Książki: „Antidepressant medication”

1

Deborah, Kotz, red. The antidepressant survival program: How to beat the side effects and enhance the benefits of your medication. New York: Crown Publishers, 2000.

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Hedaya, Robert J. The antidepressant survival guide: The clinically proven program to enhance the benefits and beat the side effects of your medication. New York: Three Rivers Press, 2001.

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Tranquillizers and antidepressants: When to take them, how to stop. London: Sheldon, 2008.

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Painkillers and tranquilisers. Oxford: Heinemann Library, 2004.

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Badger, Frances. Medication management for people with depression in primary care. [Birmingham]: University of Birmingham, 2003.

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United States. Congress. House. Committee on Veterans' Affairs. Exploring the relationship between medication and veteran suicide: Hearing before the Committee on Veterans' Affairs, U.S. House of Representatives, One Hundred Eleventh Congress, second session, February 24, 2010. Washington: U.S. G.P.O., 2010.

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Cotterchio, Michelle. Antidepressant medication use and breast cancer risk. 1999.

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Organization, World Health, red. Dose effects of antidepressant medication in different populations. Amsterdam, The Netherlands: Elsevier, 1986.

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Wegmann, Joseph. Antidepressant Medication Strategies: We've Come a Long Way... or Have We? PESI, 2012.

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Wegmann, Joseph. Antidepressant Medication Strategies: We've Come a Long Way... or Have We? PESI, 2012.

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Biernacki, Carolina, Prerna Martin, Pablo H. Goldberg i Moira A. Rynn. Treatments for Pediatric Depression. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0012.

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Practice guidelines recommend psychosocial interventions for mild or brief cases of pediatric depression. In moderate to severe cases, medication treatment is recommended, with or without cognitive-behavioral therapy (CBT). Fluoxetine and escitalopram are the only antidepressants approved by the U.S. Food & Drug Administration for acute pediatric depression. Among psychosocial interventions, CBT and interpersonal psychotherapy for adolescents (IPT-A) have the largest evidence base for treatment of depressed youth. Combination treatment with CBT and antidepressant medication is superior to treatment with either modality alone. In treatment-resistant depression, a switch in antidepressant is more likely to yield a positive response when medication is used with CBT. Antidepressants should be used judiciously in youths as higher rates of adverse events have been demonstrated, and data from adult trials cannot be systematically extrapolated to youths. Further studies are needed to assess alternative medication and psychosocial treatments as well as factors predictive of treatment response.

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Tolin, David F., i Blaise L. Worden. Combining Pharmacotherapy and Psychological Treatments for OCD. Redaktor Gail Steketee. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195376210.013.0081.

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This chapter reviews the outcome literature on the efficacy of combined pharmacotherapy and cognitive-behavioral therapy (CBT) for obsessive compulsive disorder (OCD). By far, most research on combinations of CBT and pharmacotherapy for OCD has examined antidepressant medications, particularly those in the serotonin reuptake inhibitor (SRI) class. Quantitative review of randomized studies in which treatments were combined simultaneously indicated that combined therapy shows a small but significant advantage over exposure and response prevention (ERP) monotherapy, and a moderate advantage over pharmacologic (antidepressant) monotherapy. Studies of sequential treatment combination, in which CBT was added after a trial of antidepressant medication, suggest a significant incremental benefit of CBT, including for patients who show minimal response to antidepressant medication alone. The chapter concludes by discussing new pharmacologic possibilities for combined therapy, such as the use of D-cycloserine (DCS).

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Tolin, David F., i Blaise L. Worden. Combining Pharmacotherapy and Psychological Treatments for OCD. Redaktor Gail Steketee. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195376210.013.019_update_001.

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This chapter reviews the outcome literature on the efficacy of combined pharmacotherapy and cognitive-behavioral therapy (CBT) for obsessive compulsive disorder (OCD). By far, most research on combinations of CBT and pharmacotherapy for OCD has examined antidepressant medications, particularly those in the serotonin reuptake inhibitor (SRI) class. Quantitative review of randomized studies in which treatments were combined simultaneously indicated that combined therapy shows a small but significant advantage over exposure and response prevention (ERP) monotherapy, and a moderate advantage over pharmacologic (antidepressant) monotherapy. Studies of sequential treatment combination, in which CBT was added after a trial of antidepressant medication, suggest a significant incremental benefit of CBT, including for patients who show minimal response to antidepressant medication alone. The chapter concludes by discussing new pharmacologic possibilities for combined therapy, such as the use of D-cycloserine (DCS).

