Menu Expand
Psychopharmacology

Psychopharmacology

Herbert Mwebe

(2018)

Additional Information

Book Details

Abstract

This concise and accessible text is suitable for all trainee and registered health professionals who require knowledge and understanding of drugs used in the treatment of mental health conditions for prescribing or administering purposes. Introductory material provides a background on psychotropic drugs, the etiology of mental illness, some of the commonly used drugs in practice and brief notes on common non-pharmacological interventional options. It also examines biochemical and neurodevelopmental theories and the link to the pathophysiology of mental illness as well as clinical decision making. The central chapters of the book provide comprehensive coverage of all the major medications used in mental health. Each focuses on a specific class of drug, detailing the most commonly used medicines, including side effects, average doses, contra-indications and clinical management interventions that may be required. At the end of each chapter a series of review questions enable readers to review their learning, and theory is clearly related to practice throughout.


Herbert Mwebe is a Lecturer in Mental Health in the School of Health and Education at Middlesex University. He has a special interest in psychopharmacology, adverse physical health effects associated with psychotropic and physical health outcomes of people suffering from severe mental illness. Within the Department of Mental Health, Herbert takes the lead on physical health for both undergraduate and postgraduate programmes as well as a module leader for the physical health modules and pre-registrations modules for third year BSc mental health nursing students

Prior to entering academia, Herbert worked in several settings providing mental health care to people with acute mental health illness; most recently in General Practice where Herbert led on a PMS + mental health project in City and Hackney, commissioned by NHS England. The project's focus was improving mental and physical health outcomes for people suffering from mental illness in primary care. With a key function of performance management, Herbert provided clinical support and advice to General practices to be able to meet the Quality Outcome Framework (QOF) health parameters for people with severe mental illness.

Herbert holds the following qualifications: DipHE, Adv.Dip, Pg Cert HE, B.Sc MHS, M.Sc. Public health and Health promotion, Independent Prescriber.


Table of Contents

Section Title Page Action Price
Cover Cover 1
Title page i
Copyright information ii
Table of contents iii
Meet the author vi
Acknowledgments vii
Foreword viii
What the reviewers say x
Introduction 1
The structure of this book 2
Learning features 2
1 Mental illness 4
1.1 Introduction 4
1.2 Aetiology of mental illness 6
1.3 Neurodevelopmental theories 7
Neurons and neurotransmitters 7
1.4 Clinical decision-making in practice and medicine management 11
2 Drugs used in psychoses 19
2.1 Introduction 19
2.2 Mechanism of action 20
Biochemical theories 20
Glutamate hypothesis 20
Dopamine hypothesis 21
Typical antipsychotics (first-generation antipsychotics) 23
Atypical antipsychotics (second-generation antipsychotics) 24
2.3 Dose and administration 25
Rapid tranquillisation 25
Antipsychotic drugs in depot preparation 31
Prescribing antipsychotic drugs to smokers 33
2.4 Adverse effects and management 34
Extrapyramidal side effects 34
Dystonia 35
Management of dystonia 35
Akathisia 35
Management of akathisia 36
Drug-induced parkinsonism 36
Management of drug-induced parkinsonism 37
Tardive dyskinesia 37
Management of tardive dyskinesia 38
Anticholinergic drugs 40
Non-extrapyramidal adverse effects of antipsychotic drugs 40
Muscarinic 1 receptor block 40
Cardiovascular effects 42
Weight gain and mental illness 45
Gender 45
Socioeconomic status and level of education 46
Age 46
Other contributing factors to weight gain in people with mental illness 46
Weight gain monitoring and management 48
Endocrine adverse effects 49
Allergic and dermatological effects 51
Haematological adverse effects 52
Obligatory monitoring for clozapine therapy 53
Clozapine alert 54
Other adverse effects of clozapine 54
Neuroleptic malignant syndrome 55
2.5 Medication adherence in mental health settings 55
3 Drugs used in depression 61
3.1 Introduction 61
3.2 Mechanism of action 62
Monoamine theory of depression 62
3.3 Dose and administration 63
3.4 Adverse effects and management 69
Tricyclic antidepressants 69
Adverse effects and management 69
Selective serotonin reuptake inhibitors 69
Adverse effects and management 70
Serotonin-noradrenaline reuptake inhibitors 71
Adverse effects and management 71
Examples of discontinuation symptoms 72
Tetracyclic (noradrenergic and specific serotonergic antidepressants) 72
Adverse effects and management 73
Aminoketone (bupropion) 73
Adverse effects and management 74
Monoamine oxidase inhibitors 74
Precautions, side effects and management 75
Reversible inhibitor of monoamine oxidase type A 75
Side effects 76
Serotonin syndrome 76
3.5 Differences in therapeutic effects of antidepressants 77
4 Drugs used in dementia 81
4.1 Introduction 81
4.2 Mechanism of action 82
Acetylcholinesterase inhibitors 82
4.3 Dose and administration 83
4.4 Adverse effects and management 85
Acetylcholinesterase inhibitors 85
Polypharmacy in the older person 86
Antipsychotic therapy in the care of the older person 86
4.5 Memantine (NMDA receptor antagonist) 87
Mechanism of action of memantine 87
Concomitant use of cholinesterase inhibitors and memantine 87
Adverse effects and management of memantine 88
5 Drugs used in bipolar disorders 93
5.1 Introduction 93
5.2 Mechanism of action 96
5.3 Dose and administration 97
Lithium 98
Dose and administration of lithium 99
Valproate 100
Dose and administration of valproate 100
Carbamazepine 101
Dose and administration of carbamazepine 101
Lamotrigine 102
Dose and administration of lamotrigine 102
5.4 Adverse effects, monitoring and management 103
Lithium 103
Adverse effects, monitoring and management 103
Adverse effects 104
Lithium toxicity 105
Valproate 107
Adverse effects, monitoring and management 107
Carbamazepine 109
Adverse effects, monitoring and management 109
Lamotrigine 111
Adverse effects, monitoring and management 111
6 Drugs used in anxiety disorders 115
6.1 Introduction 115
6.2 Mechanism of action 117
Benzodiazepine hypnotics and anxiolytics 117
Non-benzodiazepine hypnotics 117
Melatonin 118
Non-benzodiazepine anxiolytics 118
6.3 Dose and administration 120
6.4 Adverse effects and management 122
Adverse effects of benzodiazepines 122
Paradoxical reaction 123
Withdrawal from benzodiazepines 123
Managing withdrawal symptoms 124
Risk of overdose with benzodiazepines 124
Treatment in overdose 124
Adverse effects of non-benzodiazepine hypnotics 125
Z-drugs 125
Promethazine 126
Precautions and interactions (benzodiazepines and hypnotics) 126
Adverse effects of non-benzodiazepine anxiolytics 129
Buspirone 129
Pregabalin 129
Beta blockers (propranolol) 129
Appendix: Answers to chapter review questions 133
Chapter 1 133
Chapter 2 136
Chapter 3 141
Chapter 4 144
Chapter 5 148
Chapter 6 152
Glossary 155
References 165
Index 177