The practitioner's guide to psychoactive drugs:
Saved in:
| Format: | Book |
|---|---|
| Language: | English |
| Published: |
New York [u.a.]
Plenum Medical Book Corp.
1997
|
| Edition: | 4. ed. |
| Subjects: | |
| Online Access: | Inhaltsverzeichnis |
| Physical Description: | XXXII, 536 S. graph. Darst. |
| ISBN: | 0306454688 |
Staff View
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| 245 | 1 | 0 | |a The practitioner's guide to psychoactive drugs |c ed. by Alan J. Gelenberg ... |
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| 264 | 1 | |a New York [u.a.] |b Plenum Medical Book Corp. |c 1997 | |
| 300 | |a XXXII, 536 S. |b graph. Darst. | ||
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| 650 | 4 | |a Mental Disorders |x drug therapy | |
| 650 | 4 | |a Mental illness |x Chemotherapy | |
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Record in the Search Index
| _version_ | 1804126709983739904 |
|---|---|
| adam_text | Contents
I. State of the Art
1. Introduction: The Practice of Pharmacotherapy
Alan J. Gelenberg, M.D.
I. Historical Perspective 3
II. Current Trends in Psychopharmacology 5
A. Definition of Clinical Syndromes 5
B. Development of Brain Chemistry Models and New
Pharmacological Agents 5
C. Design of Drug Studies 6
III. Perspectives on Clinical Practice 6
A. Matching Medications with Drug Responsive Syndromes 7
B. Pharmacotherapy and Psychotherapy 8
IV. General Clinical Guidelines 9
A. Patient Evaluation 9
B. Principles of Drug Use 10
1. Understand the Pharmacokinetics of Psychotropic Agents ... 10
2. Prescribe the Simplest Drug Regimen to
Increase Compliance 12
3. Use the Fewest Number of Drugs to Achieve
the Desired Result 13
4. Provide the Most Cost Effective Treatment 13
5. Exercise Special Care with Medically 111 Patients 14
V. Conclusion 14
References 15
II. Major Psychiatric Disorders
2. Depression
Alan J. Gelenberg, M.D., and Pedro L. Delgado, M.D.
I. Introduction 19
II. Causal Models 20
A. Early Models and Historical Perspective 20
xv
xvi CONTENTS
B. Contemporary Models 20
1. Psychological 20
2. Biological 21
3. Integrative 22
III. Diagnostic Considerations 24
A. Clinical Presentations 24
B. Classifications 26
C. Biological Diagnosis 28
IV. General Therapeutic Measures 28
A. Milieu and Crisis Techniques 29
B. Psychotherapy 29
C. Electroconvulsive Therapy 31
1. Introduction 31
2. Mechanism of Action 32
3. Indications 32
4. Contraindications and Adverse Reactions 33
5. Technique 33
V. Pharmacotherapy 34
A. Heterocyclic Antidepressants 38
1. Chemistry 38
2. Mechanism of Action 41
3. Adverse Reactions 42
a. Gastric 43
b. Hematological 44
i. Leukocytic Effects and Purpura 44
ii. Agranulocytosis and Other Hemolytic Effects 44
c. Hepatic 44
d. Endocrine 44
e. Ocular 45
f. Cardiovascular 45
i. Hypotension and Hypertension 45
ii. Heart Rate Changes 46
iii. Conduction Delay 46
iv. Antiarrhythmic/Arrhythmogenic Activity 47
g. Neurological 49
i. Sedation/Stimulation 49
ii. Headaches 50
iii. Nocturnal Reactions 50
iv. Seizures 50
v. Anticholinergic Effects 50
vi. Movement Disorders 50
vii. Withdrawal Reactions 51
viii. Psychiatric Side Effects 52
h. Cutaneous 52
i. Autonomic 52
j. Sexual Side Effects 55
CONTENTS Xvii
k. Drug Interactions 56
1. Weight Changes 57
4. Precautions for Administration during Pregnancy 57
5. Acute Toxicity 58
a. Intoxication Syndromes 58
b. Anticholinergic Syndromes 62
