Psychiatric Pharmacotherapy, Suicide, and Managed Care (IN: Treatment of Suicidal Patients in Managed Care, ed. by J M Ellison)

The author reviews the pharmacotherapy of depression & suicidality & the potential supports & constraints of managed behavioural health care organizations (MBHCOs). The roles of various medications in reducing suicidal mortality are reviewed along with their target symptoms & disorders. The risks, benefits, & issues surrounding who does the prescribing & their level of expertise are also explored. Concerns are raised about the adequacy of visit lengths & frequency authorized by MBHCOs, the large multimonth prescriptions patients receive to reduce MBHCO costs, the use of restrictive formularies, & the adequacy of outreach & follow-up for patients who miss appointments. (85 refs)