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Beach, Scott R., i Theodore A. Stern. Antidepressants in critical illness. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199600830.003.0044.

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Selective serotonin reuptake inhibitors (SSRIs), serotonin norepinephrine reuptake inhibitors (SNRIs), and atypical antidepressants are considered first-line agents for depression in the intensive care unit (ICU) setting, and are preferred over older antidepressants due to their more benign side effect profile and tolerability. This chapter reviews the literature on the use of antidepressants in the ICU. Common side effects of SSRIs include insomnia and gastrointestinal discomfort, while citalopram may uniquely cause prolongation of the QTc interval. All SSRIs carry a risk for the development of serotonin syndrome following overdose. SNRIs are similar to SSRIs in their side effect profile, although they are more likely to cause hypertension. Mirtazapine is strongly associated with sedation and weight gain. Stimulants may also be used to treat depression in the medically ill, and can be particularly effective in treating apathy, low energy, and loss of appetite. Monotherapy is typically the initial treatment strategy and low doses are generally recommended in the ICU setting. Efficacy may not be apparent for up to 8 weeks. Patients who have been taking an antidepressant prior to their arrival in the ICU should continue on the medication so as to prevent discontinuation syndrome. Delirium may warrant cessation of the antidepressant and potentially dangerous medication interactions also need to be evaluated. At present, there is no evidence to suggest that an antidepressant should be initiated after a significant physical or emotional trauma.

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Koen, N., T. Amos, J. Ipser i D. Stein. Antidepressants in Post-Traumatic Stress Disorder. Redaktorzy Charles B. Nemeroff i Charles R. Marmar. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190259440.003.0034.

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This chapter discusses the use of antidepressants in treating symptoms of posttraumatic stress disorder (PTSD). Tricyclic antidepressants were the first psychotropic agents to be studied systematically and rigorously for the treatment of PTSD. While early studies focused both on the tricyclics and monoamine oxidase inhibitors (MAOIs), more recent work has centered on the selective serotonin reuptake inhibitors (SSRIs); and paroxetine and sertraline are currently approved by the U.S. Food and Drug Administration (FDA) for use in this disorder. However, given the relatively small effect sizes in SSRI trials of PTSD, there is a need for ongoing psychopharmacological research to understand underlying mechanisms of antidepressant efficacy and to optimize response to pharmacotherapy. Further data on pediatric PTSD and on medication prophylaxis are needed before routine antidepressant treatment can be endorsed in these contexts.

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Steinberg, Martin. Treatment of Depression. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199959549.003.0006.

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Most depression in the elderly can be effectively treated in the primary care setting. Psychiatric referral should be considered in the setting of severe depression, suicidal ideation, prior suicide attempts, multiple risk factors, psychotic symptoms, bipolar disorder, poor response to prior treatment, or high medical comorbidity. Combining pharmacological and psychosocial interventions is most likely to be effective. Available antidepressants include serotonin-specific reuptake inhibitors, serotonin norepinephrine reuptake inhibitors, novel mechanism agents, tricyclic antidepressants, and monoamine oxidase inhibitors. Antidepressant selection should take into account adverse effects, medical comorbidities, potential medication interactions, and patient preferences. Additional strategies (e.g. augmentation) are available for treatment resistant depression. Available psychotherapies include supportive, cognitive-behavioral, interpersonal, and problem solving. Lifestyle interventions (e.g. exercise) may be helpful adjuncts. Given limited evidence for antidepressant treatment in cognitive impairment, for those with mild to moderate depression severity, non-pharmacological interventions should be attempted first.

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Antidepressant medication use and the risk of non-Hodgkin's lymphoma: A population-based case-control study. Ottawa: National Library of Canada, 2002.

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Hedaya, Robert J. Md. The Antidepressant Survival Program: How to Beat the Side Effects and Enhance the Benefits of Your Medication. Crown, 2000.