i. Description 62
ii. Anticholinesterase Therapy 62
6. Pharmacokinetics 63
7. Plasma Levels 66
8. Preparations and Dosage 67
B. Monoamine Oxidase Inhibitors 69
1. Chemistry 69
2. Mechanism of Action 70
3. Adverse Reactions 72
a. Hypertensive Crisis 72
b. Hypermetabolic Crisis 73
c. Postural Hypotension 75
d. Cardiac Effects 75
e. Sexual Dysfunction 75
f. Edema and Weight Gain 75
g. Neuropsychiatric 76
i. Sleep Disturbances 76
ii. Psychiatric 76
iii. Other Neurological Effects 76
h. Hepatic 76
i. Other Adverse Reactions 77
j. Withdrawal Syndrome 77
4. Contraindications 77
5. Use during Pregnancy 77
6. Toxicity 77
7. Pharmacokinetics 78
8. Preparations and Dosage 78
C. Stimulants 79
D. Evaluation of the Depressed Patient 79
E. Drug Therapy for the Depressed Patient 81
1. Initiating Treatment 81
2. Completing a Medication Trial 83
3. Continuation Therapy 85
4. Maintenance Therapy for Chronic or
Recurrent Depressions 85
5. Depressive Episodes in Bipolar Disorders 86
6. Some Dichotomies: Mild versus Severe, Acute versus Chronic,
Agitated/Anxious versus Retarded 87
7. Atypical Depression 88
8. Major Depressive Episode with Psychotic Features 89
xviii contents
9. Depression in Schizophrenic Patients 89
10. Resistant Depressions 90
VI. Conclusion 92
References 93
3. Bipolar Disorder
Heather S. Hopkins and Alan J. Gelenberg, M.D.
I. Introduction 99
A. Clinical Presentation 100
B. Course of the Illness 101
II. General Measures for Treating Bipolar Disorder 102
A. Electroconvulsive Therapy 102
B. Milieu Therapy 103
C. Group Therapy 103
D. Psychotherapy and the Therapeutic Relationship 104
III. Pharmacotherapy 104
A. Lithium 105
1. Pharmacokinetics 106
2. Adverse Reactions 107
a. Endocrine 108
i. Thyroid 108
ii. Diabetes Mellitus 108
b. Renal 109
i. Decreased Concentration 109
ii. Structural Changes and Glomerular
Filtration Alterations 109
iii. Renal Function 109
iv. Other Kidney Effects 110
c. Hematological 110
d. Cardiovascular 110
e. Cutaneous Ill
f. Gastrointestinal Ill
g. Central Nervous System and Neuromuscular Ill
h. Ocular 113
i. Weight Gain 113
j. Other Adverse Reactions 113
3. Drug Interactions 113
4. Lithium Toxicity 115
5. Pregnancy 117
6. Preparations and Dosage 117
7. Other Possible Indications for Lithium 118
B. Valproate 118
1. Pharmacokinetics 119
CONTENTS xix
2. Adverse Reactions 119
a. Gastrointestinal 119
b. Central Nervous System Effects 120
c. Dermatological 120
d. Hematological 120
e. Hepatic 121
f. Other 121
3. Drug Interactions 121
4. Overdose 122
5. Pregnancy 123
6. Preparations and Dosage 123
C. Carbamazepine 123
1. Pharmacokinetics 123
2. Adverse Reactions 124
a. Hematological 125
b. Dermatological 125
c. Cardiovascular 125
d. Hepatic 125
e. Neurological 125
f. Gastrointestinal 126
g. Ocular 126
h. Metabolism 126
i. Renal 126
j. Genitourinary 126
k. Other 126
3. Drug Interactions 127
4. Overdose 129
5. Pregnancy 130
6. Preparations and Dosage 130
D. Antipsychotics 130
E. Antidepressants 131
F. Other 132
IV. Clinical Applications 133
A. Diagnostic Evaluation 133
B. Medical Evaluation 135
C. Treatment 136
1. Acute Manic Episode 138
2. Hypomania 141
3. Acute Depressive Episode 141
4. Maintenance Therapy 142
5. Rapid Cyclers 143
D. Mixed or Dysphoric Mania 144
E. Schizoaffective Disorder 144
V. Conclusion 145
References 145
XX CONTENTS
4. Psychoses
Alan J. Gelenberg, M.D., and Samuel Keith, M.D.
