Handbook of essential psychopharmacology

Title:

Author:

Pies, Ronald W., 1952-

ISBN:

9780880487658

Edition:

1st ed

Publication Information:

Washington, DC : American Psychiatric Press, c1998

Physical Description:

xvi, 416 p. : ill. ; 21 cm

General Note:

Companion v. to : Clinical manual of psychiatric diagnosis and treatment. c1994

Subject Term:

Psychopharmacology -- Handbooks, manuals, etc.

Added Author:

Pies, Ronald W., 1952- Clinical manual of psychiatric diagnosis and treatment.

Available:

Library	Call Number	Material Type	Status
Searching... State Library of Oregon	615.78 Pies	4-Week Loan	Searching... Unknown

"Dr. Pie's extraordinary breadth of knowledge and his outstanding teaching skills are evident everywhere in the Handbook of Essential Psychopharmacology. This concise volume includes so much information that anyone who delves into it will learn something new and of practical value. It is remarkably up-to-date and pays special attention to pharmacotherapy indications, medication side effects, and psychiatric drugs' interactions with other prescribed medications. Any experienced consultant will pick up a few pearls from Dr. Pies, and prescribing clinicians at all levels of experience will welcome the book's integration of scholarly and subtle detail with clear and comprehensive discussions of basic principles". James M. Ellison, M.D., M.P.H. Chief, Mental Health Department Robert H. Ebert Health Center Harvard Pilgrim Health Care Burlington, Massachusetts

Loaded with many special features, the Handbook of Essential Psychopharmacology is both a handy clinical reference for experienced clinicians and an ideal teaching tool and manual for residents, especially those preparing for the psychiatry board examinations. This useful guide provides busy residents and clinicians with a quick, current, and accessible guide to basic facts about psychotropic drugs, including dosage, indications, and drug interactions.

Packed with essential information and many useful charts and graphs, the Handbook of Essential Psychopharmacology is an essential starting point in psychopharmacology for residents and experienced clinicians alike.