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Wenzel, Amy, i Deborah Kim. Psychopharmacology in Pregnancy and the Postpartum Period. Redaktor Amy Wenzel. Oxford University Press, 2015. http://dx.doi.org/10.1093/oxfordhb/9780199778072.013.21.

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A substantial minority of pregnant and lactating women meet criteria for one or more mental health disorders and, in many of these cases, treatment with psychotropic medication is indicated. Data from empirical studies on psychopharmacology using antidepressant medications for perinatal women suggest that the risk-benefit ratio is favorable, although their usage during pregnancy is associated with a slight increase in risk of spontaneous abortion, cardiac malformations (specifically with paroxetine), preterm birth, and poor neonatal adaptation syndrome. However, these risks should be contrasted with the fact that women with moderate to severe depression who have had multiple lifetime episodes have a substantial relapse rate if they stop taking their antidepressant during pregnancy. There is more limited research on the use of other classes of psychotropic medications during pregnancy and the postpartum period. Future research should establish the efficacy and risk-benefit profile of psychotropic medications for the broad array of mental health disorders during pregnancy and lactation, as well as for postpartum mental health disorders other than depression.

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Use of Antidepressant Medication in Adults Undergoing Recovery and Rehabilitation Following Acquired Brain Injury (Concise Guidance to Good Practice). Royal College of Physicians of London, 2005.

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Fava, Giovanni. Discontinuing Antidepressant Medications. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780192896643.001.0001.

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The clinical problems that may ensue when antidepressant medications are discontinued have been neglected by the scientific literature. Patients experiencing the anguish and mental pain of withdrawal syndromes have not received appropriate medical attention and have been forced to refer themselves to websites, groups, and associations, which have the recognized merit of providing support but cannot offer the medical competence that is required. This book attempts to fill this gap. The aim of this single-author book is to provide updated information that may help professionals in determining whether discontinuation of antidepressant drugs is feasible (is it appropriate for the individual patient? what are the counter-indications of stopping? what are the counter-indications of continuing?) and how it can be performed (the different options that are available). Discontinuing antidepressants is a highly technical challenge, that requires specific strategies and information that is not likely to be available to the prescribing physician. The author analyzes each clinical step with the help of the available literature and his clinical experience, based on hundreds of personal cases. The book provides case illustrations and clinical examples throughout, emphasizing the role of clinical judgment.

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Byrne, Gerard. Anxiety disorders in older people. Oxford University Press, 2013. http://dx.doi.org/10.1093/med/9780199644957.003.0045.

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Anxiety symptoms and anxiety disorders are highly prevalent among older people, including among those with physical frailty and cognitive impairment. Clinicians are advised to consider the effects of prescribed medication and other substances, and the influence of general medical conditions, in the older person presenting with anxiety. Psychological treatments are recommended for older people with anxiety disorders of mild to moderate severity. These include relaxation training, exposure-based interventions, and cognitive behaviour therapy. Pharmacological interventions are in widespread use, although there is little evidence in support of the long-term use of either benzodiazepines or antipsychotics in older people with anxiety disorders. Instead, treatment with antidepressant medication is recommended.

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Antidepressants And Psychology: Talk Therapy Vs. Medication (Antidepressants). Mason Crest Publishers, 2006.

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Hodgkiss, Andrew. Therapeutic strategies. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780198759911.003.0013.

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A wide range of therapeutic strategies to manage cancer-related psychopathology are described. Evidence-based interventions include: surgery (e.g. oophorectomy for anti-NMDAR limbic encephalitis), radiotherapy, immunotherapy, anti-glucocorticoids, correction of electrolyte abnormalities, correction of vitamin or endocrine deficiencies, and the use of carefully selected antidepressant or antipsychotic medication. Particular attention is paid to the management of cancer-related delirium and mania, and to the depressive phenomena provoked by systemic cancer treatments. The quality of the evidence-base for these treatments is critically reviewed.

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Lam, Raymond W. Pharmacotherapy. Oxford University Press, 2012. http://dx.doi.org/10.1093/med/9780199692736.003.0007.

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• The newer antidepressants (SSRIs, SNRIs, other receptor agents) are first-line medications due to improved safety and tolerability over first-generation medications (TCAs, MAOIs).• Selection of an antidepressant must take into account efficacy, depression subtype, safety, side effect profile, simplicity of use, comorbid conditions, concurrent medications, and cost....

