Ask a Pharmacist: Your pharmacist can help with depression, anxiety and more
The men and women behind the counter at your local pharmacy are medical professionals. Use them wisely for the best outcomes from mental health treatment.
If you’re not in the habit of chatting with your pharmacist, you’re missing a free opportunity to understand how your medication works. That can have a negative impact on your treatment. In the case of mental health, it might cause you to give up too soon.
Truth is, your pharmacist may be one of your best mental health allies. For more insight, we spoke with Nathaniel M. Rickles, PharmD, PhD. He’s an associate professor of pharmacy practice at the University of Connecticut School of Pharmacy in Storrs.
Q: What can pharmacists tell patients about mental health?
Rickles: You may think of pharmacists simply as the people preparing prescriptions, but pharmacists can also be great resources. They’ve received basic training in mental health disorders, and they’ve studied how to talk with sensitivity to those with psychiatric needs. They’re able to refer patients to other useful resources, such as treatment facilities and local clinicians, and perhaps best of all, they’re very accessible. You can find them inside any pharmacy.
Q: How do I broach the topic of mental health?
Rickles: Let’s say you’re on a mental health medication such as Xanax®, Zoloft® or Celexa®. (Click each drug name to access coupons instantly.) When you pick up your prescription, your pharmacist will likely ask, “Do you have any questions?” This is an offer to counsel you. Accept that offer if you have any questions or doubts.
Your pharmacist can provide information on how the medication works to improve your mental health and how it compares to other treatment options. Many community pharmacists wish patients would be more interested in having these brief conversations. They’re helpful for patients taking all types of medications — and they’re especially important for those picking up prescriptions for mental disorders. It increases the chance that you’ll take your medication properly.
Q: Explain that. How does talking to my pharmacist increase my odds of taking my prescription as directed?
Rickles: Low adherence, or not taking medication as directed, is a common issue for those seeking psychiatric help. That’s partly because the disorder can impair motivation, memory and focus. But because your pharmacist is often the last person you talk to before taking your medication, you tend to better remember the information they offer. That improves adherence.
Q: How important is side-effect monitoring with medications for mental disorders?
Rickles: Very important. We know side effects such as weight gain, tiredness, dizziness and sexual dysfunction are barriers to taking medications regularly — or perhaps at all.
When you come in for a refill, your pharmacist may ask how the medication is helping or what side effects you’re dealing with. These follow-up questions allow the pharmacist and patient to solve issues either together or with the help of the prescriber. Research shows that when your pharmacist helps you manage side effects, you’re more willing to take your medication or switch to a better prescription. All of this increases adherence, which leads to better outcomes. And that’s what we all want.
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Q: Are there other useful questions I can ask when I’m picking up medications for mental disorders?
Rickles: Sure, ask about what you can expect. A good one to start with is, “How long will this medication take to start working?”
Say you’re taking an antidepressant. The medication only works well when taken daily, and the pharmacist will explain that to you. But he or she can also explain that you might not experience any symptom relief for the first 4 to 6 weeks. Without that counseling, you might assume your medication isn’t working. You might stop taking it after a month or less.
Another question you can ask is how long you might need to be on the medication. This info can help you figure out when you might want to talk to your doctor about discontinuing treatment.
Q: What about mental health side effects for medications for physical disorders?
Rickles: Medications for physical disorders can have an impact on mental health as well. Depression is the most common. But they can also cause irritability, heightened mood and unusual behaviors.
Unfortunately, patients aren’t usually aware of the mental health effects of medications for physical disorders. That can lead to confusion and non-adherence. So it’s always important to address these issues with your pharmacist. The medications that can impact your mood and emotions include:
- Antihypertensive medications
- Hormone-replacement therapies
- Thyroid medications
- Anticonvulsants for epilepsy
- Treatments for Parkinson’s and other neurological disorders
- Treatments for diabetes
Curious about how to fight depression? Learn more with our simplified guide to treatment.
Q: Can community pharmacists help with a mental health crisis?
Rickles: Community pharmacists don’t provide psychotherapy, and they don’t diagnose mental health conditions. But they can help. They’ve been trained in programs such as those offered by Mental Health First Aid®, an organization that teaches people how to identify and respond to signs of mental illnesses and substance misuse. Some are even qualified to conduct depression and anxiety screenings.
That means your pharmacist is able to assist you in a mental health crisis by listening, providing information and encouraging you to seek appropriate professional support.
Q: What do psychiatric pharmacists do?
Rickles: They care specifically for people with mental illnesses. They’re also useful for patients with mental disorders with complicated medication regimens. Psychiatric pharmacists aren’t at your local drug store filling prescriptions. Instead, they may work in an ambulatory or veterans clinic, a psychiatric hospital or an academic or pharmaceutical setting.
If it’s appropriate, your doctor or community pharmacist may refer you to a psychiatric pharmacy specialist. If so, that person will be able to go further in examining side effects and medication interactions. Ultimately, they can help create a therapy plan that works for you.
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