Tuesday, December 22, 2009

Psych patients won't be hiding this pill in their mouths

Some psychiatry patients may be in the habit of hiding pills in their mouths. Why? Because they may be in an in-patient setting and they are required to adhere to their medication regimen. You've probably seen this in the movies:
  • Psychiatry patients in an in-patient ward line up for their meds.
  • They are given a cup full of meds and they take their pills along with a cup of water.
  • Someone monitors compliance. "Open your mouth" and someone checks to make sure the pills are all gone. Then the patient is dismissed.
  • Did the patient really swallow the pills? Or did the patient hide the pill somewhere in his/her mouth to spit it out later?
Now, some patients may "cheek" their pill and hide it somewhere in their mouth. Well, you won't be able to that if you have a pill that dissolves in your mouth. Some dissolvable pills may not get absorbed very well if they're swallowed, so the irony is that some patients may need to swallow their pills if they don't want to effectively "take their medicine." Give someone a mouthful of pills and let's see if anyone can selectively swallow a single one.

So asenapine (Saphris) is one of the newest anti-psychotic medications that has been approved by the FDA. This pill is a sublingual tablet. That means that you put it under the tongue and the tablet will dissolve within a few seconds. There's no way to effectively hide this pill in your mouth. By the time you try, the pill dissolves. So, as long as the pill enters the mouth (and the mouth isn't completely dry), the pill will dissolve and the medication will get absorbed into the body.

Of course, if you're really trying to ensure maximal compliance to your drug regimen, then you can always just give an injection. Speaking of injections, Risperdal (risperidone) and Zyprexa (olanzapine) are both available as injections.

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