Preface to the Second Edition	p. xvii
Chapter 1 Introduction to Pharmacodynamics and Pharmacokinetics	p. 1
Pharmacodynamics	p. 2
Ligands and Receptors	p. 2
Neurotransmitters and Signal Transduction	p. 3
Figure 1-1 Drug mechanism of action (pharmacodynamics)	p. 5
Pharmacokinetics	p. 6
Absorption	p. 6
Distribution	p. 7
Elimination	p. 8
Drug Metabolism	p. 9
General Issues	p. 9
Cytochrome Families	p. 10
Table 1-1 Selected substrates, inhibitors, and inducers of major cytochrome P450 enzymes	p. 11
Glucuronidation	p. 15
Drug-Drug Interactions	p. 15
Conclusion	p. 16
References	p. 17
Chapter 2 Antidepressants	p. 19
Overview	p. 19
Drug Class	p. 19
Indications	p. 20
Mechanisms of Action	p. 20
Pharmacokinetics	p. 21
Main Side Effects	p. 22
Drug-Drug Interactions	p. 23
Potentiating Maneuvers	p. 24
Use in Special Populations	p. 25
Tables	p. 27
Drug Class	p. 27
Table 2-1 Classification of antidepressants by putative neurotransmitter effects	p. 27
Table 2-2 Non-MAOI antidepressants: formulations, strengths, and usual maintenance dosage	p. 28
Table 2-3 Monoamine oxidase inhibitors (MAOIs): tablet strengths and usual adult dosage	p. 30
Table 2-4 Relative monthly cost of selected antidepressants (low/middle therapeutic dosage range)	p. 31
Indications	p. 32
Talbe 2-5 "Off-label" and non-mood disorder indications for antidepressants	p. 32
Mechanisms of Action	p. 36
Table 2-6 Neurotransmitter effects of selected antidepressants	p. 36
Table 2-7 Effects of reuptake blockade and receptor antagonism	p. 37
Table 2-8 Effects of serotonin (5-HT) receptor stimulation	p. 38
Pharmacokinetics	p. 39
Table 2-9 Pharmacokinetics of selected antidepressants	p. 39
Table 2-10 Pharmacodynamic and pharmacokinetic profiles of newer antidepressants	p. 42
Table 2-11 Putative optimal plasma levels for tricyclic antidepressants	p. 48
Main Side Effects	p. 49
Table 2-12 Side-effect profiles of commonly used antidepressants	p. 49
Table 2-13 Side effects of tricyclic vs. selected nontricyclic antidepressants (% of patients reporting, placebo adjusted)	p. 51
Figure 2-1 Cardiac and autonomic side effects of selected antidepressants	p. 52
Figure 2-2 Gastrointestinal and sexual side effects of selected antidepressants	p. 53
Figure 2-3 Neurobehavioral side effects of selected antidepressants	p. 54
Table 2-14 Some comparative side effects of selective serotonin reuptake inhibitors (placebo-adjusted %)	p. 55
Table 2-15 Basic management of antidepressant side effects	p. 56
Table 2-16 Selected co-prescribed agents for antidepressant-induced sexual dysfunction	p. 59
Drug-Drug Interactions	p. 60
Table 2-17 Drug-drug interactions with tricyclic antidepressants (TCAs)	p. 60
Table 2-18 Some drugs used in clinical practice that may interact with selective serotonin reuptake inhibitors (SSRIs) and related antidepressants	p. 61
Table 2-19 Drug-drug interactions with monoamine oxidase inhibitors (MAOIs)	p. 65
Table 2-20 Food restrictions for patients taking conventional monoamine oxidase inhibitors (MAOIs)	p. 66
Table 2-21 The serotonin syndrome: differential diagnosis	p. 67
Table 2-22 Serotonin syndrome	p. 70
Potentiating Maneuvers	p. 71
Table 2-23 Agents used to potentiate or augment antidepressants	p. 71
Table 2-24 Psychostimulants and related agents: main features	p. 73
Use in Special Populations	p. 75
Table 2-25 Selection of nontricyclic antidepressants for patients with special needs or comorbid conditions	p. 75
Table 2-26 Antidepressant dosing in children and adolescents	p. 78
Questions and Answers	p. 79
Drug Class	p. 79
Indications	p. 79
Mechanisms of Action	p. 85
Pharmacokinetics	p. 90
Main Side Effects	p. 94
Drug-Drug Interactions	p. 101
Potentiating Maneuvers	p. 103
Use in Special Populations	p. 111
Vignettes/Puzzlers	p. 117
References	p. 123
Chapter 3 Antipsychotics	p. 139
Overview	p. 139
Drug Class	p. 139
Indications	p. 140
Mechanisms of Action	p. 140
Pharmacokinetics	p. 142
Main Side Effects	p. 143
Drug-Drug Interactions	p. 144
Potentiating Maneuvers	p. 145
Use in Special Populations	p. 145
Tables	p. 148
Drug Class	p. 148
Table 3-1 Dosages and putative therapeutic levels of currently available antipsychotics	p. 148
Table 3-2 First-generation ("typical" or "neuroleptic") antipsychotic dosage equivalents of 10 mg of haloperidol	p. 150
Table 3-3 Second-generation ("atypical") antipsychotic dosage equivalents of 10 mg of haloperidol	p. 151
Table 3-4 Comparative costs of some atypical antipsychotics	p. 152
Indications	p. 153
Table 3-5 Indications for use of antipsychotics	p. 153
Mechanisms of Action	p. 159
Table 3-6 Relative receptor affinities of haloperidol versus available atypical agents	p. 159
Pharmacokinetics	p. 160
Table 3-7 Pharmacokinetic profiles of first-generation (neuroleptic) antipsychotics	p. 160
Table 3-8 Pharmacokinetic profiles of second-generation (atypical) antipsychotics	p. 161
Main Side Effects	p. 162
Table 3-9 Comparative side effects among available first-generation (typical) antipsychotics	p. 162
Table 3-10 Comparative side effects among selected second-generation (atypical) antipsychotics	p. 163
Table 3-11 Motor and mental symptoms of neurolepticinduced extrapyramidal side effects	p. 164
Table 3-12 Selected agents for treatment of extrapyramidal side effects (EPS) of first-generation (neuroleptic) antipsychotics	p. 165
Table 3-13 Neuroleptic malignant syndrome (NMS): differential diagnosis	p. 166
