Jonathan Chick

Title : Prescribing psychiatric medications in alcohol use disorders and other addictions Risks and avoiding risk

Abstract:

Depression, anxiety, impulsivity, difficulty concentrating, mood swings and occasionally psychotic symptoms are recognised symptoms in addiction to mind-altering substances.Sufferers who protect their use of the substance may precipitate GPs and psychiatrists into inappropriate psychiatric diagnosis and thus unhelpful prescribing. Powerful antidepressants, antipsychotics, stimulants and anti-epileptic drugs get prescribed and their effects can confuse the clinical picture; in the case of SSRIs and some antipsychotics relapse rates in alcoholism can be increased. Management requires explanation to referrers and patients, and collaboration between the treating team and the patient to adjust or discontinue unnecessary medications. The upsurge in diagnosis of ‘ADHD’ in substance use disorders is not accompanied by evidence for the efficacy of stimulants in treating these disorders and prescriptions are often abused. A study shows stimulants can be discontinued without risk.

Biography:

Professor Chick worked for the Medical Research Council for Epidemiological Studies in Psychiatry and then as Consultant Psychiatrist for the Alcohol Problems Service, Royal Edinburgh Hospital, and as Senior Lecturer, Department of Psychiatry University of Edinburgh. He is now Medical Director, Castle Craig Hospital. Latterly, he extended his area of research from treatment of alcohol problems to prevention, and the role of changes in affordability of alcohol. He has been an advisor to the World Health Organisation and government departments in the UK, Australia, Canada, USA and Brazil. He is the Chief Editor of the international journal Alcohol and Alcoholism.