Developmental Services - Case Management Manual

Monitoring of Psychotropic Drugs

The caseworker's role with consumers who are taking psychotropic drugs is monitoring. It is the Case Manager's responsibility to check that psychotropic drugs are evaluated twice yearly with appropriate laboratory testing at a minimum of once a year and sometimes more often depending on the psychotropic medication. (i.e. Lithium monitoring occurs infrequently) The case manager should advocate for appropriate physical evaluation of the consumer before and during the psychotropic treatment. By periodically reviewing the medication records the caseworker will be able to follow the physician's review of a consumer's medication regime.

When a consumer is placed on a new drug, his/her reaction to the drug should be closely watched. Residential and community support staff should observe the consumer for adverse physical and emotional reactions, as well as unintended behavioral changes. In some instances, the individual will have no reaction to the drug. If the caseworker has concerns regarding the use of a particular drug they should discuss concerns with residential providers and the person's physician and discuss any concerns with the responsible physician.

If there is a sudden, unexplained change in a consumer's behavior, a medication evaluation should be considered. Also, it should be noted that an individual who has a long history with one drug should be evaluated for irreversible side effects and possible drug alternatives. In addition, medication side effects or concerns about polypharmacy should be brought to the attending Physician.

Occasionally, the prescribing physician will be unwilling to make changes in a person's drug schedule. If the consumer's behavioral or emotional problems persist, the caseworker should seek a second opinion to assure the most appropriate psychotropic medication is being utilized.