In honor of Mental Health Awareness Month, we’re spotlighting a faculty member in UC Irvine’s School of Pharmacy & Pharmaceutical Sciences who helps ensure that patients receive the right care, at the right dose, at the right time: the psychiatric pharmacist.
Psychiatric pharmacists are clinical pharmacists who specialize in the treatment of mental health and neurological disorders. They work alongside physicians and care teams to manage complex medication regimens for conditions such as schizophrenia, bipolar disorder, depression and anxiety – fine-tuning therapy, monitoring effectiveness and helping patients navigate challenges.
Farah Khorassani, Pharm.D., is a health sciences associate clinical professor in the Department of Clinical Pharmacy Practice and a clinical pharmacist at UCI Health who provides direct care to psychiatric unit inpatients while mentoring the next generation of pharmacists. Her clinical and research work centers on optimizing psychotropic medications, promoting equitable prescribing practices, and supporting the mental health of pharmacy students.
Here, Khorassani shares insights into her practice and the vital role psychiatric pharmacists play in improving outcomes for patients with serious mental illness.
For readers who may not be familiar with the field, what is a board-certified psychiatric pharmacist, and what role do you play on the mental health care team?
A board-certified psychiatric pharmacist is an advanced clinical pharmacist who specializes in the use of medications to treat psychiatric and neurological conditions. They have extensive education and training to understand how psychiatric medications work and how to optimize treatments for patients. As an inpatient psychiatric pharmacist, my role is to work directly with the treatment team (physician, nurses, social workers, psychologists, etc.) to optimize medications. This can look like assisting with developing evidence-based treatment plans, resolving medication-related problems and educating trainees on appropriate psychotropic use.
What does a typical day look like for you as a clinical pharmacist working in inpatient psychiatry?
No two days look exactly the same as a clinical pharmacist in inpatient psychiatry. Most days, I review patient profiles, participate in rounds, and provide input on medication management for patients across different units. I also teach trainees at multiple levels and in different disciplines, including medical students, pharmacy students and pharmacy residents. Some days I lead patient medication education groups or meet with patients individually to discuss their treatment and answer questions. It’s a dynamic mix of direct patient care and education.
You specialize in treating patients with serious mental illnesses such as schizophrenia and bipolar disorder. What are some of the biggest challenges in managing medications for these conditions?
Many of the antipsychotics and mood stabilizers cause adverse effects that make it difficult for patients to remain on their medications. Findings ways to maintain adherence despite the adverse effect profiles can often be challenging.
Psychiatric medications can be complex and often require adjustments. How do you work with patients and physicians to optimize treatment and minimize side effects?
I always look for ways to simplify medication regimens for patients – for example, selecting a dose that reduces the number of pills taken daily, the frequency, or using long-acting, injectable antipsychotics when appropriate. I also emphasize open, two-way communication between patients and prescribers about side effects, so treatment can be adjusted and is a part of the conversation early on to prevent side effects proactively.
Your research focuses on optimizing psychotropic medications and promoting equitable prescribing. Why is equity in mental health treatment such an important issue?
Equity in mental health treatment is critical because there are well-documented disparities in care based on race, socioeconomic status and other factors. These disparities affect not only access to medications but access to mental health care more broadly. Highlighting and studying these gaps is essential to identify strategies that promote equitable prescribing and ensure all patients receive the care they need.
Many people living with mental illness struggle with medication adherence. What strategies help patients stay on track with their treatment plans?
Medication adherence can be challenging for many patients living with mental illness, and one of the most effective strategies is reducing regimen complexity whenever possible. I’m a strong proponent of minimizing polypharmacy, reducing overall pill burden, and simplifying medication schedules so treatment is easier for patients to manage day to day. In patients with schizophrenia and bipolar disorder, long-acting, injectable antipsychotic medications can also be very helpful because they reduce the need for daily medications and can provide more consistent treatment.
As a psychiatric pharmacist, you also teach pharmacy students and residents. What do you hope the next generation of pharmacists understands about caring for patients with mental illness?
I hope the next generation of pharmacists understands that caring for patients with mental illness requires both strong clinical knowledge and genuine compassion. Psychiatric medications can be complex, and providing patient-centered, evidence-based care often means taking the time to thoughtfully evaluate each medication regimen to ensure it truly supports the overall treatment plan. This includes working to minimize inappropriate medication use, deprescribe when appropriate and reduce regimen complexity so treatments are safer and more manageable for patients to adhere to.
Mental health care often involves a team of specialists. How do pharmacists contribute to better outcomes for psychiatric patients?
Mental health care works best when it’s delivered by a collaborative team, and pharmacists play an important role in that process. As medication experts, psychiatric pharmacists help ensure that psychiatric medications are used safely, effectively and in a way that’s tailored to each individual patient. We work closely with physicians, nurses, therapists and other clinicians to help select appropriate medications, monitor how well treatments are working, and identify or manage side effects or drug interactions. We also help address medication-related problems that could affect a patient’s recovery and provide education so patients and families better understand their treatment. In many settings, psychiatric pharmacists also collaborate directly with prescribers or serve as prescribing providers themselves to adjust and optimize medication regimens. By focusing on individualized, evidence-based medication management and patient education, pharmacists help improve treatment outcomes and support better overall care for psychiatric patients.
What advances in psychiatric medications or treatment approaches are you most excited about right now?
As an inpatient board-certified psychiatric pharmacist, I subspecialize in optimizing treatment for serious mental illnesses such as schizophrenia and bipolar disorder. One development I’m particularly excited about is the new medication approved for schizophrenia with a novel mechanism of action. Having medications that target different pathways could expand treatment options for patients who haven’t responded well to existing therapies and could change how we approach treatment in the next 10 to 15 years.
This being Mental Health Awareness Month, what would you like the public to understand about mental illness and treatment?
Mental illness is common, is treatable, and deserves the same level of care and understanding as physical health conditions. Psychotropics are a huge part of treatment for many psychiatric conditions and work best when they’re managed thoughtfully, tailored to individual patients, and paired with support and education. Board-certified psychiatric pharmacists are uniquely trained and well-positioned to provide this kind of clinical expertise and patient education.
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