Successful Psychopharmacology: Evidence-Based Treatment Solutions for Achieving Remission
Stephen V. Sobel
Format: PDF / Kindle (mobi) / ePub
A guide for physicians and clinicians to understanding and choosing the proper psychiatric medications and for their patients who want to learn how this should be done.
This book teaches mental health professionals how to choose and use psychotropic medications to address the biological etiology of psychiatric disease and mental health. It helps readers understand the key aspects of psychotherapy to deal with the psychosocial factors that prescribers need to know to use these medications within the context of the patient’s life.
This book is based on the premise that all mental health—in the most symptomatic, impaired individual and in the most mentally healthy individual—is caused by a combination of biopsychosocial factors. Mental health professionals need to recognize and understand these factors and their interactions, and correct them. An understanding of all these factors, and of psychopharmacology, can lead to better treatment decisions.
This book is for many readers: for psychiatrists who recognize the daily challenges in treating patients; for primary care physicians who identify psychiatric disorders in their patients; for non-medically-trained mental health professionals who want a more sophisticated understanding of psychopharmacology; and even for patients who want and need a better understanding of the medications their doctors have prescribed them.
both doses. Not surprisingly, the 300 mg dose was much better tolerated. Dropout due to side effects was 9% with placebo, increasing to 16% with 300 mg and 26% with 600 mg. Consequently, the dose of Seroquel for bipolar depression is 300 mg. Seroquel outperformed placebo in both rapid cyclers and non–rapid cyclers and for patients who had BD Type 1 or 2. The results for those who had BD Type 1 were more impressive. Seroquel XR was studied for 8 weeks in bipolar depression.23 Patients received 50
respond to the same medication that a first-degree relative has responded to. However, everyone is different and has different comorbid disorders, both psychiatric and medical, that must be taken into consideration. The patient may have strong feelings about the medication a relative takes. He may be reassured because he has seen this medication work well. Conversely, he may have strong negative feelings about this medication and your therapeutic alliance could be ruptured should you push a
Drugs. 2011;25(3):251–267. 20. Tohen M, et al. Efficacy of olanzapine and olanzapine-fluoxetine combination in the treatment of bipolar I depression. Arch Gen Psychiatry. 2003;60(11):1079–1088. 21. Calabrese JR, et al. A randomized, double-blind, placebo-controlled trial of quetiapine in the treatment of bipolar I or II depression. J Clin Psychiatry. 2005;162(7):1351–1360. 22. Thase ME, et al. Efficacy of quetiapine monotherapy in bipolar I and II depression: a double-blind, placebo-controlled
choose medications that do not pass as readily into the breast milk such as Zoloft or Paxil. If your patient has a seizure disorder, recognize that while all psychotropic medications can lower the seizure threshold, Wellbutrin is the most likely to induce seizures. If your patient has a current eating disorder or a history of an eating disorder, avoid Wellbutrin. If you are concerned about the possibility that your patient has bipolar disorder, choose antidepressants less likely to induce cycling
Successful psychopharmacologists recognize the importance of educating patients that the goal is not to sedate them. The goal is to decrease anxiety while maintaining alertness. Short-Acting Benzodiazepines The second class of benzodiazepines is the short-acting benzodiazepines, which have shorter half-lives of approximately 6 to 20 hours. These include Xanax (alprazolam), Ativan (lorazepam), and Klonopin (clonazepam). Their dosing is somewhat similar, generally 0.25–1 mg two to three times per