Rehabilitation psychopharmacology

What is rehabilitation psychopharmacology?

Rehabilitation psychopharmacology is the careful use of psychiatric medication to support you through a wider rehabilitation programme. Medication is used to help manage symptoms that might otherwise get in the way of taking part in, and benefiting from, your rehabilitation therapies.

What conditions does it treat?

This approach may be used if you are:

• living with a serious mental illness, such as a psychotic disorder, and taking part in a psychosocial rehabilitation programme
• recovering from a condition that affects your memory or thinking, such as dementia, and taking part in cognitive rehabilitation
• managing both a mental health condition and a substance use problem at the same time, sometimes called dual diagnosis
• finding that behavioural or cognitive symptoms are making it hard to engage with a rehabilitation programme you have been offered.

What are the benefits of rehabilitation psychopharmacology?

Combining medication with rehabilitation this way is designed to help you get more from your rehabilitation programme, not to replace it. When behavioural or cognitive symptoms are holding you back, the right medication can make it easier to take part in, and benefit from, cognitive or psychosocial rehabilitation.

Bringing together medical treatment, rehabilitation and a recovery-focused approach in this way is thought to work better than looking at any one of these on its own.

Are there different types of approach?

There are a few different ways medication can be used alongside rehabilitation, depending on what is holding you back:

• if behavioural or cognitive symptoms are making it hard to take part in cognitive rehabilitation, general psychiatric medication may help
• if cognitive symptoms specifically are the obstacle, a type of medication called anticholinesterases, also used in dementia care, may be considered
• if behavioural symptoms are getting in the way, psychotropic medication can help make rehabilitation more accessible.

Your care may also draw on three different ways of thinking about treatment: the medical model, which focuses on diagnosis and biological treatment; the rehabilitation model, which focuses on your day-to-day functioning; and the recovery model, which focuses on your own goals and your role in your community, rather than only your diagnosis.

What happens before you start?

Before you start, you will usually have a thorough assessment. This often happens in two stages:

• an initial assessment with a therapist, looking at all aspects of how you are functioning day to day
• a medical evaluation with a consultant psychiatrist, who will review your full medical and psychiatric history, your current and past medications, any allergies, and your nutritional status.

As part of building your treatment plan, you may also be offered blood tests, allergy testing, or genetic testing that looks at how your body processes certain medications. The aim is not just to treat symptoms in isolation, but to put you in a good position to engage with the cognitive or psychosocial rehabilitation that follows.

What happens once treatment starts?

1. Your prescriber uses the findings from your assessment to agree a medication plan with you, alongside your rehabilitation programme.
2. You start taking the prescribed medication, chosen to target the behavioural or cognitive symptoms getting in the way of your rehabilitation.
3. Your care team monitors how you respond, using further blood or other testing where needed.
4. Your medication plan is adjusted over time, working alongside your rehabilitation therapies rather than instead of them.
5. Your team continues to consider your care from a medical, rehabilitation and recovery perspective, so treatment supports your wider goals, not just your symptoms.

What does ongoing care look like?

This is ongoing medication management rather than a one-off procedure, so there is no hospital stay or separate home-recovery phase to describe. Instead, care continues for as long as it is helping you engage with your rehabilitation.

Your prescriber will keep reviewing how well the medication is working alongside your rehabilitation, adjusting your plan as your needs change. Because the goal is to support your wider recovery, not just to manage symptoms, your medication plan is kept closely linked to your progress in rehabilitation, rather than reviewed on its own.