiatrists in such manner, or participate in research related to this?
Thank you in advance for your feedback.
Google up Pfizerpharmacyguide, chapter 25.
chapter twenty-five
psychiatric pharmacist
A TRUE TALE
Each year, 23 percent of adult Americans suffer from diagnosable mental
disorders, of which anxiety disorders are the most common. Four of the ten
leading causes of disability in the United States are mental disorders and
approximately a fourth of total hospital admissions in the U.S. are psychiatric
admissions.
As startling as these statistics may seem, the bright side is that ongoing
research in this area has led to increasingly successful treatment for a growing
number of affected people. Most people with
mental illness recover well with appropriate
ongoing treatment and support. On the team
for treating these types of conditions are
psychiatric pharmacists like Sara Grimsley
Augustin, PharmD, BCPP.
No one in Sara Grimsley Augustin's family
ever had any connection to pharmacy. Her
mom is a teacher and her dad is a game
warden. Her stepfather is an accountant and
her stepmother is a banker. But the 36-yearold,
eldest of three girls and native of the
small town of Waverly, Tennessee was always
interested in science. She chose pharmacy, among the various healthcare related
professions she was considering, during her first year of undergraduate studies
at the University of Tennessee at Knoxville. Although that choice was made
rather quickly, as she was feeling pressure to declare a major, she's never
been sorry. "Pharmacy turned out to be the perfect career choice for me."
Dr. Augustin enrolled in Mercer University Southern School of Pharmacy in
Atlanta in 1985. In 1989, she received her doctorate degree in pharmacy
(while working for three years part-time at Boyles Drug Company in Atlanta)
and in the next year completed a post-doctoral residency in psychiatric
pharmacy there. Since then she has been on the faculty. She became a board
certified psychiatric pharmacist (BCPP) in February 1997.
Profiling the job
It wasn't until her last year of pharmacy school, during her clinical psychiatry
clerkship, that Dr. Augustin found her true niche in pharmacy: dealing with
the pharmaceutical care needs of mentally ill patients. Although she had
always been fascinated by psychology and psychiatry, she wasn't previously
aware of this area of specialization in pharmacy. She quickly learned about
the many activities psychiatric pharmacists can be involved in and realized
this was the specialty for her. "Psychiatric pharmacists can have a real
impact on patients, providing education about medications, monitoring for
side effects of medications, and making recommendations to improve the
outcomes of drug therapy," she says. A big problem in the area of psychiatry
is that mentally ill individuals often stop taking the medications, which are
necessary for the control of chronic illnesses, such as schizophrenia and
bipolar disorder. Whether because of
adverse effects, poor understanding
of a medication's potential benefits,
or poor recognition of their illness,
non-compliance signals a gap in
treatment. Pharmacists can play
a vital role in filling this gap by
identifying and addressing reasons
for the discontinuation of pharmacotherapy,
leading cause of relapse
of mental illness and hospitalization.
A day in the life
Dr. Augustin's area of practice in psychiatric pharmacy involves a lot of
teaching. In fact, much of her week is devoted to teaching fourth-year
pharmacy students in the clinical psychiatry clerkship program at the
Georgia Regional Hospital of Atlanta, a 250-bed state psychiatric facility.
This is an elective advanced practice experience, and four to six students
usually sign up for the clerkship she precepts each five-week session. While
Dr. Augustin works for the pharmacy school, she uses the hospital, which
is 20 minutes away, as a training site. Her students go there every day;
Dr. Augustin meets them there several days a week. Under her direction,
students become experienced at interacting with and providing medication
counseling to the psychiatric patients there. They also learn to work with
members of the treatment team (comprising psychiatrists, psychologists,
nurses, social workers, activity therapists, and other staff) to develop and
carry out the individualized treatment plan for each patient. Various units
throughout the hospital are designated for treating specialized psychiatric
populations, such as children, adolescents, developmentally disabled clients,
the elderly, and those with substance abuse problems. Currently, the adult
forensic psychiatry units are frequently utilized for student clerkship training.
These units are devoted to treating patients with legal issues, such as those
found not guilty of a crime for reasons of insanity or those deemed incompetent
to stand trial because of their mental illness. "One of the most important
things students learn on this rotation is to give up the stereotypic fears about
people who are mentally ill. They
quickly realize that even psychotic
criminals are human beings with
medically treatable conditions and
deserve to be dealt with honestly,
respectfully and compassionately."
Other activities of the clerkship
include conducting patient medication
education groups and attending
group meetings on specific topics,
such as depression, anxiety disorders, substance abuse, schizophrenia,
and epilepsy, during which students present patient cases for discussion.
