Physicians, nurses, psychologists, pharmacists, and social workers can earn continuing education credits and learn more about the side effects of antipsychotic drugs in the latest series of tapes produced by Dr. Saltz. Tapes 1 & 2 use a case approach and cite research of interest to physicians. Tape 3 provides information for nurses, psychologists, social workers and other medical professionals. Tape 4 offers similar content, but is written for caregivers and consumers. (Click here to read more about this series.) The National Institutes of Health, Institute on Aging, provided a grant to develop this series, to ensure that important information about medications is shared with all the decision makers in mental health treatment. Ordering Information: Medical professionals and consumers can order the tape series by contacting Mental Health Advocates at 561-368-8430. Or fax us the form on the contact us page on this website. The videotapes, in VHS or CD-ROM format, can be ordered separately or as a set. $50 per tape, $175 for the 4-part set. Description of Videotapes 1- 4 Key content and concepts Antipsychotic Medications: A Guide for Physicians, Health Care Professionals, Family Caregivers, and Consumers. This series of four videotapes (available on CD ROM or VHS) covers who should and who should not take antipsychotic medications, and how to prevent, recognize, and treat the reversible and the potentially irreversible side effects that may occur with treatment. Experts that appear on tape include: Dr. P. M. Doraiswamy, Duke University Medical Center, Durham, NC Dr. John M. Kane, Albert Einstein College of Medicine, NY Dr. Joseph P. McEvoy, Duke University Medical Center, Durham, NC Dr. Bruce L. Saltz, Mental Health Advocates, Inc., Boca Raton, FL The videotapes, in VHS or CD-ROM format, can be ordered separately or as a set. $50 per tape, $175 for the 4-part set. Tape 1 - Evaluating Psychosis and Agitation Full title: Antipsychotic Medications For Older Adults: A Guide For Physicians. Approximately 30 minutes Introduction - This section will show footage of the signs and symptoms of psychosis in geriatric patients. Experts discuss the actions general practitioners should take when their patients have psychotic symptoms. Indications - The conditions that have been highlighted by OBRA '87 as appropriate indications for antipsychotic drugs will be reviewed. Signs and Symptoms of Psychosis - Proper therapy for psychotic patients begins with identification of the signs and symptoms of psychosis. The major types of psychotic symptoms (e.g. delusions, hallucinations, thought disorder) are presented. Potential signs of underlying psychosis such as withdrawal, "anxiety" and refusal to eat or take medications are discussed. Videotape vignettes are presented to illustrate interview techniques to elicit psychotic symptoms. The need to obtain information from multiple sources (family, other care givers) is emphasized. What to Do Once Psychosis Is Identified - The first requirement is to determine if the patient is an immediate danger to himself/herself or others. We present techniques to obtain the information needed to make this determination. Medical conditions, which may present with psychosis, will be discussed as well as the proper evaluation needed to rule in/out these conditions. The role of adverse medication effects such as those caused by steroids and opiate analgesics will be included. Social contributions such as isolation and decreased hearing will also be discussed. The role of the general practitioner in treatment is discussed. This will include a discussion of the appropriate use of psychiatric and neurologic consultation. Summary - The tape ends with a review of the most important information. Tape 2 - Drug Induced Movement Disorders Full title: Side Effects of Antipsychotic Treatment Of Older Adults: A Guide For Physicians Introduction - This tape focuses on the identification and the management of side effects of antipsychotic drugs in geriatric patients. It is equally relevant in addressing the side effects of antipsychotic drugs in younger adults as well. Overview of Antipsychotic Medications-This section covers the low and high potency standard (first generation) antipsychotics and the new generation (atypical) agents including currently approved and investigational agents. Non-motor Side Effects- This section shows the nonmotor side effects of antipsychotics including their frequency, differential occurrence with each class of agent, health and social implications, and management. Side effects discussed will include: sedation, orthostatic hypotension, changes in heart rate and rhythm, incontinence, changes in appetite and weight, anticholinergic side effects, sexual side effects, and cognitive changes. Neuroleptic Malignant Syndrome-The diagnostic evaluation and management of this rare but potentially fatal side effect of antipsychotic drug treatment will be presented. Motor Side Effects- This section of the tape will summarize the most important points about motor side effects. This will include a discussion of reversible side effects (Parkinsonism, akathisia, acute dystonias) and potentially irreversible side effects (tardive dyskinesia). Tape 3: Antipsychotic Medications For Older Adults: A Guide For (non-physician) Health Professionals Introduction - this tape emphasizes the key role of nurses, social workers, psychologists and other nonphysician health professionals who often are the first to observe problem behaviors that may benefit from