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 |