Psychiatry turns to compounding pharmacy for expert help in drug-drug interactions

The exponential growth of psychopharmacology has been both a boon to modern psychiatry and a source of challenge. The range of antidepressant, antipsychotic, and increasingly, anticonvulsant drugs now available to psychiatry are far greater than ever before. When you add off-label medications to the mix, the list climbs to well over 300.

The impressive arsenal of medications now at the disposal of psychiatrists means they can tailor treatments and therapies to the needs of the individual patient. The days of one-size-fits-all medication for everyone who presents with depression, bi-polar or any mental illness, are long gone, and a good thing too. No two people are the same and neither should their medication be.

Research shows that only one-third of patients who present with symptoms of depression respond to the first antidepressant they try. The other two-thirds can look forward to many months, sometimes years, of trial-and-error until an effective drug, or combination of drugs, is found that proves effective.

This unsophisticated guessing game is exacerbated by the fact that people with mental illness are often taking a range of medications for comorbidities like diabetes, cardiovascular disease, thyroid disease, COPD, fibromyalgia and many other conditions.

Without the benefit of a pharmacology degree, researching what’s in all these medications and flagging potentially adverse drug-drug interactions becomes an enormous challenge for the mental health practitioner. Could one drug block the actions of another? Could there be a volatile reaction between drugs? And could that lead to serious health consequences?

Each time a new course of medication is trialled in a non-responsive patient, the psychiatrist must go through the process of examining potential drug-drug interactions again. For some patients with complex health issues, the situation can turn into a minefield for prescribing psychiatrists. And the situation is only going to get more complex with new and improved medications for a kaleidoscope of medical conditions hitting the market every day.

Psychiatrists cannot be expected to have an encyclopaedic knowledge of every new pharmaceutical on the market – however a pharmacist can. Specialist compounding pharmacists in particular have an extraordinary understanding and knowledge of medications and their reactions to each other. This includes drugs used in psychiatry.

Compounding pharmacists regularly make up combined medications – several medications in one capsule –  to make administration, as well as adherence easier for patients with a long list of prescriptions. This work means their knowledge of drug-drug reactions is extremely high and they can flag issues of which a physician may not be aware.

For this reason partnering with a compounding pharmacist can be a highly effective solution for mental health practitioners treating patients with complex health needs. A compounding pharmacy partnership should never replace a psychiatrist’s own research and due diligence, however the second tier of verification by an expert affords the psychiatrist peace of mind that the risk of their patient coming to harm from a new drug regime is very low.

Compounding pharmacists are also able to make up hard-to-get medications during national drug shortages as well as produce medications as liquids, troches or transdermal creams – alternatives to pill-taking that might help some patients stick to their treatment plan.

For more information on how a specialist compounding pharmacy can help in the management of mental health patients with complex medication needs, contact Head Compounding Pharmacist, Matthew Bellgrove at National Custom Compounding on 1300 731 755 or [email protected].


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