I. Introduction 153
II. Other Treatments 154
A. Nonbiological 154
B. Nondrug, Biological 155
1. Electroconvulsive Therapy 156
2. Psychosurgery 156
HI. Antipsychotic Drugs 156
A. Introduction and Terms 156
B. Effects on Behavior and the Nervous System 157
C. Mechanism of Action 159
D. Classes and Chemistry 162
E. General Principles of Use 166
F. Pharmacokinetics 168
G. Adverse Effects and Toxicity 170
1. Neurological 170
a. Extrapyramidal Syndromes 170
i. Acute Dystonic Reactions 170
ii. Akathisia 172
iii. Parkinson s Syndrome 173
iv. Tardive Dyskinesia and Tardive Dystonia 176
b. Sedation 185
c. Seizures 185
d. Neuroleptic Malignant Syndrome 186
2. Anticholinergic 187
a. Peripheral 187
b. Central 188
c. Serious Toxicity 188
3. Cardiovascular and Respiratory 188
a. Hypotension 188
b. Cardiac 189
4. Ocular 190
5. Cutaneous 191
6. Hormonal, Sexual, and Hypothalamic Reactions 191
7. Hepatic 192
8. Hematological 193
9. Pregnancy and Lactation 194
10. Withdrawal Reactions 195
11. Overdose 195
H. Drug Interactions and Combinations 196
I. Laboratory Tests and Monitoring 198
J. Clinical Uses of the Antipsychotic Drugs 199
1. Acute Treatment 199
CONTENTS XXi
2. Transition and Continuation Therapy 204
3. Maintenance Therapy 205
a. Definition 205
b. Chronic Schizophrenia 205
c. Other Diagnostic Groups 208
IV. Conclusion 208
References 209
5. Anxiety
Eric M. Reiman, M.D.
I. Introduction 213
II. Current Concepts/Etiological Theories 213
A. Symptoms 213
B. Substrates 214
1. Neuroanatomical Substrates 214
2. Neurochemical Substrates 215
3. Psychological Substrates 216
C. Integrating Biological and Psychosocial Contributions
to the Problem 217
D. Differential Diagnosis 218
1. The Anxious Response to Everyday Stressors 219
2. Anxiety Disorders 219
a. The Physiological Effect of a Nonpsychiatric
Medical Condition 219
b. The Physiological Effect of a Substance or
Its Discontinuation 220
c. Panic Disorder 220
d. Agoraphobia 221
e. Social Phobia 221
f. Specific Phobia 222
g. Obsessive Compulsive Disorder 223
h. The Response to a Catastrophic Stressor 225
i. Generalized Anxiety Disorder 226
3. Other Psychiatric Disorders 227
III. Nonpharmacological Treatment Measures 227
A. Supportive Therapy 227
B. Cognitive and Behavioral Therapies 228
C. Neurosurgical Treatments 229
IV. Pharmacotherapy 229
A. Benzodiazepines 229
1. Introduction 229
2. Mechanism of Action 231
3. Chemistry 231
XXU CONTENTS
4. Principles of Benzodiazepine Use 232
5. Pharmacokinetics 233
a. Onset 233
b. Administration Route 235
c. Duration 235
d. Potency 237
6. Adverse Effects 237
a. Cognitive and Performance Effects 237
b. Uncommon Effects 238
c. Dependence 239
d. Pregnancy Related Risks 240
e. Risks in the Elderly 241
f. Toxicity 241
7. Drug Interactions 241
8. Laboratory Tests 242
B. Other Sedative Hypnotics 242
C. Buspirone 243
D. P Blockers 245
E. Antidepressants and MAO Inhibitors 246
V. Clinical Considerations 248
A. General Principles 248
B. Adjustment Disorder 249
C. Panic Disorder 251
D. Agoraphobia 254
E. Social Phobia, Circumscribed Type 255
F. Social Phobia, Generalized Type 255
G. Specific Phobia 256
H. Obsessive Compulsive Disorder 257
I. Acute and Posttraumatic Stress Disorders 259
J. Generalized Anxiety Disorder 260
VI. Conclusions 262
References 262
Selected Readings 262
6. Insomnia
Jeffrey B. Weilburg. M.D.. and Heather S. Hopkins
I. Introduction 265
