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As mentioned, a
significant percentage of adults with severe DD have epilepsy. Most will have a neurologist who follows
them. It is critical that the primary
care physician stay in close communication with the neurologist. Anti-epileptics have many side effects,
drug interactions, and actions which must be understood. The same is true for psychiatric care and
the use of psychotropics. It is important to realize that the same
“behaviors” which are tracked and responded to with psychotropic medication
administration may, at times, be the patient’s effort to communicate physical
distress from an underlying medical problem.
Therefore it is important that the psychiatrist know when medical
problems are present and that the PCP know when psychotropics have been added
or changed.
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Adults with
severeDD may require numerous medications posing the risk for drug
interactions or other medication related problems. Consultation with a clinical pharmacist can provide a valuable
“second look” at the therapeutic approach.
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Just as in other
populations where an “interdisciplinary team” is engaged in care, e.g.
residents of skilled nursing facilities, it is important that the PCP be an
active team leader and engage the services and input of appropriate
clinicians. These other clinicians may include OTs, PTs, and speech
pathologists, audiologists, nutritionists, and assistive technology
(communication, mobility etc) specialists.
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