Treat Conditions, Not Symptoms

Let’s say, for example,  I went to my local emergency room with a broken leg.  Instead of setting my leg in a cast to heal, the E.R. physician makes the poor choice of giving me an excessive amount of pain medication so  I could not feel the entire lower half of my body, much less the localized pain associated with my leg injury, and sends me home with a broken leg and a prescription for more pain meds.  The doctor would have treated the symptom, being my pain, and not the condition, being my broken leg.

Very often senior adults are prescribed benzodiazepines (anti-anxiety medications) by their family physicians for such symptoms as sleeplessness, agitation, and verbal / physical aggression.  Often these symptoms are being caused / exacerbated by conditions such as psychosis and/or depression.  In these cases, attempting to treat symptoms with anti-anxiety medications usually leads to worsening of the condition, over-sedation, and increased confusion and disorientation.

The most important factor in avoiding the pitfalls being outlined in this post is the completion of  a comprehensive and thorough assessment of the problem.  Side effects and contraindications among prescribed medications are often the source of many problems.  Exploration of this and the presence of infections / new medical conditions are the two interventions that should first be initiated.  Once these interventions have been completed,  considering the prescription of anti-psychotic and/or anti-depressant medications should take place.

In my experience, most primary physicians are comfortable prescribing anti-anxiety and anti-depressant medications to try and address symptoms related to dementia.  Most though, would prefer an inpatient psychiatric evaluation be completed to best identify the condition or conditions present, and in the event medications are needed to address psychosis, have the condition(s) treated by a psychiatrist to best handle the introduction of appropriate psychotropics.

For more information on the topic of inpatient hospitalization in these types of treatment scenarios, please click on the following link:   “The Road Less Traveled; The Geriatric Psychiatric Option”