A. Normal Sleep 266
B. Sleep Disorders 266
1. Sleep Apnea 267
2. Nocturnal Myoclonus 267
3. Phase Shifts 268
4. Psychophysiological Insomnia 268
5. Primary Idiopathic Insomnia 268
II. Diagnostic Considerations 268
CONTENTS xxiii
III. General Therapeutic Measures 270
IV. Pharmacotherapy 271
A. Benzodiazepines 272
1. Mechanism of Action 272
2. Pharmacokinetics 272
3. Onset and Duration of Action 273
4. Adverse Effects 273
a. Next Day Sedation 274
b. Rebound Insomnia and Anxiety 274
c. Cognitive and Psychomotor Impairment 274
d. Behavioral Alterations 274
e. Respiratory and Cardiovascular 275
f. Elderly Patients 275
5. Drug Interactions 275
6. Dependence and Withdrawal 277
7. Toxicity 277
8. Pregnancy and Breast Feeding 277
9. Preparations and Dosing 278
B. Zolpidem 278
1. Pharmacokinetics 278
2. Adverse Effects 279
3. Withdrawal 279
4. Drug Interactions 279
5. Overdose 279
6. Pregnancy 280
7. Preparations and Dosing 280
C. Antihistamines 281
D. Barbiturates 281
E. Chloral Hydrate 281
F. Ethchlorvynol 282
G. Over the Counter Drugs 283
H. Other Psychotropics for Insomnia 283
1. Antidepressants 283
2. Antipsychotics 284
3. Buspirone 284
4. Clonidine 284
V. Clinical Application Summary 284
VI. Conclusion 286
References 286
HI. Psychoactive Substance Abuse
7. Psychoactive Substance Use Disorders
Shelly F. Greenfield, M.D., M.P.H., Roger D. Weiss, M.D., and Steven M. Mirin, M.D.
I. Introduction and Definitions 291
xxiv CONTENTS
II. Opioid Abuse and Dependence 293
A. Classification 293
B. Pharmacology 294
C. Acute Effects 294
1. Central 294
2. Peripheral 294
D. Tolerance and Physical Dependence 295
E. Acute Intoxication and Overdose 295
1. Etiology 295
2. Clinical Manifestations 295
3. Management 296
a. General Life Support Measures 296
b. The Use of Naloxone 296
c. Other Considerations 296
F. Opioid Withdrawal 297
1. Clinical Manifestations 297
2. Management 297
a. Medical Detoxification 297
b. Detoxification with Methadone 298
i. Pharmacology 298
ii. Principles of Use 298
iii. Clinical Application 298
c. The Use of Clonidine in Opioid Detoxification 299
d. Clonidine/Naltrexone Rapid Detoxification 300
e. The Use of Buprenorphine in Opioid Detoxification 300
G. Treatment of Chronic Opioid Abuse 301
1. Medical Complications 301
2. Treatment Approaches 302
a. General Considerations 302
b. Methadone Maintenance 302
i. Background and Theory 302
ii. Clinical Application 302
iii. Detoxification from Methadone 303
iv. Current Issues in Methadone Treatment 304
v. LAAM Maintenance 304
c. The Use of Narcotic Antagonists 304
i. Rationale 304
ii. Clinical Use 305
d. Outpatient Psychosocial Treatments 306
e. Treatment of Co occurring Psychiatric Disorders 307
f. Therapeutic Communities 307
III. Sedative Hypnotic and Benzodiazepine Abuse and Dependence .... 307
A. Introduction 307
B. Tolerance and Physical Dependence 308
C. Classification 308
1. Benzodiazepines 308
CONTENTS XXV
2. Barbiturates 309
3. Other Sedative Hypnotics 309
D. Abuse of Sedative Hypnotics and Benzodiazepines 310
E. Acute Intoxication and Overdose 311
1. Etiology 311
2. Clinical Manifestations 311
3. Management 312
F. Withdrawal from Benzodiazepines and Sedative Hypnotics 312
1. Clinical Manifestations 312
a. High Dose Benzodiazepine Withdrawal Syndrome 313
b. Low Dose Benzodiazepine Withdrawal Syndrome 313
2. Treatment of Benzodiazepine and Sedative Hypnotic
Withdrawal Syndromes 314
