Psychiatric Drugs Explained

Title page
Table of Contents
Copyright
Preface
Introduction
Consumers and Compliance
Individual End-Points
Pharmacopsychology
1. The person on treatment
Chapter contents
Introduction
Christmas tree light bulb test
Section 1: Management of the Psychoses
2. The antipsychotics
Chapter contents
Introduction
History of the antipsychotics
Are antipsychotics antischizophrenic?
How antipsychotics work
A ‘who cares’ feeling
Antipsychotics and positive symptoms of psychosis
Antipsychotics and negative schizophrenia
Clozapine and second-generation antipsychotics
Antipsychotic doses
Flexible therapy
For how long should treatment continue?
Depot antipsychotics
Antiemetics
Antipsychotics and psychotherapy
Significant interactions
Special conditions
3. Antipsychotic side effects and their management
Chapter contents
Introduction
Dopamine system effects and side effects
Non-dopamine side effects
Management of side effects
References
Section 2: Management of Depression
4. The antidepressants
Chapter contents
Introduction
History
Depression
Do antidepressants work?
What do Antidepressants do?
Antidepressants: first choice or last resort?
Starting antidepressants
Stopping antidepressants
Antidepressants and children
5. Side effects of antidepressants
Chapter contents
Introduction
The ambiguous side effects of antidepressants
Effects special to the MAOIs
References
Section 3: Management of Bipolar Disorders
6. Management of acute bipolar disorder
Chapter contents
Introduction
Lithium for mania
Antipsychotics for mania
Anticonvulsants for mania
Carbamazepine
Sodium valproate
Lamotrigine, gabapentin and oxcarbazepine
Topiramate and vigabatrin
Acetazolamide
Electroconvulsive therapy (ECT)
Benzodiazepines
Do antidepressants cause mania?
Bipolar-mania
7. Mood-stabilisers
Chapter contents
History of mood-stabilisation
Lithium as a mood-stabiliser
The anticonvulsant mood-stabilisers
Carbamazepine and oxcarbazepine
Sodium and semi-sodium valproate
Lamotrigine
Gabapentin and pregabalin
Topiramate and levetiracetam
Antipsychotics as mood-stabilisers
Cocktail treatment
Coda
References
Section 4: Psychotropic Drugs For Children
8. Stimulants and drugs for children
Chapter contents
The history of the stimulants
The emergence of ADHD
Stimulant treatment for ADHD
Non-stimulant drug treatments of ADHD
Non-drug treatments of ADHD
Other uses of stimulants
Psychotropic drugs and children: general principles
The use of antidepressants for children
The use of antipsychotics for children
References
Section 5: Management of Anxiety
9. The anxiety disorders
Chapter contents
Drugs used in anxiety
Forms of anxiety
The notion of an anxiolytic
10. Benzodiazepine and gabapentinoid anxiolytics
Chapter contents
Introduction
Mechanism of action of the benzodiazepines
Classes of benzodiazepines
Clinical uses for benzodiazepines
Benzodiazepine dependence and withdrawal
Gabapentinoids
11. Serotonin and anxiolysis
Chapter contents
Introduction
Serotonergic receptors and drugs
Serotonin and anxiolysis
12. Beta-blockers and anxiety
Chapter contents
Introduction
Performance-related anxiety
Generalised anxiety disorder (GAD)
Panic attacks: a puzzle?
Tremor
Akathisia and restlessness
Prazosin and post-traumatic stress disorder (PTSD)
References
Section 6: Management of Sleep Disorders and Insomnia
13. Sleep disorders and insomnia
Chapter contents
Introduction
The sleep disorders
Insomnia
14. Non-pharmacological management of insomnia
Chapter contents
Caffeine
Environmental factors
Relaxation
Body awareness
Stimulus-control treatments
Routines
Paradoxical intention
Forward planning
Use of mantras and yogic breathing exercises
Medication
15. Hypnotics
Chapter contents
Introduction
Common hypnotics
16. Sedatives
Chapter contents
Melatonin and its analogues
Chloral compounds
Barbiturates and related compounds
Chlormethiazole
Sedative antidepressants and antipsychotics
Antihistamines
References
Section 7: Management of Cognitive Impairment
17. Cognitive enhancement and the dementias
Chapter contents
Introduction
The dementias
18. Cognitive enhancement and neuroprotection
Chapter contents
Introduction
Second-generation cholinomimetics
Cholinomimetics in other therapeutic areas
Memantine (EVISTA)
Management of multi-infarct dementia
Management of subcortical dementias
Neuroprotection
Cognitive enhancement and the politics of diagnosis
Smart drugs
References
Section 8: Management of Sexual Difficulties
19. The range of sexual difficulties
Chapter contents
Introduction
Women and men
Male potency
Ejaculation and orgasm
Libido
Sexual responses in women
Sexual orientation, objects and practices
20. Effects of drugs on aspects of sexual functioning
Chapter contents
Drug effects on sexual function: males (See Appendix 20.1)
Ejaculatory and orgasmic effects
Drug effects on sexual function: females (See Appendix 20.2)
Aphrodisiacs
Yohimbine, trazodone and cyproheptadine
Intrapenile treatments
Phosphodiesterase inhibitors
Anti-aphrodisiacs
Post-SSRI sexual dysfunction (PSSD)
Persistent genital arousal disorder (PGAD)
Appendix 20.1
References
Section 9: Management of Dependence and Withdrawal
21. Dependence and withdrawal
Chapter contents
Introduction
Rebound symptoms
Withdrawal syndromes
Brain physiology
Tolerance
Withdrawal syndrome
22. Dependence and craving
Chapter contents
Introduction
Craving
Behavioural sensitisation
Appetites
Pharmacological management of appetites
Psychological factors in substance abuse
Disinhibition
23. Dependence and protracted withdrawal
Chapter contents
Historical perspective
Antipsychotic and antidepressant dependence
Stress syndromes
Protracted withdrawal or legacy effects?
References
Section 10: Consent, Abuse And Liability
24. Consent
Chapter contents
Introduction
Voluntary consent
Information and comprehension
Clinical trials and legal jeopardy
Compliance
Prescribing
25. Pharmacological abuse
Chapter contents
The problem
The dynamics of abuse
Prescription ‘rights’
The Right not to be disabled by treatment
References
Section 11: The Marketing Of Tranquillity
26. The ethical industry
Chapter contents
Introduction
The magic bullet
The interface between ethics and markets
Consequences
27. Evidence-biased care
Chapter contents
Access to data
The origin of randomised trials
The placebo effect
Rcts and efficacy
What's wrong with RCTs?
Pharmagnosia
Rcts are risky
28. Marketing and risk
Chapter contents
The marketing of depression
The marketing of bipolar disorder
The marketing of female sexual dysfunction
Rating scale mongering
Risk management
The new marketing
29. From healthcare to pharmageddon
Chapter contents
Perceptions of progress in mental health
Healthcare versus health products ltd
Pharmageddon
References
Index