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Osborne, David, i Chris Williams. Treatment. Oxford University Press, 2017. http://dx.doi.org/10.1093/oso/9780198801900.003.0011.

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This chapter discusses talking therapies, or psychotherapies, for people with depression. For many years the predominant clinical model of depression has relied on medication as the gold standard for treatment. However, the cost of antidepressant medication prescribing is significant and rising. In response, recent government mental health targets also emphasize psychological interventions as an important treatment option. This chapter provides an overview of the characteristics of people who typically access talking therapies before turning to talking therapies that are available, including those that are recommended by national treatment guidelines such as NICE in England and Wales and SIGN in Scotland. In particular, it considers evidence-based talking therapies such as cognitive behavioural therapy, mindfulness-based cognitive therapy (MBCT), interpersonal therapy (IPT), and psychoanalysis and psychodynamic psychotherapy. The chapter also assesses the implications of talking therapies for clients of legal professionals.

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The Evidencebased Guide To Antidepressant Medications. American Psychiatric Publishing, Inc., 2011.

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Misri, Shaila, Jasmin Abizadeh i Sonya Nirwan. Depression During Pregnancy and the Postpartum Period. Redaktor Amy Wenzel. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199778072.013.19.

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Depression affects 9–13% of pregnant women and 12–16% of postpartum women. Rates vary depending on whether depressive symptoms or DSM diagnoses of depression are considered. Risk factors of perinatal depression include socioeconomic status, social support, personality style, personal and family history of depression, and hormonal changes. The Edinburgh Postnatal Depression Scale (EPDS) is a self-report instrument commonly used to assess for perinatal depression. The treatment of perinatal depression with antidepressant medication is controversial. Most guidelines recommend psychotherapy for mild to moderate depression and medication for moderate to severe depression. Established psychotherapies include interpersonal psychotherapy and cognitive behavioral therapy, as well as alternative therapies such as infant massage in the postpartum. Although extensive research on perinatal depression has been conducted over the past two decades, future research could include designing prospective, methodologically sound studies with larger samples to compare treatment modalities, teratogenicity associated with pharmacotherapy, and prevalence of perinatal depression in various cultures.

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Suls, Jerry, i Karina W. Davidson. Depression and Cardiovascular Diseases. Redaktorzy C. Steven Richards i Michael W. O'Hara. Oxford University Press, 2013. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.006.

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This chapter provides a selective review of empirical studies concerning the relationship between depression and depressive symptomatology as risk factors for cardiovascular diseases. Depression appears to confer a twofold risk for both cardiac disease incidence and cardiac disease progression. Several factors appear to contribute to this risk, including the effects of depression on immune activity, endothelial function, SNS and HPA activity, and medical adherence. However, it remains unclear whether depression is only marking risk of some unmeasured third variable responsible for increased heart disease. Although antidepressant medication and cognitive behavioral therapy produce some reduction of depression in cardiac patients, there are no definitive clinical trial data showing medical or behavioral treatment reduce cardiac deaths. Only large-scale randomized clinical trials can fill this gap. The chapter concludes with a series of critical questions requiring resolution to decide what treatment would work most effectively for the cardiac patient with depression.

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Kendall-Tackett, Kathleen. Complementary and Alternative Treatments for Perinatal Depression. Redaktor Amy Wenzel. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199778072.013.28.

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Complementary and alternative (CAM) treatments for depression are increasingly popular with new mothers seeking alternatives to antidepressants. This chapter reviews recent studies on the modalities that have the strongest empirical support. These include long-chain omega-3 fatty acids, S-adenosyl-L-methionine (SAMe), bright light therapy, exercise, and two herbal antidepressants (i.e., St. John’s wort, and kava). As our understanding of the anti-inflammatory mechanism underlying treatments for depression increases, this research may suggest still more treatments or combinations of treatments that can help pregnant and postpartum women recover quickly from perinatal depression. Safety considerations for breastfeeding mothers are reviewed for each modality, and reasons that mothers might choose these approaches over antidepressant medications are described.

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Burns, Tom, i Mike Firn. The role of medication. Redaktorzy Tom Burns i Mike Firn. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780198754237.003.0007.