a. Treatment of High Dose Benzodiazepine and Sedative
Hypnotic Withdrawal 314
i. Phenobarbital Substitution 314
ii. The Phenobarbital Tolerance Test 315
iii. Gradual Dose Reduction 316
b. Treatment of Low Dose Benzodiazepine Withdrawal .... 317
3. Mixed Opioid Sedative Dependence 317
IV. Alcohol Abuse and Dependence 317
A. Introduction 317
B. Pharmacology 318
C. Tolerance and Physical Dependence 318
D. Acute Intoxication 319
1. Simple Type 319
2. Alcohol Intoxication Delirium 320
E. Chronic Intoxication 320
1. Peripheral and Central Nervous System Effects 320
2. Effects on Other Organ Systems 321
F. Alcohol Withdrawal 321
1. Minor Abstinence Syndrome 321
a. Clinical Manifestations 321
b. Management 322
2. Major Abstinence Syndrome (Alcohol
Withdrawal Delirium) 323
a. Clinical Manifestations 323
b. Management 324
3. Alcohol Induced Psychotic Disorder 324
G. Treatment of Chronic Alcohol Use Disorders 324
1. Introduction 325
2. Biological Treatment 325
a. Disulfiram 325
b. Naltrexone 326
c. Psychotropic Drugs 326
3. Aftercare 327
XXVi CONTENTS
4. Cognitive Behavioral and Behavioral Approaches
to Treatment 327
a. Cognitive Behavioral Techniques 327
b. Other Behavioral Techniques 327
5. The Psychotherapies 328
6. Brief Interventions 328
7. Alcoholics Anonymous and Other Self Help Groups 328
8. Adjunctive Services 329
9. Summary 329
V. Central Nervous System Stimulant Abuse and Dependence 329
A. Cocaine 329
1. Epidemiology 329
2. Pharmacology and Methods of Use 330
3. Acute Intoxication 330
4. Abstinence Symptoms 331
5. Tolerance and Physical Dependence 331
6. Medical Complications 332
7. Treatment of Cocaine Abuse 332
B. Amphetamines 333
1. Introduction 333
2. Pharmacology 333
3. Acute Effects 334
4. Tolerance and Physical Dependence 334
5. Patterns of Abuse 334
6. Acute Intoxication 335
a. Clinical Manifestations 335
b. Management 336
7. Amphetamine Withdrawal 336
8. Amphetamine or Similarly Acting Sympathomimetic Induced
Delusional Disorder 336
VI. Hallucinogen Abuse 337
A. Introduction 337
B. Classification 337
C. ^/ Lysergic Acid Diethylamide 338
1. Pharmacology 338
2. Tolerance and Physical Dependence 338
3. Acute Intoxication 338
D. Adverse Reactions following Use of LSD or
Other Hallucinogens 340
1. Panic Reactions 340
2. Toxic Delirium 341
3. Drug Precipitated Functional Psychosis 341
4. Flashbacks —Hallucinogen Persisting
Perception Disorder 341
E. Sequelae of Chronic Hallucinogen Use 342
VII. Phencyclidine Abuse 342
CONTENTS xxvii
VIII. Inhalant Abuse 343
A. Introduction 343
B. Patterns of Abuse 343
C. Acute Intoxication 343
D. Sequelae of Chronic Inhalant Use 344
E. Treatment Approaches 344
IX. Designer Drugs: MDMA and MDEA 344
X. Marijuana Use and Abuse 346
A. Introduction 346
B. Patterns of Use and Abuse 346
C. Tolerance and Dependence 347
D. Pharmacology 347
E. Acute Intoxication 348
1. Subjective Effects 348
2. Physiological Changes 348
3. Cognitive and Psychomotor Effects 348
F. Adverse Reactions following Marijuana Use 349
1. Acute Panic 349
2. Toxic Delirium 349
3. Recurrent Reactions ( Flashbacks ) 349
G. Sequelae of Chronic Use 350
1. Cannabis Psychosis 350
2. Amotivational Syndrome 350
3. Depression 351
4. Medical Problems 351
H. Treatment of Chronic Marijuana Abuse 351
XI. Substance Abuse in Perspective 352
Selected Reading 353
IV. Special Topics
8. Geriatric Psychopharmacology
Carl Salzman, M.D.