Table 3-14 Management of antipsychotic (AP) side effects	p. 171
Table 3-15 Clozapine and white blood cell count (WBC): managing abnormalities	p. 173
Drug-Drug Interactions	p. 175
Table 3-16 Antipsychotic (AP) drug interactions	p. 175
Table 3-17 Second-generation (atypical) antipsychotics (APs): potential drug-drug interactions	p. 177
Potentiating Maneuvers	p. 178
Table 3-18 Potentiation of antipsychotics (APs)	p. 178
Use in Special Populations	p. 182
Table 3-19 Antipsychotics (APs) in special populations	p. 182
Questions and Answers	p. 186
Drug Class	p. 186
Indications	p. 188
Mechanisms of Action	p. 195
Pharmacokinetics	p. 200
Main Side Effects	p. 201
Drug-Drug Interactions	p. 212
Potentiating Maneuvers	p. 214
Use in Special Populations	p. 219
Vignettes/Puzzlers	p. 227
References	p. 236
Chapter 4 Anxiolytics and Sedative-Hypnotics	p. 253
Overview	p. 253
Drug Class	p. 253
Indications	p. 254
Mechanisms of Action	p. 255
Pharmacokinetics	p. 256
Main Side Effects	p. 256
Drug-Drug Interactions	p. 257
Potentiating Maneuvers	p. 258
Use in Special Populations	p. 258
Tables	p. 260
Drug Class	p. 260
Table 4-1 Commonly used benzodiazepine anxiolytics	p. 260
Table 4-2 Commonly prescribed benzodiazepine and nonbenzodiazepine hypnotics	p. 261
Table 4-3 Nonbenzodiazepine anxiolytics and hypnotics	p. 262
Table 4-4 Dosage and cost of selected benzodiazepines	p. 265
Indications	p. 266
Table 4-5 Indications for benzodiazepines (BZDs)	p. 266
Table 4-6 Selective serotonin reuptake inhibitors (SSRIs) or related antidepressants with FDA-approved labeling for use in treating DSM-IV-TR anxiety disorders	p. 270
Table 4-7 Off-label uses for beta-blockers and clonidine for anxiety/agitation in selected disorders	p. 271
Mechanisms of Action	p. 272
Table 4-8 Effect of various agents on GABA[subscript A] receptors	p. 272
Table 4-9 Pharmacodynamic aspects of hypnotic agents	p. 273
Pharmacokinetics	p. 274
Table 4-10 Pharmacokinetics of orally administered benzodiazepine anxiolytics	p. 274
Table 4-11 Pharmacokinetics of benzodiazepine hypnotics	p. 275
Table 4-12 Pharmacokinetics of nonbenzodiazepine hypnotics	p. 276
Figure 4-1 Simplified metabolic pathways of benzodiazepines	p. 277
Main Side Effects	p. 278
Table 4-13 Frequency (%) of benzodiazepine (BZD) and buspirone side effects (average for various BZDs)	p. 278
Table 4-14 Side effects and management of benzodiazepines (BZDs)	p. 279
Drug-Drug Interactions	p. 282
Table 4-15 Benzodiazepine (BZD) drug interactions	p. 282
Table 4-16 Nonbenzodiazepine (non-BZD) hypnotic drug interactions	p. 285
Potentiating Maneuvers	p. 286
Table 4-17 Agents used in combination with benzodiazepines (BZDs) for augmentation of effect	p. 286
Use in Special Populations	p. 287
Table 4-18 Potential concerns of benzodiazepine (BZD) use during pregnancy	p. 287
Table 4-19 Risks of benzodiazepine (BZD) use in elderly and/or dementia patients	p. 288
Questions and Answers	p. 289
Drug Class	p. 289
Indications	p. 290
Mechanisms of Action	p. 302
Pharmacokinetics	p. 304
Main Side Effects	p. 306
Drug-Drug Interactions	p. 310
Potentiating Maneuvers	p. 313
Use in Special Populations	p. 315
Vignettes/Puzzlers	p. 320
References	p. 324
Chapter 5 Mood Stabilizers	p. 337
Overview	p. 337
Drug Class	p. 337
Indications	p. 338
Mechanisms of Action	p. 340
Pharmacokinetics	p. 340
Main Side Effects	p. 342
Drug-Drug Interactions	p. 343
Potentiating Maneuvers	p. 344
Use in Special Populations	p. 344
Tables	p. 346
Drug Class	p. 346
Table 5-1 Selected mood stabilizers: preparations, usual daily doses, and putative therapeutic blood levels	p. 346
Indications	p. 349
Table 5-2 Indications for lithium	p. 349
Table 5-3 Preferred treatments of acute manic or mixed episodes in bipolar disorder	p. 351
Table 5-4 Preferred treatments of acute depressive episodes in bipolar disorder	p. 353
Table 5-5 Preferred treatments of rapid cycling in bipolar disorder	p. 355
Table 5-6 Preferred maintenance treatments in bipolar disorder	p. 356
Mechanisms of Action	p. 357
Table 5-7 Mood stabilizer and anticonvulsant mechanisms of action	p. 357
Pharmacokinetics	p. 358
Table 5-8 Pharmacokinetics of selected mood stabilizers	p. 358
Main Side Effects	p. 360
Table 5-9 Lithium side effects	p. 360
Table 5-10 Stages of lithium toxicity	p. 361
Table 5-11 Five most common side effects of carbamazepine	p. 362
Table 5-12 Management of common anticonvulsant mood stabilizer side effects (non-placeboadjusted rates)	p. 363
Table 5-13 Management of lithium side effects	p. 366
Table 5-14 Potential risk factors for antidepressant-induced mania (AIM) or cycling	p. 369
Drug-Drug Interactions	p. 370
Table 5-15 Drug-drug interactions with lithium	p. 370
Table 5-16 Drug-drug interactions with carbamazepine (CBZ)	p. 373
Table 5-17 Drug-drug interactions with valproate	p. 377
Table 5-18 Drug-drug interactions with lamotrigine	p. 379
Potentiating Maneuvers	p. 381
Table 5-19 Augmenting strategies in treating patients with bipolar disorder	p. 381
Use in Special Populations	p. 387
Table 5-20 Use of mood stabilizers in special populations	p. 387
Questions and Answers	p. 389
Indications	p. 389
Mechanisms of Action	p. 403
Pharmacokinetics	p. 407
Main Side Effects	p. 410
Drug-Drug Interactions	p. 416
Potentiating Maneuvers	p. 420
Use in Special Populations	p. 423
Vignettes/Puzzlers	p. 428
References	p. 434
CME Questions and Answers	p. 449
Index	p. 469

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