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This chapter focuses mainly on the importance of maintenance antipsychotic medication and mood stabilizers. It examines procedures to support persistence with these drugs and maintain engagement. The techniques for initiating and monitoring clozapine therapy in the community for patients with resistant schizophrenia are outlined. The practical processes for ensuring and conducting regular structured reviews of long-term medication, both to assess progress and to identify side effects, are described in detail. In addition, the judicious use of antidepressants and benzodiazepines is outlined.

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Barnes, Thomas R. E. Pharmacological management of treatment-resistant schizophrenia: alternatives to clozapine. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198828761.003.0009.

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Other than for clozapine, there are no pharmacological interventions with robust evidence of a positive benefit–risk balance for the treatment-resistant schizophrenia. For patients with treatment-resistant schizophrenia, there is usually little to be gained, in comparison to switching the antipsychotic to clozapine, from alternatives such as a further switch to a non-clozapine antipsychotic medication, the prescription of high-dose or combined antipsychotic medications, or the augmentation of continuing antipsychotic medication with other medications, such as antidepressants, mood stabilizers, or benzodiazepines. However, where these are tried, each initiation of high-dose or combined antipsychotic medication or an augmentation strategy should be treated as an individual trial and appropriately monitored and reviewed, with discontinuation in case of inefficacy or benefit that is outweighed by safety or tolerability concerns.

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Li, Madeline, Joshua Rosenblat i Gary Rodin. Psychopharmacologic Management of Anxiety and Depression. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190491857.003.0005.

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Depression and anxiety are highly prevalent in patients with cancer. Defining the quality and severity of these symptoms, along with ruling out other causes for them, is required before treatment is initiated. The continuum of symptoms of depression or anxiety ranges from a normative response to more severe symptoms. Pharmacological management of depression and anxiety should be reserved for the latter, often in conjunction with psychotherapeutic interventions. Relative efficacy, adverse effects, and potential drug–drug interactions should be considered in the selection of medications. Antidepressants are first line in the treatment of both major depression and anxiety disorders. Antipsychotics may also be considered if antidepressant monotherapy yields only a partial response. Psychostimulants may be considered when time is short and when there are associated symptoms of fatigue or anergia. The short-term judicious use of benzodiazepines may also be considered for situational or severe anxiety, until an antidepressant takes effect.

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Duman, Ronald S. Neurotrophic Mechanisms of Depression. Redaktorzy Dennis S. Charney, Eric J. Nestler, Pamela Sklar i Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0027.

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Early theories of depression and treatment response were centered on the monoamine neurotransmitters, but more recent work has focused on functional and structural synaptic plasticity and the role of neurotrophic factors, particularly brain derived neurotrophic factor (BDNF). Neurotrophic factors regulate all aspects of neuronal function, including adaptive plasticity, synapse formation, and neuronal survival. Chronic stress and depression cause reductions in levels of BDNF and other key factors, including vascular endothelial growth factor (VEGF) and fibroblast growth factor 2 (FGF2), in cortical regions that contribute to atrophy and loss of neurons observed in depressed patients and rodent stress models. In contrast, these neurotrophic factors are upregulated by chronic administration of typical antidepressants and are required for antidepressant responses. Moreover, fast acting, highly efficacious antidepressant agents such as ketamine rapidly increase BDNF release and synapse formation, paving the way for a new generation of medications for the treatment of depression.

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Williams, J. Corey, i Gustavo A. Angarita Africano. Treatment of Depression in Patients with Alcohol or Drug Dependence. Redaktorzy Ish P. Bhalla, Rajesh R. Tampi, Vinod H. Srihari i Michael E. Hochman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190625085.003.0022.

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This chapter provides a summary of a landmark study on the treatment of major depressive disorder and co-morbid substance use disorders. Are antidepressants efficacious in treatment of combined depression and substance use disorders? Starting with that question, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The main study findings suggest that Major Depressive Disorder can be effectively treated with antidepressant medications in patients with co-morbid substance use disorders. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.

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Quântica, Sabrina. Depressão, em busca da libertação - Um estudo sobre a cura sem medicamentos. Brazil Publishing, 2021. http://dx.doi.org/10.31012/978-65-5861-424-1.