I. Introduction 367
II. Adverse Reactions 367
A. Central Nervous System 368
1. Sedation 368
2. Confusion 372
3. Extrapyramidal 373
4. Other Central Nervous System Symptoms 373
B. Cardiac 374
1. Effects on Blood Pressure 374
2. Effects on Rate, Rhythm, and Contractility 374
C. Other Organ Systems 375
XXViH CONTENTS
III. Clinical Application 375
A. Principles of Medication Use to Treat Elderly Patients Safely ... 375
B. Clinical Use 376
1. Agitated Behavior and Psychotic Thinking 376
a. Neuroleptic Treatment of Acute Psychosis or
Behavior Problems 376
b. Non Neuroleptic Treatment of Acute Psychosis or
Behavior Problems 377
c. Treatment of Extrapyramidal Symptoms 378
2. Dementia 378
3. Anxiety 379
4. Insomnia 380
5. Depression 381
6. Bipolar Affective Disorder 383
IV. Conclusion 384
9. Pediatric Psychopharmacology
Janet Wozniak, M.D., Joseph Biederman, M.D., Thomas Spencer, M.D.,
and Timothy Wilens, M.D.
I. Introduction 385
II. Attention Deficit Hyperactivity Disorder 386
III. Major Depression 399
IV. Bipolar Disorder 401
V. Anxiety Disorders 404
VI. Obsessive Compulsive Disorder 406
VII. Tic Disorders 406
VIII. Psychosis 408
IX. Developmental Disorders 411
X. Sleep Disturbances 412
XI. Enuresis 412
XII. Combined Pharmacotherapy 412
XIII. Conclusions 413
References 413
10. Psychotropic Drug Use in Pregnancy
Lee S. Cohen, M.D., Lori Altshuler, M.D., Vicki L. Heller, M.D.,
and Jerrold Rosenbaum, M.D.
I. Introduction 417
II. Assessment of Women of Childbearing Potential 418
A. Risks of Pharmacotherapy 418
B. Risks Associated with Psychiatric Illness 419
CONTENTS XXix
III. Psychotropic Drugs in Pregnancy 420
A. Antipsychotics 420
B. Antidepressants 421
1. Tricyclic Antidepressants 421
2. Serotonin Selective Reuptake Inhibitors 422
3. Other Antidepressants 422
C. Electroconvulsive Therapy 423
D. Mood Stabilizers 423
1. Lithium 423
2. Anticonvulsants 424
E. Benzodiazepines 425
IV. Treatment Guidelines 426
A. Psychosis 426
B. Mood Disorders 427
1. Major Depression 427
2. Bipolar Disorder 428
C. Anxiety Disorders 430
1. Panic Disorder 430
2. Obsessive Compulsive Disorder 431
V. Breast Feeding 431
VI. Conclusion 431
References 432
11. Psychopharmacology of HIV Related Psychiatric Disorders
Francisco Fernandez, M.D., and Jorge Maldonado, M.D.
