Concise Psychotropic Medication Prescribing Directions

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In the early days of psychiatric consultation in the Collaborative Care setting, the need for standardized medication instructions for primary care providers and behavioral health providers quickly became evident. Based on this need, we developed a collection of prescribing protocols for commonly prescribed psychotropic medications that were succinct and tailored to the outpatient setting. These prescribing protocols integrated the drug’s FDA label information and information gathered from the published literature including practice guidelines, together with the clinical prescribing acumen of the psychiatric prescribers participating in the Collaborative Care setting. To maximize usability, the protocols were organized into three sections: dosing information, monitoring, and general information. 

Currently these prescribing protocols are in broad and daily use in the Mental Health Integration Program (MHIP) in Washington State. That being said, it is important to consider how best to use these protocols as well as their limitations. Broadly speaking, these prescribing protocols are intended to facilitate the best possible prescribing practices in the outpatient setting. They should always be used with discrimination and where questions arise, e.g., as new prescribing information comes out about a medication, in consultation with a pharmacist and with current FDA drug label guidelines (available at http://www.accessdata.fda.gov/scripts/cder/drugsatfda/).