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Is it possible to develop techniques and mechanisms so that women can get out of a depression without the help of medication, even though they are in a deep state of apathy? It is scientifically proven that moving, eating well, cultivating good relationships and even meditating are actions that help the human being to become fuller and happier. The recipe is easy. There is a step-by-step that, most of the time, provides positive results to those who follow it. But what about when the individual is listless? At that stage of unwillingness, lack of strength and courage to change the stage? He may be fully aware of what he should do, how he should act and how much it would be beneficial for his well-being, yet he still does not find the strength to act. It is a feeling of pain and anguish that does not pass and there is no desire to do anything to pass. Would it be possible to use or create a revolutionary technique or set of techniques, "magical" that help the start of psychological / emotional change, without the aid of drugs? There are numerous studies that demonstrate both the ineffectiveness and the various side effects of antidepressant and psychotropic drugs. To check if there are mechanisms that help individuals to restore mental and emotional health without the aid of allopathy is to find a way out so that less people, in addition to not getting rid of depression, become dependent on the medications they use. Nowadays depression is often diagnosed and treated incorrectly, especially among women – one in seven is medicated. If there are effective mechanisms to change a depressive stage in a natural way, there will be a reduction in the consumption of medications, thus avoiding serious side effects such as dependence, reactions and physical changes such as disorderly weight loss or gain, sexual dysfunction and incapacity to live in society.

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Stewart, Jessica Ann, L. Mark Russakoff i Jonathan W. Stewart. Pharmacotherapy, ECT, and TMS. Oxford University Press, 2014. http://dx.doi.org/10.1093/med/9780199326075.003.0016.

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Physicians’ attention to patients’ concerns and attitudes about taking medication will engender adherence, as will close monitoring of potentially disconcerting side effects. The primary indication for antipsychotic medications is the treatment of psychotic disorders and mania, even in the absence of psychosis. The more troublesome side effects of antipsychotic medications include increased appetite and weight gain; extrapyramidal side effects, tardive dyskinesia, and neuroleptic malignant syndrome. Antidepressants are effective for treating depressive illness, including major depression, persistent depressive disorder (dysthymia) and premenstrual dysphoric disorder. They are also often used effectively in the treatment of anxiety disorders, obsessive-compulsive disorder, bulimia nervosa, and somatic symptom disorders. Selective serotonin reuptake inhibitors (SSRIs) are generally well tolerated. Other important categories of medications include mood stabilizers and anxiolytics.

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John, Rush A., red. Mood disorders: Systematic medication management. Basel: Karger, 1997.

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(Editor), Husseini K. Manji, Charles L. Bowden (Editor) i Robert H., M.D. Belmaker (Editor), red. Bipolar Medications: Mechanisms of Action. American Psychiatric Publishing, Inc., 2000.

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Bipolar medications : mechanisms of action. Washington, DC: American Psychiatric Press, 2000.

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Hendrickson, Rebecca C., i Murray A. Raskind. Pharmacological Treatment of Nightmares, Sleep Disturbance, and Daytime Hyperarousal in PTSD: The Role of Prazosin, Other Noradrenergic Modulators, and Sedative Hypnotics or Commonly Used Sedating Medications. Redaktorzy Charles B. Nemeroff i Charles R. Marmar. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190259440.003.0035.

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Disruption of stress-response systems contributes to the pathophysiology of post-traumatic stress disorder (PTSD). Consistent with this, daytime hyperarousal and nighttime sleep disruption, including trauma-related nightmares, are core symptoms of the disorder, often requiring targeted pharmacologic treatment. Although a variety of medications that target sleep–wake and arousal mechanisms are commonly used for this purpose, there remains the best empirical support for prazosin, a brain-active antagonist of the α‎1 noradrenaline receptor, with emerging evidence for doxazosin, a longer-acting medication with the same mechanism of action. This chapter reviews the evidence for use of prazosin and doxazosin as well as for the sedative hypnotics (benzodiazepines, nonbenzodiazepine hypnotics, and related medications), antihistamines, and sedating antidepressants trazodone and nefazodone to address hyperarousal symptoms and trauma-associated nightmares in PTSD. Clinical recommendations for the use of prazosin in PTSD, as well as a discussion of emerging pharmacologic treatments, are also included.