I. Introduction 441
II. Laboratory Diagnosis of HIV/AIDS Disease 442
III. Neurobehavioral Manifestations of HIV Disease 443
A. General Considerations 443
B. Neuropsychiatric Complications 443
1. Dementia 445
a. Epidemiology 445
b. Clinical Features 445
c. Differential Diagnosis 445
d. Evaluation 446
2. Depression 446
a. Epidemiology 446
b. Clinical Features 446
c. Differential Diagnosis 448
d. Evaluation 448
3. Anxiety 449
a. Epidemiology 449
b. Clinical Features 450
XXX CONTENTS
c. Differential Diagnosis 450
d. Evaluation 450
4. Delirium 450
a. Epidemiology 450
b. Clinical Features 450
c. Differential Diagnosis 451
d. Evaluation 451
5. Psychosis 451
a. Epidemiology 451
b. Clinical Features 452
c. Differential Diagnosis 453
d. Evaluation 453
6. Insomnia 453
a. Epidemiology 453
b. Clinical Features 453
c. Differential Diagnosis 454
d. Evaluation 454
IV. Treatment of HIV Related Neuropsychiatric Syndromes 454
A. Dementia 454
1. Primary Therapy 454
2. Adjunctive Therapy 455
3. Palliative Therapy 455
4. Nonbiological Treatments 455
B. Depression 456
1. Heterocyclic Antidepressants 456
2. New Agents 457
3. Other Agents 457
4. Nonbiological Treatments 457
C. Anxiety 458
1. Anxiolytics 458
2. Nonbiological Treatments 458
D. Delirium 459
E. Psychosis 460
1. Neuroleptics 460
2. Lithium 461
3. Anticonvulsants 462
4. Nonbiological Treatments 462
F. Insomnia 462
1. Pharmacotherapy 462
2. Nonbiological Treatments 462
V. Conclusions 463
Selected Reading 463
12. Eating Disorders
Andrew W. Brotman, M.D., David B. Herzog, M.D., and David C. Jimerson, M.D.
I. Introduction 467
CONTENTS XXXi
II. Diagnostic Considerations 468
A. Anorexia Nervosa 468
B. Bulimia Nervosa 468
C. Binge Eating Disorder 470
III. General Approach to Treatment 471
A. Outpatient Treatment 471
B. Inpatient Treatment 471
IV. Pharmacotherapy for Eating Disorders 471
A. Anorexia Nervosa 471
1. Use of Medications in AN 471
2. Clinical Recommendations 473
3. Outcomes 474
B. Bulimia Nervosa 474
1. Use of Medications in BN 474
2. Clinical Recommendations 476
C. Binge Eating Disorder 477
Use of Medications in BED 477
V. Conclusion 477
References 478
13. Borderline Disorders
Paul H. Soloff, M.D.
I. Introduction 483
A. Psychobiologic Models 484
B. Psychosocial Models 485
II. Diagnostic Considerations 486
A. Diagnostic Criteria 486
B. Differential Diagnosis 488
C. Course of the Illness 488
III. General Therapeutic Measures 489
A. General Nonbiological Therapeutic Approaches: Psychotherapy .... 489
B. General Issues Related to Pharmacotherapy 490
1. Attrition 490
2. Hospitalization 490
3. Special Risks 490
IV. Pharmacotherapy 491
A. Approach to Treatment 491
B. General Clinical Considerations in Pharmacotherapy of BPD .... 492
C. Main Effects of Medications on Target Symptoms in BPD 492
1. Low Dose Neuroleptic Strategy 492
2. Antidepressants 493
3. Anticonvulsants 494
4. Lithium Carbonate 495
5. Benzodiazepines 495
V. Clinical Considerations/Applications 496
A. The Globally Symptomatic/Depressed Borderline Patient 496
xxxii CONTENTS
B. The Hostile/Depressed Borderline Patient 496
C. The Schizotypal Borderline Pattern 497
D. The Impulsive Borderline Symptom Pattern 497
VI. Conclusion 497
References 498
14. Medicolegal Psychopharmacology
Thomas G. Gutheil, M.D.
