Dr. Bryan White has stayed at the cutting edge of technology in his own practice and encourages his peers to keep up with medical advances to ensure only the best care for all patients. Recently, he’s proposed a few dosage reduction protocols including more careful monitoring and administering of antidepressants for nursing homes patients across Texas.
As a medical professional, Dr. Bryan White is always on the hunt for alternative solutions to improve medical care and to reform facilities everywhere. He’s already served as an instrumental component of many dosage reduction protocols in Texas, and helps ensure all
patients receive appropriate care and medicine that doesn’t threaten their well-being.
Recently, he instituted a reduction protocol for nursing home patients that keeps antidepressant administration in check in elderly patients while they’re being treated for other conditions. He acknowledges that antidepressants are frequently used in facilities around the US to treat many mental conditions. However, he worries that too many doctors never reduce the dosage or give a trial off of antidepressant medications all together. The natural history of Depression is that it often resolves within a few months. Life long treatment with medications is often not necessary.
“Antidepressants can do a lot of good for people because they balance out chemicals in the brain called neurotransmitters that determine our mood and how we feel overall,” says Dr. Bryan
White. “I often see patients in facilities with polypharmacy, often with more than 10 medications. Stopping medications that are no longer effective or needed is a cornerstone of good care.”
Antidepressants have been a staple of psychological medicine since the 1980s when selective serotonin reuptake inhibitors (SSRIs) were heavily introduced into psychological treatment. They work by boosting mood or at least numbing certain feelings or thoughts to help patients overcome symptoms of depression. During regular use, they have proven to help people achieve more peaceful sleep regularly, boost appetite, and enjoy activities with a more positive mood overall.
Today, SSRIs are widely used across the country and prescribed to treat conditions in every age range, from children and teens to elderly patients. They’ve grown from only treating depression and anxiety to being vital in helping patients with obsessive-compulsive disorder, eating disorders, and other psychiatric conditions find lasting peace.
Most doctors agree that these types of antidepressants are typically safer than other forms of antidepressants for older patients since they don’t disturb heart rhythms and don’t usually cause dizziness or similar symptoms. Because liver function is a lot less efficient in elderly patients, though, Dr. Bryan White warns that higher doses of certain SSRIs can have a harmful impact on their cardiac rhythm.
“By instituting this new protocol, we can reduce the potential harm done to patients through reduction or elimination of antidepressants,” says Dr. Bryan White. “Already, it has led to a significant reduction in the use of unneeded antidepressant medications in nursing home patients. The protocol has been especially successful in facilities that provide skilled and long term nursing care, helping physicians to deliver only the safest and most appropriate health care for their elderly patients.”
