College of Psychiatric and Neurologic Pharmacists

1. What is the history of psychiatric pharmacy?
2. Where are psychiatric pharmacists found and what do they do?
3. How are psychiatric pharmacists educated?
4. How many psychiatric pharmacists are there in the United States?
5. How is a psychiatric pharmacist Involved with patients?
6. Where can I locate a psychiatric pharmacist?

What is the history of psychiatric pharmacy?

The origins of the practice of psychiatric pharmacy are generally traced back to the early 1970’s and to pioneers such as Dr. Glen Stimmel practicing in the acute psychiatric setting. At that time, the psychotropic medications commonly used to treat serious mental illness (eg, Thorazine®, Elavil®, Parnate®) were considered fairly effective, but were associated with some significant side effects. Additionally during this time, little was known about the risk of drug interactions. Working alongside psychiatrists in a consultative role, pharmacists provided drug treatment recommendations to the physicians and closely monitored the effects of these medications. Research during this period conclusively demonstrated that when pharmacists participated in this medication process, consumers had fewer adverse reactions and were able to be discharged from treatment facilities sooner than expected.

At about the same time that Dr. Stimmel was demonstrating the value of pharmacist services in psychiatry, Schools of Pharmacy throughout the country were making revolutionary changes to core curricula that ultimately led to the Doctor of Pharmacy (PharmD) degree, the only pharmacy degree offered at most schools today. As school faculty and administrators became aware of the promising role for pharmacists in mental health, they increased emphasis on psychopharmacology in the PharmD programs. Eventually, many psychiatric facilities and institutions created specialized residencies and fellowships in psychiatric pharmacy enabling postdoctoral students to hone their research and clinical skills under the guidance of an experienced psychiatric pharmacist.

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Where are psychiatric pharmacists found and what do they do?

A psychiatric pharmacist is a pharmacist that has extensive knowledge regarding psychiatric medications. Psychiatric pharmacists can be involved in many diverse roles. Some are involved with drug research and development. Others work in hospitals and VA’s and have direct patient contact. Still others are involved in the area of academia and therefore mentor and teach pharmacists, physicians and nurses currently in training. No matter what the practice, patient care and safety are top priorities of the psychiatric pharmacist.

Most psychiatric pharmacist spend the bulk of their time consulting with physicians or psychiatrists. Other core responsibilities include:

• Teaching pharmacy, nursing and medical students / residents
• Answering drug questions
• Assisting in formulary decisions
• Providing direct patient care
• Assisting in medications selection and dosing
• Publishing in peer-reviewed journals / books.
• Educating patients and their families on non-psychiatric disease states such as diabetes and high blood pressure.

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How are psychiatric pharmacists educated?

All psychiatric pharmacists complete pharmacy school and pass a national test to become licensed. Following licensure, the practitioner can complete a first year general residency and may choose to complete a second year of residency which focuses on psychiatric pharmacy alone. Or a pharmacist may choose to complete a fellowship. Psychiatry pharmacy fellowships are 2-year commitments and traditionally focus on research related to psychiatric agents. Once a pharmacist has met certain criteria, they may sit for a specific national exam that qualifies them to use the credentials of Board Certified Psychiatric Pharmacist (BCPP). The benefit to the patient of their pharmacist having this certification is that the pharmacist must maintain expertise in this area.

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How many psychiatric pharmacists are there in the United States?

The Board of Pharmaceutical Specialties states the number of Board Certified Psychiatric Pharmacists (BCPP) is 509 as of 2007.  The professional group representing these pharmacists is the College of Psychiatric and Neurologic Pharmacists (CPNP) which currently has near 1000 members.

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How is a psychiatric pharmacist involved with patients?

A psychiatric pharmacist is often directly involved with patient care. Some of these activities may include attending family meetings or consulting with patients on an individual basis for medication education or dosage adjustment. However, even if a psychiatric pharmacist is working in another area, he/she will always be concerned with the patient and their medications.

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Where can I locate a psychiatric pharmacist?

Contact your nearest school of pharmacy, psychiatric hospital or Veterans Affairs Medical Center for the name and location of an expert in your area. You can also search for Board Certified Psychiatric Pharmacists (BCPPs) at the Board of Pharmaceutical Specialties website at http://www.bpsweb.org/07_Locate.asp.

Content contributed by Patrick R. Finley, PharmD, BCPP, UCSF, San Francisco and Elizabeth Eichel, PharmD, BCPP, BCPS, University of Cincinnati, Cincinnati