I. Introduction 501
II. Informed Consent 501
A. Consent Forms and Alternatives 502
B. Exceptions to Informed Consent 503
III. Liability 503
A. Definition 503
B. Some Common Forms of Liability 504
1. Lack of Informed Consent 504
2. Misdiagnosis 505
3. Inadequate Treatment 505
4. Side Effects and Bad Reactions 505
5. Tardive Dyskinesia 505
6. Special Problems with Tricyclic Antidepressants 506
C. Fundamentals of Liability Prevention 507
1. Sharing Uncertainty 507
2. The Therapeutic Alliance 508
3. Selection 508
4. Documentation and Consultation 508
IV. The Right to Refuse Treatment 508
A. Basic Issues 508
1. Emergencies 509
2. Vicarious Consent 509
B. Some Modern Developments 509
V. Guidelines for Clinicians 510
VI. Conclusion 510
References 510
Index 513
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| callnumber-sort | RC 3483 |
| callnumber-subject | RC - Internal Medicine |
| ctrlnum | (OCoLC)37322840 (DE-599)BVBBV012105707 |
| dewey-full | 615/.78 |
| dewey-hundreds | 600 - Technology (Applied sciences) |
| dewey-ones | 615 - Pharmacology and therapeutics |
| dewey-raw | 615/.78 |
| dewey-search | 615/.78 |
| dewey-sort | 3615 278 |
| dewey-tens | 610 - Medicine and health |
| discipline | Medizin |
| edition | 4. ed. |
| format | Book |
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| id | DE-604.BV012105707 |
| illustrated | Illustrated |
| indexdate | 2024-07-09T18:21:46Z |
| institution | BVB |
| isbn | 0306454688 |
| language | English |
| oai_aleph_id | oai:aleph.bib-bvb.de:BVB01-008196868 |
| oclc_num | 37322840 |
| open_access_boolean | |
| owner | DE-20 |
| owner_facet | DE-20 |
| physical | XXXII, 536 S. graph. Darst. |
| publishDate | 1997 |
| publishDateSearch | 1997 |
| publishDateSort | 1997 |
| publisher | Plenum Medical Book Corp. |
| record_format | marc |
| spelling | The practitioner's guide to psychoactive drugs ed. by Alan J. Gelenberg ... 4. ed. New York [u.a.] Plenum Medical Book Corp. 1997 XXXII, 536 S. graph. Darst. txt rdacontent n rdamedia nc rdacarrier Mental Disorders drug therapy Mental illness Chemotherapy Psychopharmacology Psychotropic Drugs Psychotropic drugs Psychopharmakologie (DE-588)4176249-6 gnd rswk-swf Psychopharmakologie (DE-588)4176249-6 s DE-604 Gelenberg, Alan J. Sonstige oth HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008196868&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | The practitioner's guide to psychoactive drugs Mental Disorders drug therapy Mental illness Chemotherapy Psychopharmacology Psychotropic Drugs Psychotropic drugs Psychopharmakologie (DE-588)4176249-6 gnd |
| subject_GND | (DE-588)4176249-6 |
| title | The practitioner's guide to psychoactive drugs |
| title_auth | The practitioner's guide to psychoactive drugs |
| title_exact_search | The practitioner's guide to psychoactive drugs |
| title_full | The practitioner's guide to psychoactive drugs ed. by Alan J. Gelenberg ... |
| title_fullStr | The practitioner's guide to psychoactive drugs ed. by Alan J. Gelenberg ... |
| title_full_unstemmed | The practitioner's guide to psychoactive drugs ed. by Alan J. Gelenberg ... |
| title_short | The practitioner's guide to psychoactive drugs |
| title_sort | the practitioner s guide to psychoactive drugs |
| topic | Mental Disorders drug therapy Mental illness Chemotherapy Psychopharmacology Psychotropic Drugs Psychotropic drugs Psychopharmakologie (DE-588)4176249-6 gnd |
| topic_facet | Mental Disorders drug therapy Mental illness Chemotherapy Psychopharmacology Psychotropic Drugs Psychotropic drugs Psychopharmakologie |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008196868&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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