antipsychotic treatment. They also may be the first to observe adverse effects and thus are crucial to ensure optimal treatment for patients. Recognizing Indicators of Psychosis - The conditions that have been highlighted by OBRA Ô87 as appropriate indications for antipsychotic drugs will be reviewed. The major types of psychotic symptoms (e.g. delusions, hallucinations, thought disorder) will be illustrated. The tape will focus on how these symptoms are expressed in the settings in which nonphysician health professionals practice (i.e. nursing homes, acute medical and surgical units of general hospitals and providers' offices). Potential signs of underlying psychosis such as withdrawal, "anxiety", agitation, uncooperativeness and refusal to eat or take medications will be discussed. Help in distinguishing psychosis from non-psychotic problem behaviors and normal changes with age will be presented. Side Effects - This portion of the tape begins with an overview of antipsychotic agents. Then experts discuss the side effects of antipsychotics including their frequency and health and social implications. Side effects discussed will include: sedation, orthostatic hypotension, changes in heart rate and rhythm, incontinence, changes in appetite and weight, anticholinergic side effects, sexual side effects, cognitive changes, potential interactions with other medications, extra pyramidal symptoms, tardive dyskinesia and the neuroleptic malignant syndrome. Proper reporting of adverse events to the treating doctor will be emphasized. Tape 4: Antipsychotic Medications: A Guide for Patients and Their Families Introduction - The tape begins with a brief listing of the most commonly prescribed antipsychotic medications. The purpose is to help patients and their families understand what symptoms the medication will help and how to take medications safely and effectively. Diagnostic categories will be examined, but the primary thrust will be on the characteristics of psychosis and agitation, regardless of the specific diagnostic condition in which the symptoms may occur. Symptoms - Common problems that can be helped by antipsychotic medication will be illustrated: being afraid of people, fears of harm, beliefs that the body has changed, excessive jealousy, hearing voices, seeing things, problems thinking, unusual ideas, and severe agitation. What to Expect with Treatment - This section begins by discussing the usual duration of treatment before improvement occurs. Experts emphasize the benefits of treatment may not occur until several weeks or months of treatment. Patients may experience side effects before the beneficial effects begin. The tape will discuss the side effects of antipsychotics: sedation, drops in blood pressure, changes in heart rate and rhythm, changes in appetite and weight, blurred vision, dry mouth, constipation, decreases in sexual desire or performance, memory problems, muscle stiffness, tremor, decreased spontaneity and restlessness. We will also discuss tardive dyskinesia, a potentially irreversible side effect. The need to report side effects to the doctor will be emphasized as well as the need to consult with doctors before combining antipsychotics with other medications, and to keep their doctors informed of all drugs or medicines they take, including "over the counter" and health food store preparations. How To Take The Medication - The emphasis in this section will be on following the doctor's advice on taking medication. The importance of taking the medication regularly will be stressed. Strategies to aid this such as pill dispensers and reminders to take medication will be illustrated. Summary - This section will review the major points presented previously. To illustrate the benefits of treatment, case vignettes of successfully treated patients will be presented. This series of four programs has been funded by the SBIR (small business innovation research) program in the Institute on Aging at NIH. Its purpose is to create and to evaluate the effectiveness of videotape training material for health care professionals who treat older adults, or who are themselves geriatric patients who take antipsychotic medications for a variety of illnesses ranging from schizophrenia to manic-depressive illness, and from Alzheimer's disease to stroke - related dementia and other neuropsychiatric conditions. The production phase of this project is dedicated to the creation of a series of four videotapes about who should and who should not take antipsychotic medications, and how to prevent, recognize, and treat the reversible and the potentially irreversible side effects that may occur with treatment, (both neuromotor and non - motor). The evaluation phase is dedicated to the evaluation of knowledge, skill, and information in five groups of people before and after the provision of training materials developed in the production phase of this project. The groups include providers of medical and mental health services in the disciplines of primary care (physicians), psychology, nursing, social services. An additional group consists of patients who are affected by these conditions that warrant such treatment, and their family members or caregivers. Ordering Information: Medical professionals and consumers can order the tape series by contacting Mental Health Advocates at 561-368-8430. Or fax us the form on the contact us page on this website. The videotapes, on VHS or CD-ROM format, can be ordered separately or as a set. $50 per tape, $175 for the 4-part set.