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Clinicians recognize that monitoring psychotropic levels provides invaluable information to optimize therapy and track treatment adherence, but they lack formal training specifically focused on the use of plasma antipsychotic levels for these purposes. As new technologies emerge to rapidly provide these results, the opportunity to integrate this information into clinical care will grow. This practical handbook clarifies confusing concepts in the literature on use of antipsychotic levels, providing clear explanations for the logic underlying clinically relevant concepts such as the therapeutic threshold and the point of futility, and how these apply to individual antipsychotics. It offers accessible information on the expected correlation between dosages and trough levels, and also provides a clear explanation of how to use antipsychotic levels for monitoring oral antipsychotic adherence, and methods to help clinicians differentiate between poor adherence and variations in drug metabolism. An essential resource for psychiatrists, psychiatric nurse practitioners, and mental health professionals worldwide.
Real-world and clinical trial data support that clozapine is the only effective antipsychotic for treatment resistant schizophrenia and other severe mental illnesses. Clozapine also reduces rates of suicidality, psychiatric hospitalization and all-cause mortality. However, clozapine is underutilized for two reasons: misunderstandings of its efficacy benefits and misapprehension of, limited knowledge or misinformation about the management of treatment related risks and adverse effects. In response to worldwide efforts to promote clozapine use, this user-friendly Handbook provides clinicians with evidence-based approaches for patient management, as well as logical approaches to the management of clinical situations and adverse effects. It outlines clearly the rationale for specific management decisions and prioritises the options based on this logic. This Handbook is designed for use by clinicians worldwide and is essential reading for all mental health care professionals.
Antipsychotic Long-acting Injections (LAIs) were introduced in the 1960s to improve treatment adherence in schizophrenia. Subsequently, first-generation antipsychotic LAIs became widely used in many countries. Since the initial publication of Antipsychotic Long-acting Injections in 2010, new trial data have been published on long-acting injection (LAI) preparations of the drugs Risperidone, Paliperidone, and Olanzapine. Furthermore, a new LAI preparation of the drug Aripiprazole has recently been approved for clinical use in the United States and is likely to be approved in Europe soon. The second edition of this successful book has been fully updated to include this new data, with reference to both observational studies and randomized controlled trials, as well as other new developments in the clinical use of antipsychotic LAIs. New chapters have been added covering the comparison between oral and injectable antipsychotics, Olanzapine LAI, Aripiprazole LAI, and the practicalities of organizing a specialized clinic for long-acting injectable antipsychotics. Existing chapters have also been thoroughly updated to take into account the most recently published research. Antipsychotic Long-acting Injections, Second edition brings together clinical and research findings on LAIs in a comprehensive volume, with chapters written by international experts.
The guideline offers clear, concise, and actionable recommendation statements to help clinicians to incorporate recommendations into clinical practice, with the goal of improving quality of care. Each recommendation is given a rating that reflects the level of confidence that potential benefits of an intervention outweigh potential harms.
An essential handbook providing practical guidance and medication advice on the effective management and treatment of psychotic disorders.
This is a spin-off from Stephen M. Stahl's new, completely revised and updated version of his much-acclaimed Prescriber's Guide, covering drugs to treat depression.
A practical and easy-to-use guide for healthcare professionals on the prevention, assessment and treatment of people at risk of suicide.
The new edition of this popular handbook has been thoroughly updated to include the latest data concerning treatment of first-episode patients. Drawing from their experience, the authors discuss the presentation and assessment of the first psychotic episode and review the appropriate use of antipsychotic agents and psychosocial approaches in effective management.
The introduction of chlorpromazine in 1953, and haloperidol in 1958, into clinical practice dramatically altered the therapy of schizophrenic patients. Although representing by no means a cure for this severe psychiatric ill ness, it allowed, for the first time, to adequately control the severe hallu cinations and delusional beliefs which prevent these patients from leading a more or less independent life. Indeed these antipsychotics (and the many congeners that were to follow) significantly reduced the number ofchronic schizophrenic inpatients in psychiatric clinics all over the world. However soon after their introduction it became clear that, like all other available drugs, antipsychotics were by no means miracle drugs. In fact, two major problems appeared. First, the antipsychotics had very little effect on the so-called negative or defect symptoms, like social isolation, apathy and anhedonia, and secondly virtually all antipsychotics produced a number of side-effects, of which the neurological (often called extra pyramidal) side-effects were the most troublesome. Especially the tardive dyskinesia, which occurred in about 15 to 20% of the patients after pro longed treatment, represented a major problem in the treatment of schizo phrenic patients.
The brain is the most complex organ in our body. Indeed, it is perhaps the most complex structure we have ever encountered in nature. Both structurally and functionally, there are many peculiarities that differentiate the brain from all other organs. The brain is our connection to the world around us and by governing nervous system and higher function, any disturbance induces severe neurological and psychiatric disorders that can have a devastating effect on quality of life. Our understanding of the physiology and biochemistry of the brain has improved dramatically in the last two decades. In particular, the critical role of cations, including magnesium, has become evident, even if incompletely understood at a mechanistic level. The exact role and regulation of magnesium, in particular, remains elusive, largely because intracellular levels are so difficult to routinely quantify. Nonetheless, the importance of magnesium to normal central nervous system activity is self-evident given the complicated homeostatic mechanisms that maintain the concentration of this cation within strict limits essential for normal physiology and metabolism. There is also considerable accumulating evidence to suggest alterations to some brain functions in both normal and pathological conditions may be linked to alterations in local magnesium concentration. This book, containing chapters written by some of the foremost experts in the field of magnesium research, brings together the latest in experimental and clinical magnesium research as it relates to the central nervous system. It offers a complete and updated view of magnesiums involvement in central nervous system function and in so doing, brings together two main pillars of contemporary neuroscience research, namely providing an explanation for the molecular mechanisms involved in brain function, and emphasizing the connections between the molecular changes and behavior. It is the untiring efforts of those magnesium researchers who have dedicated their lives to unraveling the mysteries of magnesiums role in biological systems that has inspired the collation of this volume of work.