The broadcast message below provides information regarding the Texas Implementation Medication Algorithms (TIMA), the recommendations from the DSHS Psychotropic Treatment Recommendations Workgroup (formerly TIMA Workgroup), and clinical and contract implementation of the recommendations:
As of November 2010, Dr. Lakey, Commissioner of DSHS approved the replacement of TIMA with the following:
- Use the 2009 PORT recommendations as a guideline for treatment and medication of schizophrenia.
- Use the 2010 American Psychiatric Association Practice Guidelines as a guideline for the treatment and medication of major depressive disorder.
- Treatment for diagnoses other than schizophrenia and major depressive disorder should conform to DSHS Executive Formulary audit guidelines, a specific set of guidelines for each psychotropic medication that include indications, contraindications, patient monitoring parameters and dosing information. The Executive Formulary Committee updates them quarterly.
- Treatment for children should conform Department of Family and Protective Services (DFPS) guidelines, which are maintained on the DFPS website at http://www.dfps.state.tx.us/Child_Protection/Medical_Services/guide-psychotropic.asp.
- Use current administrative rules as a mechanism to monitor polypharmcy (25 Texas Administrative Code §§ 415.7, 415.10, 415.11, 415.12). These rules describe practice guidelines for polypharmacy and require monitoring of polypharmacy.
- Use patient/ family education available from Substance Abuse and Mental Health Services Administration. http://store.samhsa.gov/product/SMA09-4423
- Rating scales, while highly recommended for tracking patient progress and symptoms, are optional.