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Reducing the physical health side effective of medication in mental health

Dr Jonathan Mitchell, Consultant Psychiatrist at Sheffield Health and Social Care NHS Foundation Trust & Member Psychosis and Schizophrenia in Adults: treatment and management Guideline Development Group National Institute of Health and Care  Excellence (NICE)  spoke at today’s Improving Physical Health for People with Mental Health Conditions conference on:

  • reducing the physical health side effects of mental health medication
  • meeting the national target for those on antipsychotic medication
  • working in partnership with service users to identify the appropriate medication for them and ensuring the side effects are understood
  • why reducing the impact of medication side effects is key to parity of esteem and improving physical health of those with mental health problems
  • national developments

In his presentation Jonathan Stated: 

"Common side affect of anti psychotic medication is weight gain"

"Because there is the risk of weight gain, we need to support & do something to help from the start - advice & support"

"10% of people with schizophrenia have diabetes"

In his presentation Jonathan covered:

Why this topic is important

  • Untreated mental health conditions have a higher mortality rate than treated, but drug side effects affect adherence with treatment, quality of life and can impact on physical health
  • Ideal -  drug works perfectly, no side effects
  • Reality - aim to find a balance between positive and negative effects of the drug

General Principles

  • Involve the patient in the choice of drug
  • Give information about expected effects and side effects
  • Take personal and family medical history into account
  • Regularly review treatment emergent effects and side effects
  • Agree a plan how to manage side effects and when & how to change drug

What can be done?

  • Some drugs with higher risk have been withdrawn or have not been licensed in UK, others require ECG monitoring as condition of use
  • Reduce risk by prescribing single drug within BNF limit and avoid high dose or polypharmacy
  • ECG if higher risk eg recommended in SPC, inpatients, people prescribed high doses
  • If using high dose - monitor ECG, but aim to limit time, reduce to standard dose, try change of drug

Jonathan Mitchell’s full presentation is available for download at the end of this page.

Jonathan Mitchell’s Biography:

Jonathan qualified in Medicine at the University of Sheffield in 1998 and trained in psychiatry on the mid and North Trent psychiatric training rotations.  He has been a consultant psychiatrist working in Sheffield since August 2006.  He worked in the early intervention in psychosis and continuing needs community mental health teams until summer 2012.  Following a community team reconfiguration he has worked in the home treatment, access and recovery teams.  Since October 2013 he has been the Associate Medical Director for Quality and Governance in Sheffield Health and Social Care Trust.

Jonathan has been involved in writing NICE guidelines as a guideline development group member contributing to the writing of the Psychosis and Schizophrenia in adults and Psychosis and coexisting substance misuse, and as a special advisor to the Psychosis and Schizophrenia in children and young people.  He is a co-investigator in a multicentre randomised controlled trial investigating a lifestyle education programme aiming to reduce the consequences of antipsychotic induced weight gain for people with schizophrenia.

Future conferences of interest:

Improving Mental Health Crisis Care
Thursday 15 October 2015 , Hallam Conference Centre, London

Positive and Proactive Care Meeting the New National Guidance on Reducing Seclusion
Tuesday 20 October 2015, Hallam Conference Centre, London

Smoking Cessation in Mental Health
Tuesday 20 October 2015 , Hallam Conference Centre, London

Masterclass: Deprivation of Liberty Safeguards
Friday 13 November 2015 , Hallam Conference Centre, London

Safe Staffing for Nursing in Mental Health Inpatient Units
Monday 16 November 2015 , Hallam Conference Centre, London

Identifying and Supporting Victims of Domestic Violence & Improving the effectiveness of MARACs
Monday 16 November 2015, Hallam Conference Centre, London

Deprivation of Liberty Safeguards: Ensuring Compliance in Practice
Tuesday 17 November 2015, Hallam Conference Centre, London


Download: dr-jonathan-mitchell_1158.pdf

14 September 2015

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