The Consultant Psychiatrist with training and experience in helping Patients with disabling pain has a great deal to offer.
The prescribing and supervision of medications for disabling pain and depression requires a background in Psychiatry in order to achieve an optimal outcome, because the effective doses of these medicines must be highly individualised, and are often optimally used in combination. In addition, management of effective medicine combinations require skilled attention to possible side effects and their management.
The list of appropriate medications in these circumstances is daunting for doctors without Psychiatry experience in the Pain Medicine field- what combination from venlafaxine, amitryptaline, pregabalin, gabapentin, duloxetine, sodium valproate, carbamazepine, lamotrigine, diazepam, clonidine, oxycodone, fentanyl, ketamine, etc, etc are appropriate in any particular case? At what doses? For what duration?
One must not underestimate the value of the professional network coordinating treatments supervised by Clinical Psychologists, such as relaxation training, and meditation techniques, and treatments supervised by Physiotherapists and Exercise Physiologists, by Anaesthetists with expertise in pain blocking techniques, nor the value of a Solicitor skilled in the field of compensation issues.
One must also not underestimate the extremely stressful complexities for patients in negotiating Workers Compensation and Transport Accident Commision systems. The Consultant Psychiatrist with expertise in the field of Pain and Depression Management has a vital role in helping the Patient and Patient's Family to negotiate such stresses.
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