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Behavioral health is essential for the safety, well-being, and performance of crewmembers in both human spaceflight and Antarctic exploration. Over the past five decades, psychiatric issues have been documented in orbital spaceflight. In Antarctica, literature suggests up to 5% of wintering crewmembers could meet criteria for a psychiatric illness, including mood disorders, stressor-related disorders, sleep-wake disorders, and substance-related disorders. Experience from these settings indicates that psychiatric disorders on deep space missions must be anticipated. An important part of planning for the psychological health of crewmembers is the onboard provision of psychotropic drugs. These medications have been available on orbital missions. A greater variety and supply of these drugs exist at Antarctic facilities. The size and diversity of a deep space psychiatric formulary will be greater than that provided on orbital missions. Drugs to be provisioned include anxiolytics, antidepressants, mood stabilizers, antipsychotics, and hypnotics. Each drug category should include different medications, providing diverse pharmacokinetic, pharmacodynamic, and side effect profiles. The formulary itself should be rigorously controlled, given the abuse potential of some medications. In-flight treatment strategies could include psychological monitoring of well-being and early intervention for significant symptoms. Psychiatric emergencies would be treated aggressively with behavioral and pharmacological interventions to de-escalate potentially hazardous situations. On long-duration space missions, a robust psychiatric formulary could provide crewmembers autonomy and flexibility in treating a range of behavioral issues from depression to acute psychosis. This will contribute to the safety, health, and performance of crewmembers, and to mission success.Friedman E, Bui B. A psychiatric formulary for long-duration spaceflight. Aerosp Med Hum Perform. 2017; 88(11):1024-1033.
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http://dx.doi.org/10.3357/AMHP.4901.2017 | DOI Listing |
Psychiatr Serv
January 2025
Department of Psychiatry and Behavioral Neuroscience (Bunting, Gray), Department of Pharmacy (Gray), and Pritzker School of Medicine (Chalmers), University of Chicago, Chicago; Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta (Cotes); Department of Psychiatry, University of Washington, Seattle (Chalmers); Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor (Nguyen).
Objective: Long-acting injectable antipsychotics (LAIAPs) enable safe and effective long-term management of chronic psychotic disorders but are underused in clinical practice. The authors examined whether Medicare formulary restrictions (prior authorization [PA] or step therapy) impose barriers to LAIAP uptake.
Methods: The authors analyzed formulary restrictions and patient cost-sharing for several LAIAPs and estimated the percentage of plans (N=2,494 were available per year) applying formulary restrictions.
Tijdschr Psychiatr
January 2025
J Pharm Pract
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Clinical Pharmacy Manager, NewYork-Presbyterian Hospital, New York, NY, USA.
This report explores the potential role of glucagon-like peptide 1 (GLP-1) receptor agonists in minimizing the metabolic side effects of psychotropic medications in patients with underlying type 2 diabetes (T2D) in inpatient psychiatric settings. The introduction of novel antidiabetic medications such as GLP-1 receptor agonists has broadened the options for managing metabolic disorders, particularly T2D. These medications not only offer effective glycemic control but also provide cardiovascular and renal benefits and help with weight management.
View Article and Find Full Text PDFNeuroimage Rep
September 2024
Division of Psychiatry, Imperial College London, London, UK.
Alcohol dependence (AD) and gambling disorder (GD) are common addiction disorders with significant physical and mental health consequences. AD and GD are associated with dysregulated responses to reward which could be due to a common mechanism of dysregulated endogenous opioid signalling. We explored associations between reward anticipation responses, using the Monetary Incentive Delay (MID) functional magnetic resonance imaging (fMRI) task, and mu-opioid receptor (MOR) availability and endogenous opioid release capacity using [C]carfentanil positron emission tomography (PET), in 13 AD, 15 GD and 14 heathy control (HC) participants.
View Article and Find Full Text PDFSaudi Pharm J
October 2024
Pharmacy Services Department, Johns Hopkins Aramco Healthcare, Saudi Arabia.
Johns Hopkins Aramco Healthcare (JHAH) is a leading healthcare organization dedicated to revolutionizing healthcare practices in Saudi Arabia. This review article features the significant strides made by the JHAH ambulatory care pharmacy to symbolize Saudi Arabia's ambitious vision of healthcare transformation. This evolving journey includes details of JHAH's adoption of modern automation tools, several technological advancements, and establishing a pharmacist role far beyond dispensing medications.
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