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Fozdar, Manish A., i Jacob C. Holzer. Psychopharmacological Agents, Side Effects, and Black Box Warnings. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199374656.003.0015.

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From a medical-legal viewpoint, psychopharmacological management in the elderly population requires a multifaceted, comprehensive approach, involving a detailed clinical diagnostic assessment, an awareness of a patient’s current medical status, risk factors, and an understanding of the risks and benefits of various treatment options. Several risk management strategies can be employed as part of the treatment process, which are reviewed in this chapter. Special attention is needed in the pharmacological management of the elderly population with respect to efficacy and risk as well as polypharmacy. It is important that clinicians have a broad understanding of the different medication classes, including antidepressants, antipsychotics, mood stabilizers, cognitive-enhancing medications, benzodiazepines, sedative-hypnotics, and stimulants; specific agents; indications; kinetics; and side effects in both the clinical management of elderly patients and in medical-legal consultation.

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Howland, Robert H. Multidisciplinary Treatments and Medications for Depressive Disorders and Comorbidity. Redaktorzy C. Steven Richards i Michael W. O'Hara. Oxford University Press, 2014. http://dx.doi.org/10.1093/oxfordhb/9780199797004.013.008.

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Compared with episodic depression, chronic depression and treatment resistant depression have higher rates of comorbidity, more persistent social and vocational disability, an increased risk of suicide, greater medical morbidity and mortality, and greater health care utilization and costs. A large number of antidepressant medications and other psychotropic drugs, depression-focused psychotherapies, and neuromodulation therapies are available for the treatment of depression. Many drugs or psychotherapies are used for the treatment of other psychiatric disorders or medical conditions, and they should be considered relevant when these comorbidities exist with depression. Selecting treatments for depression must take into account the clinical implications of the presence of any comorbidities. Because comorbidity is associated with depressive chronicity and treatment resistance, various approaches to treating chronic depression or TRD have been investigated. Treating depressed patients with comorbid psychiatric, personality, or medical disorders is a clinical challenge that requires effective multidisciplinary collaboration.

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Diaz, Christina D., i Steven J. Weisman. Multimodal Approach to Acute Pain Management after Nuss Bar Placement and Other Pain Scenarios. Redaktorzy Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi i Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0053.

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Acute pain management can involve regional blocks with local anesthetics, neuraxial blocks such as caudal blocks and epidurals, oral and intravenous opioids, and nonsteroidal anti-inflammatory drugs. Other pain management modalities include neuropathic pain medications, muscle relaxants, antidepressants, acupuncture, techniques for stress relief, and behavioral modification therapy. While there are many options for treating a patient’s pain, the best approach is to understand the symptoms, attempt to determine the cause of the pain, and understand the patient’s goals with regard to treatment. This chapter discusses the multimodal acute pain management for a case of Nuss bar placement, utilizing an epidural, patient-controlled analgesia, and oral pain medication. The chapter has an additional scenario discussing neuraxial analgesia and nerve blocks for a hypospadias repair in an infant. Finally, the third case-based discussion focuses on the treatment of common types of headaches.

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Kimmel, Ryan J., Peter P. Roy-Byrne i Deborah S. Cowley. Pharmacological Treatments for Panic Disorder, Generalized Anxiety Disorder, Specific Phobia, and Social Anxiety Disorder. Oxford University Press, 2015. http://dx.doi.org/10.1093/med:psych/9780199342211.003.0015.

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Selective serotonin reuptake inhibitors (SSRIs) are the first-line pharmacological treatment for panic disorder based on their low rate of side effects, lack of dietary restrictions, and absence of tolerance. SSRIs and venlafaxine are attractive first-line treatments for social anxiety disorder. Pharmacological treatments of choice for generalized anxiety disorder are buspirone and antidepressants, including SSRIs and venlafaxine. Benzodiazepines, although effective for all these disorders, lack efficacy for comorbid depression and carry the risk of physiological dependence and withdrawal symptoms. Their greatest utility seems to be as an initial or adjunctive medication for patients with disabling symptoms requiring rapid relief and for those unable to tolerate other medications. Chronic treatment with benzodiazepines is generally safe and effective but should probably be reserved for patients nonresponsive or intolerant to other agents. Larger trials are necessary to determine whether pharmacological agents might be useful as monotherapies, or adjuncts to exposure psychotherapy, for specific phobia.