These meetings are held two to three times weekly with Dr. Augustin or
her colleague.
Dr. Augustin also teaches a number of psychiatry and neurology-related
courses to second and third-year students. Her lecture topics include obsessivecompulsive
disorder, panic disorder, post-traumatic stress disorder, social
anxiety disorder, postpartum depression, premenstrual dysphoric disorder,
insomnia, narcolepsy, anorexia and bulimia nervosa, obesity, weight loss
and seizure disorders. She is faculty coordinator for the required clinical
pharmacokinetics course and teaches the pharmacokinetics of antidepressants,
lithium, and anticonvulsants in that course. Dr. Augustin also teaches an
elective substance abuse course, in which she lectures on alcoholism, drug
testing, and abuse of substances such as cocaine, amphetamines, ecstasy,
heroin, inhalants, anabolic steroids, and prescription medications.
Because she teaches different courses, Dr. Augustin's classroom teaching
load is much heavier at certain times of the year. Sometimes she teaches four
hours a day four days a week, sometimes she doesn't teach for weeks. "I'm
on whenever my topic comes up," she says. There are about 520 pharmacy
students in the pharmacy program. Dr. Augustin will ultimately teach every
one of them.
With such a focus on teaching psychiatric pharmacy, Dr. Augustin's work
largely reflects that of an academic. She also conducts research, writes papers
for publication in professional pharmacy journals and textbooks, and serves
on various committees of the pharmacy school, such as the Curriculum
Committee, the Admissions Interview Committee, and the Honors Awards
and Scholarships Committee. But the part she likes best is teaching psychiatric
issues, particularly helping students gain a better understanding of various
mental illnesses and their treatments. Dr. Augustin has enormous freedom,
doesn't overwork ("I probably average 45 hours a week," she says), has
excellent benefits and vacation (22 days a year), and is constantly stimulated.
"My job allows me to continue learning. I must keep up with what is current."
Dr. Augustin is a member of several professional pharmacy organizations,
using her expertise in psychiatry to serve as a reviewer for manuscripts submitted
for publication in a variety of pharmacy journals. She is a member
of the national Board of Pharmaceutical Specialties Council on Psychiatric
Pharmacy, which is responsible for developing and administering standards
for board certification in psychiatric pharmacy. There are currently
352
board certified psychiatric pharmacists (BCPP) around the world; she
predicts this number will grow as
more people realize the value of this
level of specialty practice.
Dr. Augustin, recently married to a
research scientist with a pharmaceutical
company, also spends one
morning a week as a clinical
pharmacy consultant to the
neurobehavioral unit — a private
brain injury rehabilitation program.
The patients in this program have
severe psychiatric and behavioral
problems, secondary to traumatic brain injuries most commonly due to
car accidents, falls, or assaults. "We use a combination of medications and
behavioral therapies to control their psychiatric symptoms so they can
continue with other aspects of their rehabilitation. The effects of psychiatric
medications in patients with brain injuries are often very different from
what we see in people without such injuries, so this can be a very challenging
population to treat." The 10 to 15 patients in this small program may remain
several months to several year
PATIENT POINT OF VIEW
The 20-year-old schizophrenic male had been hearing voices telling him to
kill family members and harm himself. He thought the television and radio
personalities were talking to and about him and he had become paranoid
about everyone. He'd been on the acute psychiatric unit for several weeks
and had initially resisted taking medication because he thought the care
providers were trying to poison him. When finally convinced to try an
antipsychotic medication, he suffered distressing side effects (acute muscle
spasms and hand tremors). Interpreting this experience as proof the medication
was poison, the young man refused to take any more. Dr. Augustin
worked with the patient, finally convincing him to try another antipsychotic
medication, and within a short time his psychosis resolved. Shortly thereafter,
he was discharged from the hospital and was able to get his first real job.
He and his family were educated about schizophrenia and the importance of
medications in its treatment. Dr. Augustin cites this as an instance in which
a psychiatric pharmacist can really make a difference in a patient's life.
>>>What do you need?
• Ability to work as part of a multidisciplinary team
• A broad knowledge of psychiatric disorders and treatments
• A interest in interacting with psychiatric patients
What's it take?
• A current, active license to practice pharmacy
• Bachelor of Science (BS) or Doctor of Pharmacy (PharmD) degree*
• One-year residency in psychiatric pharmacy is preferred
• Certification as a Board Certified Psychiatric Pharmacist (BCPP) is preferred
Where will you practice?
• Psychiatric hospitals
• Hospitals
• Universities
• Home health care
• Nursing home care
• Acute care facilities
• Ambulatory care facilities