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Nestler, Eric J. New Approaches for Treating Depression. Redaktorzy Dennis S. Charney, Eric J. Nestler, Pamela Sklar i Joseph D. Buxbaum. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190681425.003.0030.

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Several obstacles have impeded the introduction of new antidepressant medications over the past six decades. These obstacles include our still rudimentary knowledge of the biological basis of depression, as well as difficulties in evaluating the therapeutic efficacy of new putative antidepressant mechanisms in pathophysiologically distinct subtypes of the syndrome. Despite these obstacles, several tangible steps can be taken to advance depression treatment moving forward. The field needs to continue to take advantage of serendipitous discoveries in humans, such as the demonstration of rapid antidepressant effects of ketamine. Re-establishing experimental pharmacology in humans, to make it possible to establish the actions of new mechanisms in people, is essential, combined with the judicious use of a growing range of chronic stress models in animals. We anticipate that, with these approaches, the field can at long last breakthrough the logjam of discovery and introduce new treatments for depression over the next decade.

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Gorman, Jack M. Sadness and Depression. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850128.003.0004.

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Two cellular processes are affected by stressful life events: dendritic remodeling and neurogenesis. Dendritic remodeling occurs when dendrites—projections from neurons that receive signals from the axons of other neurons—either grow or retract. Stress causes retraction of dendrites and disrupts brain connections. This may occur when people are depressed and is responsible for the inability of the logical brain to communicate with the emotional brain. Psychotherapy and antidepressant medications may both cause the dendritic tree to grow and restore connections. Neurogenesis is the creation of new neurons in the adult brain, which occurs in only a few regions. Neurogenesis is decreased by adverse events and increased by enriched environments and by antidepressant treatments. Thus, cellular brain processes that respond to our environment may underlie depression and other changes in mood.

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Jani, Suni, Ryan Herringa i Derek Hursey. Pharmacologic Treatment of Children with Trauma- and Stressor-Related Disorders. Redaktorzy Frederick J. Stoddard, David M. Benedek, Mohammed R. Milad i Robert J. Ursano. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457136.003.0023.

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This chapter reviews the principles of psychopharmacological treatment for trauma and stressor-related disorders in children. It will discuss emerging psychopharmacological treatments and theories of trauma- and stress-related disorders (TSRDs) common to childhood, reactive attachment disorder, and disinhibited social engagement disorder. Although there is limited literature on the role of pharmacotherapy in treating TSRDs in children, it has been recognized that α‎- and β‎-adrenergic blocking agents, novel antipsychotic agents, non-selective serotonin reuptake inhibitor antidepressants such as tricyclic antidepressants, and mood-stabilizing agents may be effective for children based on several open clinical trials. These trials, as well as existing promising clinical trials, are discussed in this chapter. It also provides an in-depth review of factors such as potential side effects, medication interactions, and black box warnings as they specifically apply to the pediatric population.

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Nobles, Ryan. Pharmacology. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190217518.003.0008.

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This chapter focuses on principles of pharmacokinetics, pharmacodynamics, adverse effects, drug interactions, and common indications with regard to opioids, nonsteroidal anti-inflammatory agents, acetaminophen, anticonvulsants, and antidepressants. The questions are formulated to focus on the most relevant topics that may be tested on the listed medications, but it is not a comprehensive review. The information provided should be supplemented with additional study of the cited literature in the Further Reading section for each question.

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Buttram, Sandra D. W., i Anne-Michelle Ruha. Toxicological Emergencies. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780199918027.003.0017.

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This chapter includes essential information about common toxic exposures requiring pediatric intensive care unit care. Specific agents, grouped into categories, are reviewed, including analgesics (acetaminophen and aspirin), opiates, carbon monoxide, cardiovascular medications (calcium channel antagonists and β‎ blockers), tricyclic antidepressants, sulfonylureas, and toxic alcohols. An overview of each agent followed by clinical presentation, and appropriate diagnostic evaluation and management are provided, including alkalinization with administration of sodium bicarbonate, need for hemodialysis, and use of specific antidotes (e.g., naloxone, n-acetyl cysteine, glucagon, fomepizole).

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